Age-Friendly Framework Guides Pharmacists to Improve Older Adults’ Vaccination Care

Consultant pharmacists have long been the quiet backbone of vaccine delivery in long-term care, but a rapidly evolving immunization landscape with mounting vaccine fatigue is pushing their role to the forefront. In nursing homes and assisted living facilities, where residents are at highest risk for complications from influenza, COVID-19, and now respiratory syncytial virus (RSV), pharmacists are not only managing medication regimens; they are also emerging as key strategists in vaccine policy, education, and implementation.

Against a backdrop of lingering controversy around vaccines and misinformation, pharmacists are being asked to do more: identify high-risk patients, navigate reimbursement hurdles, and integrate vaccines into already complex workflows. National guidance now recommends RSV vaccination for many adults 60 years and older and for certain high-risk individuals aged 50 to 74 years, including those with chronic cardiovascular and lung disease, diabetes with complications, end-stage renal disease, severe obesity, and immunocompromising conditions. At the same time, providers are expected to continue seasonal influenza and COVID-19 vaccination efforts, often in populations burdened by multiple chronic illnesses and functional limitations.

Within this challenging environment, professional organizations such as the American Society of Consultant Pharmacists (ASCP) are working to expand pharmacists’ authority and support their practice. ASCP is advocating for federal legislation like the Expanding Community Access to Pharmacist Services (ECAPS) Act, which would grant pharmacists provider status for key services—including vaccinations—under Medicare, improving reimbursement and allowing pharmacists to practice at the top of their license. The organization is also promoting age-friendly care through the 4Ms framework—what matters, medication, mentation, and mobility—developed in partnership with academic and philanthropic collaborators to reshape how older adults receive care.

In this interview, Avra Thomas, PharmD, BCGP, FASCP, senior director of pharmacy practice at ASCP, and Chad Worz, PharmD, BCGP, FASCP, executive director and CEO at ASCP, discuss how consultant pharmacists can overcome vaccine fatigue, personalize recommendations, and build sustainable vaccination programs that protect some of the most vulnerable patients in the health care system.

“I really think everyone is experiencing some significant fatigue, but some suggestions for pharmacists trying to make it easy [would be to] make it easy for the patients,” Thomas said. “Some same-day administration of these vaccines really to give the patient while they're available and they're present, making it personal, making these recommendations really specific based on the individual, and framing the benefits around the risk.”