Study shows pharmacists can boost vaccine rates

New research from the University of Waterloo and the University of Toronto has found that a novel clinical service, called VaxCheck, can effectively support vaccination assessments by pharmacists—and potentially improve vaccination rates.

“Our study demonstrated that the program can be operationalized within community pharmacy practice and is well received by patients,” the researchers, led by Sherilyn Houle of the University of Waterloo, note in their paper, “Uptake and outcomes of VaxCheck, an adult life-course vaccination service: A study among community pharmacists,” published in the June 2024 issue of Vaccine.

The primary goal was to develop and test a comprehensive service for “proactive life-course vaccination assessments” by community pharmacists in Ontario. VaxCheck consists of a structured in-person assessment of a patient’s vaccination status followed by recommendations and development of an action plan agreed to by the patient.

Vaccination rates in Canada are below recommended levels. Data for 2021 indicates that only 27% of adults 50 years of age and older reported having received a herpes zoster vaccine and 34% a pertussis-containing vaccine. Only 55% of those 65 years of age and older had received a pneumococcal vaccine and, in the last 10 years, 67% had received a vaccine against tetanus.

In this study, which ran from October 2022 to May 2023, pharmacists conducted 123 VaxCheck consultations at nine community pharmacies within the Wholehealth Pharmacy Partners banner in Ontario. Patients were 60 years of age on average and 36% had at least one chronic disease risk factor, 18% had lifestyle-related risk factors, and 15% were immunocompromised.

More than 95% of VaxCheck consultations resulted in at least one vaccine recommendation, with an average of three vaccines per patient.

The recommended vaccines were those against pneumococcal disease, tetanus/diphtheria, herpes zoster, COVID-19, and influenza. Acceptance was highest for those available without a prescription and free of charge.

Of the 371 total recommendations, six per cent were accepted by patients at the time of the VaxCheck, i.e., vaccines were administered, and an additional 12% of recommended vaccines were administered within three months of the consultation. Slightly more than 60% were delayed or referred and 22% were declined.

“Such a proactive approach may contribute to increased vaccination uptake as 70% of patients completing the post-VaxCheck survey agreed or strongly agreed that they were unaware that they were missing vaccinations before receiving the VaxCheck,” noted the researchers.

Future research will explore the effectiveness and efficiency of a digital version of the VaxCheck tool and expansion to other healthcare providers and jurisdictions, including jurisdictions with fewer access barriers related to pharmacists’ scope of practice (i.e., vaccine prescribing authority) and public funding of vaccines.