Hospital-Based Outpatient Pharmacy Successfully Completes RZV Vaccination Pilot Program


The program administered 60 vaccines to patients referred by their primary care physicians.

Because recombinant zoster vaccine (RZV) administration at an ambulatory clinic visit is not covered by Medicare Part D, clinicians frequently must instruct patients to receive this important vaccine at an outside pharmacy—a practice creating challenges around close follow-up and creating cost-based challenges.

Researchers from Tufts Medical Center in Boston, Massachusetts, implemented a herpes zoster (HZ) administration program to alleviate these challenges. Program outcomes were shared in a poster presented at the 2022 American Society of Health-System Pharmacists 2022 Summer Meetings & Exhibition in Phoenix, Arizona.

Over a 3-month period (January to March 2022), clinicians working in an adult primary care clinic sent patient referrals for RZV administration to a designated certified pharmacy technician (CPhT) who worked at the hospital-based outpatient pharmacy. The CPhT was tasked with documenting these referrals; determining patient costs and contacting patients to disclose these costs; and scheduling vaccination appointments. Patients were then counseled immunized at the HZ clinic by a pharmacist.

Administration of the RZV vaccine was documented in the patients electronic medical record. Patients also completed an 8-question survey to document their experience.

During the 3-month pilot period, 151 ambulatory referrals were made; 50 patients received their first RZV dose and 10 patients received their second. The most common reason a patient was not scheduled was an inability for the CPhT to reach the patient. On the patient survey, 96% of patients responded that their overall satisfaction was improved.

Researchers also hoped to use the pilot program project as a way to increase the number of pharmacists in Massachusetts meeting immunizer criteria through completion of an American Council on Pharmaceutical Education (ACPE) accredited training course, a current CPR certification, and 2 hours of APCE-approved immunization-related continuing education every 2 years. Results showed that the number of staff pharmacists who met Massachusetts immunizer criteria increased from 2 to 5 pharmacists during the program.

“The expansion of services in the hospital-based outpatient pharmacy has been beneficial to the adult primary care population at [Tufts Medical Center] and has also improved the ability of clinicians…to confirm their patients received the [HZ] immunization,” the researchers wrote. “With the conclusion of a successful pilot period, this program has the potential to expand to serve a greater patient population and offer a larger variety of immunizations.”


Flaspohler NK. Implementation of a herpes zoster immunization program. Presented at: American Society of Health-System Pharmacists 2022 Summer Meetings and Exhibition; June 11-15, 2022; Phoenix, AZ.

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