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The Safety Implications of Pharmacists Giving Vaccines

pharmacistStory Highlights

  • A recent survey reports that 62 percent of Americans prefer the convenience of going to their local pharmacy to get vaccinated.
  • In 1995, pharmacists were officially recognized as vaccine providers.
  • There are serious safety implications of vaccines administered in pharmacies.

A new survey conducted by healthcare communications solutions firm PrescribeWellness LLC of Irvine, CA found that 62 percent of respondents preferred visiting their local pharmacy to get vaccinated rather than going to their doctor’s office. In its 2017 Vaccination and Preventive Care Survey, PrescribeWellness interviewed 1,000 Americans over the age of 35 on their views of vaccination and neighborhood pharmacies.1 The reasons given for this preference was predominantly based upon convenience.

Twenty-six percent of respondents said that their local pharmacy is a “one-stop shop” for all their health and wellness needs. Twenty-four percent stated that their local pharmacy was easier to get to than their doctor’s office and twenty-one percent reported that going to the pharmacy was more convenient when they had their children with them.1 However, although local pharmacies may be convenient locations for receiving vaccines from the perspective of families, the expanding role of pharmacists in administering vaccines has serious implications.

In 1993, U.S. Secretary of Health and Human Services Donna Shalala asked the American Pharmacists Association (APhA) to help define the role of pharmacists in the national vaccine program for children.2 Given that pharmacies offer convenience, accessibility, and extended hours of operation, in 1995, the Health Care Financing Administration (HCFA), now known as the Centers for Medicare and Medicaid Services (CMS), recognized pharmacists as vaccine providers.2

In 1996, the APhA initiated its nationally recognized 20-hour training program for pharmacists on pharmacy-based vaccine delivery.2 According to a review published in the Journal of the American Pharmacists Association:

By 2004, an estimated 15,000 pharmacists and student pharmacists had been formally trained through recognized programs as vaccine experts, and the practice of pharmacist-administered immunizations, particularly for adult patients, has become routinely accepted as an important role of the pharmacist. Arguably, few initiatives have done more to move the pharmacy profession forward in direct patient care than the pharmacist-administered immunization movement.3

When Pharmacies are Allowed to Deliver Vaccines

While there are numerous issues regarding the role of pharmacists in vaccine delivery, one of the most serious concerns relates to safety resulting from the growing corporate pressure for pharmacists to work faster in order to meet quotas.4

The pressure to work faster has led to increases in prescription drug errors. In an investigation led by The Chicago Tribune in 2016, half of the 255 pharmacies tested in the Chicago area failed to warn prescription users for potential drug interactions that could be harmful or fatal.4 5 The investigation found that pharmacists frequently hurry through legally required drug safety reviews, omit them altogether and/or and fail to ask patients whether they are taking other medications.4 In fact, pharmacists are required to work at such a high speed that many have complained they are hesitant to drink liquids during their shift because they do not have the time for a bathroom break.4

Initially states in the U.S. only authorized pharmacists to administer the influenza vaccine. However, today nearly every state allows pharmacists to administer almost all vaccines.6 Given what is already known about corporate quotas and their effect on medication dispensing speed and prescription drug errors, there is legitimate reason to be concerned about the safety of vaccine delivery by pharmacists. Although pharmacists are required to assess and screen patients for contraindications and take precautions before administering a vaccine,7 this is unlikely to occur given the time constraints and quota requirements, all of which creates a potentially dangerous situation for children and adults getting their vaccines in pharmacies.

This leads to another question: Are most pharmacists monitoring and reporting serious reactions, hospitalizations, injuries and deaths that follow vaccinations they administer to people to the federal Vaccine Adverse Events Reporting System (VAERS)? Are they keeping patients in the drug store long enough to monitor for anaphylaxis or syncope (fainting)? Since pharmacists are now administering a substantial portion of vaccines, they do have the responsibility of reporting vaccine adverse events to VAERS, but is this actually occurring given that they are working at high speeds to meet their quotas?

Rep. Mary Flowers (D-Chicago) is sponsor of a bill in the Illinois House of Representatives supported by pharmacy workers that would restrict the hours pharmacists can work each day, limit the number of prescriptions they can fill each hour, require break time during their shifts and provide whistleblower protection if they expose safety problems. Rep. Flowers states that “It is just a matter of time before there will be a major catastrophe.”4 Not surprisingly, the bill has received heavy opposition from corporate lobbyists representing owners of pharmacies.4

Additionally, states are now beginning to authorize pharmacists to play a role in recommending and prescribing vaccines. According to the APhA:

