Q&A: Why Pharmacists Staying Informed on Evolving Vaccine Guidelines is Critical

As vaccine guidelines continue to shift at both the federal and state levels, pharmacists face the complex challenge of navigating overlapping recommendations from multiple health authorities—making it more critical than ever to stay current on the rules governing what they can and cannot do as immunizers.

“I think specifically in pharmacies, we're not looking at all childhood vaccines being given, but those ones, like flu, maybe COVID, those are the ones that we've seen changing more often,” Gretchen Garofoli, PharmD, BCACP, CTTS, FAPhA, clinical professor at the West Virginia University School of Pharmacy, told Drug Topics. “Pharmacists really need to stay up to date with where we are now and looking at those guidelines and recommendations.”

While pharmacists are significantly less utilized when it comes to child-administered vaccines, they have an important role to play amid organizations like the US Department of Health and Human Services (HHS) updating vaccination guidelines and going against certified, scientific evidence from the past.

In part 2 of our interview with her, Garofoli taps into the pharmacist’s role in steering patients and parents in the right direction when it comes to immunizations in the US.

READ MORE: Vaccine Policy Shifts Erode Patient and Parent Trust

Drug Topics: How do you think these rolling decisions on vaccine guidelines—with constant updates and deliberations reported in the news—have affected the day-to-day lives of pharmacists in the US?

Gretchen Garofoli: I know that pharmacists don't vaccinate a ton of children. Most of the time, they go to their pediatrician. But for things like the flu vaccine, we know that, with the changes that were made in January by HHS, a big change that they had was with regards to the flu vaccine. We know that pharmacists are typically providers of that.

In my practice, I always would enjoy when the whole family would come in. We would vaccinate mom, dad, and kids. It would make it easier for the children to move forward whenever they see their parents getting vaccinated. I know my oldest, that's always his big thing. He said, ‘I want to see mom and dad get it.’ He feels more comfortable after having that done. I think specifically in pharmacies, we're not looking at all childhood vaccines being given, but those ones, like flu, maybe COVID, those are the ones that we've seen changing more often. Pharmacists really need to stay up to date with where we are now and looking at those guidelines and recommendations.

It's very state specific, for whenever all the changes were going back and forth. Some of the states, for example, Pennsylvania—where I hold one of my licenses—they started to follow the American Academy of Pediatrics’ (AAP) guidelines. They followed the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Family Physicians guidelines. They were allowed to, as pharmacists, in addition to the Advisory Committee on Immunization Practices’ (ACIP) guidelines. Whereas, where I practice now in West Virginia, through our pharmacy practice act, we have to follow what ACIP says.

It's even more confusing when we're looking at all these guidelines out there. This is what's being recommended, but pharmacists in their specific state might have other requirements. I think that that adds to the confusion for them, at least. Being able to know specifically what their pharmacy practice act says, what their state laws say, is important for them as we are moving through this ever-changing landscape.

Drug Topics: With potential for further updates and overhauls in the future, what’s your advice for pharmacist’s seeing this now and what should they be relaying to their patients in the community setting?

Gretchen Garofoli: [For pharmacists,] it’s important for us to know all of the information that's out there. The good, the bad, the ugly—know all of it, and know where it's coming from, because our patients are going to come in and ask us all of these questions based on what they've seen anywhere, whether it's on social media, whether it's in the news. We need to be familiar with the changes. We need to know what's going on. Ultimately, we need to know what legally we are allowed to do as the immunizer.

When we look at pharmacists with regards to immunizations, we do a number of things. We do that education piece. That's where it really comes into play that we know the different guidelines that are out there, why they are the way they are, and what is recommended for our patients. We also need to be able to then know our state laws and what we can do as an immunizing pharmacist in order to provide those vaccines to our patients. What can we do with the changes that have been made, or may be made in the future, and where do we look for that guidance as a practitioner? [It’s] looking back to your state’s practice act, seeing what legally you can do so that you are following all the rules and regulations that you need to in order to safely and effectively vaccinate your patients and keep everyone protected. That's ultimately what we're here to do: Keep folks protected from vaccine-preventable diseases.

READ MORE: Immunization Resource Center

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