Adult Immunizations

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Overview

The provision of immunizations is one of the most important public health achievements of the 20th century. The modern vaccine era ushered in interventions that have eradicated or greatly reduced several life-threatening infectious diseases in the U.S., including smallpox, polio, diphtheria, measles and rubella. However, despite the availability of effective vaccines for a number of common diseases, immunization rates for many vaccines remains low. For example, the vaccination rate against influenza among non-institutionalized, high risk adults (< 65 years old) was 28% in 2006; far below the 90% goal developed by the U.S. Department of Health and Human Services. The vaccination rate among health care workers, last reported in 2000 at 37%, is also well below the goal of 60%. Considerable effort is needed to increase access to influenza vaccine for those at greatest risk, as well as the individuals most likely to expose high risk persons to the flu.

One approach for improving vaccination rates that has been successfully implemented over the last decade is to increase public access by providing vaccinations in pharmacies. As the most accessible health professionals in almost all communities, pharmacists are playing important roles in immunization advocacy, education, and administration. Today, every state except Maine has passed legislation authorizing pharmacists to administer immunizations. As of March 2008, an estimated 30,000 immunization-trained pharmacists in independent and chain pharmacies, clinics, and health care systems were actively involved in vaccinating their patients.

This issue provides basic information that can serve as a checklist for initiating a pharmacy-based immunization program. Recommended adult vaccines are reviewed including those commonly administered by pharmacists (influenza, pneumococcal, herpes zoster, tetanus/diptheria/pertussis, and hepatitis B). The rationale for vaccination, current indications, side effects, precautions, and administration schedules are discussed and presented in easy-to-read tables. Vaccine “myths” and questions commonly asked by patients are simply explained in the Patient Connection.

Publication Date: Feb-1-09
Expiration Date: Feb-1-12
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Heidemarie Windham, PharmD, Assistant Clinical Professor, Department of Clinical Pharmacy, UCSF School of Pharmacy and Clinical Pharmacist, UCSF Medical Center, San Francisco, CA. Sharon L Youmans, PharmD, MPH, Associate Professor of Clinical Pharmacy, Associate Dean for Diversity, Vice Chair for Educational Affairs, Department of Clinical Pharmacy, UCSF School of Pharmacy, San Francisco, CA.

Disclosure Statement

Dr. Windham and Dr. Youmans report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Editorial and Review Board

Editor Terry M. Baker, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Assistant Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA< Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Candy Tsourounis, PharmD Associate Clinical Professor Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Director of the Drug Information Analysis Service University of California, San Francisco San Francisco, CA

Assistant Editor and CE Coordinator Tracy Farnen, PharmD Assistant Editor Cynthia Chan Huang, PharmD, MBA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

• Describe the benefits and risks of the vaccines currently recommended for adults and adolescents to a patient.
• Explain the primary benefits of pharmacy-based immunization
• services and list 3 key steps pharmacists must take to set up a service.
• Discuss the recommended use, dose, schedule, common side effects, and contraindications for influenza, pneumococcal, tetanus/diphtheria/pertussis, and herpes zoster vaccines.