Implementation of a herpes zoster immunization program in an outpatient hospital-based pharmacy

Abstract

BackgroundAdministration of the recombinant zoster vaccine (RZV) in an ambulatory clinic visit is not covered by Medicare, and the pharmacy at Tufts Medical Center (TMC) had not previously offered immunizations, leaving clinicians to instruct their patients to receive RZV at outside pharmacies without close follow-up. ObjectiveImprove immunization access by standardizing administration of RZV for eligible patients at TMC. Practice descriptionTMC is an academic medical center that serves a vast patient population. The adult primary care clinic offers services for approximately 40,000 patients. Atrium 3 Pharmacy is a 340B hospital-based outpatient pharmacy located in TMC. Practice innovationPatient referrals for RZV administration were sent from the adult primary care clinic to a designated certified pharmacy technician (CPhT) working within the outpatient pharmacy. The CPhT contacted patients for cost disclosure and scheduling vaccination appointments. Evaluation methodsAfter the CPhT processed the referrals and scheduled the patient, they were then immunized at the herpes zoster clinic by a pharmacist and asked to complete a survey to assess their experience. ResultsOver a 3-month pilot period from January 1, 2022, to March 15, 2022, there were 151 patient referrals placed from the adult primary care clinic. A total of 50 patients received their first RZV dose and 10 patients received their second RZV dose for an overall total of 60 RZV doses. Survey results showed that 96% of patients answered that their overall satisfaction improved, with 57% of patients selecting that they strongly agree and 39% of patients selecting that they agree. ConclusionAn outpatient pharmacy-based herpes zoster vaccine immunization program was successfully established. Most patients found the expansion of services in the outpatient pharmacy satisfactory.