Shooting from the 'Scrip: Scope of Practice Laws and Access to Immunizations in the Pharmacy Setting.

Charles Stoecker

doi:10.3390/vaccines9050444

Abstract

In the past two decades, most states in the United States have added authorization for pharmacists to administer some vaccinations. Expansions of this authority have also come with prescription requirements or other regulatory burdens. The objective of this study was to evaluate the impact of these expansions on influenza immunization rates in adults age 65 and over. A panel data, differences-in-differences regression framework to control for state-level unobserved confounders and shocks at the national level was used on a combination of a dataset of state-level statute and regulatory changes and influenza immunization data from the Behavioral Risk Factor Surveillance System. Giving pharmacists permission to vaccinate had a positive impact on adult influenza immunization rates of 1.4 percentage points for adults age 65 and over. This effect was diminished by the presence of laws requiring pharmacists to obtain patient-specific prescriptions. There was no evidence that allowing pharmacists to administer vaccinations led patients to have fewer annual check-ups with physicians or not have a usual source of health care. Expanding pharmacists’ scope of practice laws to include administering the influenza vaccine had a positive impact on influenza shot uptake. This may have implications for relaxing restrictions on other forms of care that could be provided by pharmacists.

Highlights

On 19 August 2020, Alex Azar, Head of the United States Department of Health and Human Services, used emergency powers to allow pharmacists to administer vaccinations to children over 3 years of age
The analysis focused on adults age 65 and older as they were recommended to receive the vaccine throughout the years that vaccination status is observed in the Behavioral Risk Factor Surveillance System (BRFSS) [10]
Summary statistics from BRFSS data show that influenza immunization rates were higher after this authorization was given (Table 1), but this simple comparison does not account for national trends and state-level differences

Summary

Introduction

On 19 August 2020, Alex Azar, Head of the United States Department of Health and Human Services, used emergency powers to allow pharmacists to administer vaccinations to children over 3 years of age. This directive overrode many state licensing laws that previously prohibited pharmacists from administering some vaccines to some patients. Over the past six decades, most states have given additional authority to pharmacists to administer vaccinations to adults. These authorities may take several forms, ranging from the authority to prescribe and administer vaccines to only being allowed to administer vaccines when the patient had already been prescribed the vaccine by a licensed medical doctor. The objective of this study was to examine the impact of expanded scope of practice for pharmacists in the United States on influenza vaccine uptake rates in those age 65+

Objectives

Methods

Discussion

Conclusion