Feds look to pharmacists to boost childhood immunization rates
Federal officials are banking on pharmacists to undergo additional training and help reverse the slump in child immunization rates caused by the coronavirus pandemic. Fears over COVID-19 have led parents to avoid the doctor’s office and pediatricians to curtail in-person care. As a result, many children are missing routine vaccinations.
Children who fall behind on vaccinations usually don’t pose a health risk if kids around them are immunized, said Dr. Sean O’Leary, vice chair of the American Academy of Pediatrics committee for infectious diseases. However, large groups of children are now behind, and highly contagious vaccine-preventable diseases circulating in other parts of the world are only a plane ride away, he said.
“That’s a big deal,” he said in an email.
In August, the Department of Health and Human Services took steps to override restrictions in many states that kept state-licensed pharmacists from immunizing children.
“Today’s action means easier access to lifesaving vaccines for our children, as we seek to ensure immunization rates remain high during the COVID-19 pandemic,” HHS Secretary Alex Azar said in announcing the policy change.
However, challenges remain in getting pharmacists fully integrated into the nation’s framework of childhood vaccinations, immunization experts said.
A key issue is that few pharmacists participate in the Vaccines for Children program, a federal initiative that purchases vaccines for the nation’s neediest kids. Half of children in the U.S. receive immunizations through the program, which purchases government-recommended vaccines for kids ages 0 to 18 who are low-income, uninsured or belong to an indigenous group.
Compared with last year, VFC-funded orders for vaccines overall are down 9.6 million doses as of Nov. 9, said a spokesperson from the Centers for Disease Control and Prevention. Measles-containing vaccines are down an estimated 1.3 million doses.
Weekly orders of non-flu vaccines and measles-containing vaccines have begun to rebound to levels seen last year, though the volume could again be affected if current COVID surges have a chilling effect on doctors’ visits.
Without solving the issues that keep pharmacists from participating in the Vaccines for Children program, said Claire Hannan, executive director of the Association of Immunization Managers, the steps to give parents more access to immunizations through drugstores may ultimately help only Americans wealthy enough to use it.
“Yes, we have a situation with the pandemic that has caused a drop in routine vaccinations,” Hannan said.
“But I don’t want to see us go to a solution that is only serving those who can pay.”
Drugstores serve as a convenient access point. Nearly 90% of Americans in 2018 lived within five miles of a community pharmacy.
In contrast, about 5% of rural counties in 2019 had no family physicians, according to a report from researchers at the University of Washington. Thirty-five percent of rural counties had no pediatricians.
Additionally, KFF found over 51% of children in 2017 did not have a medical home, meaning they do not have a primary care doctor that manages their care. (KHN is an editorially independent program of KFF.)
“We need our pharmacists to be vaccinators” in order to catch children up on their immunizations, said L.J Tan, chief strategy officer at the Immunization Action Coalition, a national organization of physicians and health experts focused on vaccine education.
Pharmacist and drugstore owner Tim Mitchell offers vaccines at his three pharmacies in Neosho, Missouri, about 30 minutes from the Oklahoma state line. He said he’s been immunizing patients since the late 1990s after he realized children coming into his pharmacies were missing routine vaccinations.
“I saw it as a way to help my community,” he said, “but I also saw it as a business opportunity.”