Implications on Vaccine Compliance Rates with the Implementation of a Pharmacist Driven Vaccination Assessment: Phase 2

Purpose: To determine if a pharmacist driven immunization screening assessment influences compliance with the current CDC immunization recommendations for hepatitis A, hepatitis B, influenza, tetanus/diphtheria/pertussis (TDaP), human papillomavirus (HPV) and pneumococcal disease at a community teaching hospital internal medicine (IM) and obstetrics and gynecology (Ob/Gyn) clinic.

Methods: Phase 1 of the study included a baseline retrospective chart review of IM and Ob/Gyn patients seen in the clinic during a 4 week period in 2009.  Phase 2 of the study included an identical chart review 15 months after the initiation of a pharmacist driven screening assessment. Rates were compared to determine efficacy of the protocol at increasing immunization rates. The chart reviews included baseline demographics and patient specific indications for the various vaccines.  Compliance was defined as having an indication for the vaccine and receiving at this visit or previously within the appropriate time frame. 

Results: A total of 311 patients were eligible to be included in phase 1 of the study and 376 patients in phase 2 of the study. Overall compliance with the CDC immunization recommendations was generally low.  However, vaccination rates increased for flu (18.4% vs 41.1%; p<0.001), hepatitis A (25% vs 38.8%; p=0.006), hepatitis B (12.2% vs 39%; p<0.001), and TDaP (4% vs 15%; p<0.001) with assessment implementation. There was no significant difference in vaccination rates for HPV (8.6% vs 8.7%) or pneumococcal (28.2% vs 25.5%) vaccinations.

Conclusion: The compliance with the CDC immunization recommendations improved with the implementation of a pharmacist driven assessment; however, rates are still low signifying a need for additional pharmacist intervention.