Through the years, many states’ laws have evolved from requiring a prescription from a physician for the pharmacist to administer vaccines, to allowing for protocol-based administration, to some states finally allowing pharmacists to serve as the vaccine prescriber. By allowing for an additional health care provider—in this case a pharmacist—to serve as the screener, recommender, prescriber, and administrator of the vaccine, access is increased, and patients are more likely to actually receive the vaccine that is recommended for them. As of July 2015, eight states allow pharmacists to prescribe or administer, without a prescription, all recommended vaccines (many states don’t allow this for young children); and another nine states allow this for the influenza vaccine.6

Assigning pharmacists the role of vaccine prescriber ultimately removes the physician as the middleman. The entire process of prescribing, selling and administering vaccines in one location i.e., the pharmacy, is a value added product and service that ultimately saves costs on extra labor charges, storage facilities, etc.—an efficient business strategy. So what appears to be a move in the best interest of public health is merely a disguise for expanding the profits of owners of pharmacies and the pharmaceutical industry.


References:

1 Johnsen M. Survey: Americans Prefer Pharmacy Over Physician When It Comes to Vaccines. Drug Store News Mar. 20, 2017.
2 Rothholz M. The Role of Community Pharmacies/Pharmacists in Vaccine Delivery in the United States. The American Pharmacists Association January 2013.
3 Hogue MD, Grabenstein JD, Foster SL, Rothholz MC. Pharmacist involvement with immunizations: a decade of professional advancement. Journal of the American Pharmacists Association 2006; 46(2): 168-79.
4 Long R, Roe S. House Bill Aims to Increase Pharmacy Safety, Draws Fire. The Chicago Tribune Feb. 7, 2017.
5 Roe S, Long R, King K. Pharmacies Miss Half of Dangerous Drug Combinations. The Chicago Tribune Dec. 15, 2016.
6 American Pharmacists Association. Pharmacist-administered immunizations: What does your state allow? Pharmacist.com Oct. 1, 2015.
7 American Pharmacists Association. Applying the Pharmacists Patient Care Process to Immunization Services. Pharmacist.com.
8 Collins S. Pharmacists urged to report adverse events to VAERS. Pharmacy Today 2016; 22(8): 64. 

9 Responses to The Safety Implications of Pharmacists Giving Vaccines

  1. Anna Reply

    April 24, 2017 at 9:49 am

    Pharmacists use to dispense medications without prescriptions/in many countries you can find pharmacists doing just that… but in US that was stopped… but for Vaccines they can… how is this even logical..

  2. Buffet Reply

    April 24, 2017 at 3:49 am

    No known peddler of poisons is gonna jab anything into me!

  3. A douglas Reply

    April 23, 2017 at 10:59 pm

    Bottom line, vaccines are fu*ked up and it has always been and always will be only about the money. Pharma are evil bcc tools and baby killers.

  4. Louise Reply

    April 23, 2017 at 9:47 pm

    There’s another very good reason to be concerned about pharmacist-administered flu vaccines. Flu vaccines must be administered high up in the arm, very close to the shoulder joint. Because of this, they must be given very carefully in order to avoid injury to the shoulder. Such injuries are becoming increasingly common: SIRVA is the acronym for shoulder injury due to vaccine administration. It doesn’t just mean a sore arm for a couple of days; it’s actually a chronic injury that can result in serious and in some cases permanent incapacitation of the arm. This is not a trivial issue. Certainly VAERS is well aware of it; there have been numerous awards as a result of documented cases of SIRVA.

  5. Lisa Reply

    April 23, 2017 at 6:36 pm

    All providers are middlemen for big pharma here. Every hospital admission triggers automatic flu vaccine orders for all people over 6 months of age (all year long). Too sick to refuse? No problem, since it’s so “safe” my state is no longer requiring informed consent and I am told that all patients should be approached by stating, “I’m here to give your flu shot; now let’s just get this done.” I can’t override the order unless the patient is currently receiving chemo. I must otherwise give it or report it as “refused.”

    • caws Reply

      April 24, 2017 at 5:06 am

      This is especially concerning for the very young & elderly who often can’t defend themselves. My 88 yr old father got flu pneumonia shot yearly. The Hg in flu shot may have contributed to his dementia. When he broke his hip they shot him up again in hospital & AGAIN in nursing home. He died few weeks later of pneumonia. Mom [age 82] got pneumonia shot after I begged her not to & also died not long after from pneumonia.

    • Colorado Reply

      April 24, 2017 at 10:06 am

      Myself, claiming deathly fear of needles makes for a convenient work around. If only more people had needlephobia like I do.

  6. Jo Reply

    April 23, 2017 at 12:35 pm

    In 2008, my aunt, 60 years old and in good health, got a flu vaccine at a pharmacy. The next morning her daughter found her dead. Rep. Flowers states that “It is just a matter of time before there will be a major catastrophe.” In our family it has already happened.

    • Anna Reply

      April 24, 2017 at 10:06 am

      So sorry for your lost… not right…just not right.. how can they continue to get away with this???

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