Pharmacy vaccination is now legal in 49 states

April 1, 2009

Now that pharmacists are empowered to vaccinate and immunize in every state but Maine, each state must work out regulatory requirements and protocols.

Key Points

  • The annual demand for flu shots outstrips the number of patients doctors can vaccinate, giving rise to the need for vaccination by pharmacists.

  • Maine is the only state that has not yet legalized vaccination by pharmacists.

  • APhA offers an immunization certificate training program attended by 60,000 pharmacists since 1996.

  • To date, approximately 43 percent of independent community pharmacies offer vaccination.

  • Because of unmet need, the Infectious Diseases Society of America is promoting vaccination by supermarket pharmacists, as well.

More pharmacists are administering vaccinations across the United States, since 49 states (Maine is currently the only exception) have passed laws allowing them to do so. As the laws come into full effect, states and boards must figure out how to successfully integrate pharmacists into the ranks of vaccinators. For example, in West Virginia, where pharmacists fought for five years and finally won the right to vaccinate in 2008, the Board of Medicine must set the rules for how pharmacists will be actually be performing this task.

After the West Virginia Board of Medicine determines the detailed rules on pharmacist administration of vaccines this spring, the law can go into complete effect later this year. Already, hundreds of pharmacists have taken training courses through the West Virginia University School of Pharmacy to receive their certificate from the American Pharmacists Association (APhA).

"There is a lot of excitement among pharmacists to find out about this and incorporate vaccinations into their practices," said Patty Johnston, president and owner of Colony Drug in Buckley, W. Va. "I expect a large number to be ready to go as soon as this is [fully] approved." Johnston and other pharmacists worked with the West Virginia Pharmacists Association to get the legislation in place.

More than 60,000 pharmacists have taken the APhA Immunization Certificate Training Program since the group - along with pharmacy schools and state pharmacy associations - began offering the program in 1996.

New York State is also making progress toward allowing pharmacists to vaccinate. In December 2008, the state legislature passed a law allowing pharmacists to give vaccinations and immunizations to people 18 years and older. By the end of March, approximately 150 pharmacists will be eligible to give flu and pneumonia vaccinations after going through training sponsored by APhA and the School of Pharmacy and Pharmaceutical Sciences at the State University of New York at Buffalo.

"The biggest reason we and so many others pushed for this is that not enough people are getting flu shots," said Karl Fiebelkorn, RPh, MBA, and associate dean of student affairs and professional relations at the University of Buffalo School of Pharmacy and Pharmaceutical Sciences.

While pharmacists have made significant progress on state regulations of vaccines, they are not necessarily taking advantage of these efforts. Only about 43 percent of independent community pharmacies offer vaccinations, according to the National Community Pharmacists Association (NCPA).

In addition, the Infectious Diseases Society of America (ISDA) recently contended that, instead of promoting the popular free antibiotic programs, supermarket pharmacies should offer free flu vaccinations. While antibiotics are overused, leading to drug resistance, the influenza vaccine is underused, according to a statement from ISDA. "Millions of doses were thrown away at the end of the last two flu seasons," the statement said.

Some industry experts believe that pharmacies not currently providing immunizations should consider offering these services to help their communities, their businesses, and the overall perception of the profession. "If you offer that, people view you in a different light than people who don't offer that service," Johnston said.

John Norton, public relations manager for NCPA, says that administering vaccines and immunizations creates a positive perception of the pharmacy profession. "It is a great way [for pharmacists] to raise their profile as multi-purpose healthcare providers. We want to be seen as more than purveyors of a commodity or simply dispensers of pills," Norton said.

To help pharmacists get educated about providing vaccinations, NCPA recently launched an "Immunization Resource Center" on its Web site, which includes educational programs for pharmacists and links to other resources. Maine remains the only state that does not allow pharmacists to administer vaccinations. However, in the next month or two, a bill is expected to be introduced in the state legislature that would allow pharmacists to administer certain vaccinations to people older than 18 years old.

"We are trying to increase immunizations in Maine because we are falling behind. In rural areas, it is hard to match people's schedules with doctor visits," said Laurier Lamie, a pharmacist and president of the Maine Pharmacy Association (MPA) in Scarborough.

While the MPA has been trying to get similar bills into the state legislature for the past four years, Lamie is confident the legislation will pass this year, thanks to cooperation from medical and pharmacy groups.

CHRISTINE BLANK is a writer based in Orlando, Fla.