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Adult Immunizations

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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: 02/01/2009
Expiration Date: 02/01/2012
CE Credit: 1.5 (0.15 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.


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.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

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

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

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 428-0000-09-002-H01-P

Exam & 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.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

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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