Pharmacy and immunization services: Pharmacists' participation and impact

Objectives: To conduct a follow-up to the National Pharmacist Immunization Survey of 1998 to determine changes in pharmacist involvement in immunizations and obstacles to pharmacy-based immunization services and to assess the descriptive information about pharmacy-based immunization services provided. Design: Cross-sectional mail survey. Setting: United States. Participants: A randomly selected national sample of 6,000 pharmacists. Interventions: None. Main Outcome Measures: An updated version of the 1998 study questionnaire was used to collect data about pharmacists' current involvement in adult or childhood immunizations, perceived obstacles to such involvement, and characteristics of pharmacist-administered immunization services. Results: Four mailings in fall 2001 yielded a response rate of 21.2% (1,266 completed, usable surveys out of 5,958 deliverable surveys). Immunization activities that reportedly increased during this period, compared with results from the 1998 survey, include counseling about adult immunizations (increase from 11.9% to 14.7%), nurse-administered childhood immunizations (6.3% to 7.8%), nurse-administered adult immunizations (16.2% to 30.2%), pharmacist-administered childhood immunizations (0.9% to 1.3%), pharmacist-administered adult immunizations (2.2% to 6.8%), and immunization promotion (18.9% to 27.3%). Only counseling for childhood immunizations appears to have decreased slightly, from 13.4% to 8.9%. Willingness to provide all of the above immunization services also increased during the 1998-2001 period. In addition to flu shots and pneumococcal vaccines, pharmacists were administering vaccines for hepatitis A and B, Lyme disease, tetanus, and chicken pox, but flu shots accounted for the majority of immunizations being administered. Conclusion: Pharmacist involvement in childhood and adult immunizations has increased significantly in the last few years. Pharmacists perceived obstacles to their involvement in immunizations as less problematic.