Implications on Vaccine Compliance Rates in an Obstetrics and Gynecology Outpatient Clinic with the Implementation of a Pharmacist Driven Vaccination Assessment: Phase 2

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

Methods: Phase 1 of the study included a baseline retrospective chart review of 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 initiation of a pharmacist driven screening assessment. Rates were compared to determine efficacy of the protocol at increasing immunization compliance. 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: Overall compliance with the 2010 CDC immunization recommendations was low but significantly improved from 2009 (25.9% 2010 vs. 6.7% 2009, p<0.001).  Nearly all individual vaccines rates significantly improved in 2010 compared to 2009 (Table 1).   

Vaccine	Ob/Gyn 2010 (n=182)	Ob/Gyn 2009 (n=102)	p-value
Influenza	37.1%	13.7%	<0.001
Pneumococcal	7.2%	0%	0.06
Hepatitis A	54.3%	10.5%	0.002
Hepatitis B	42%	14%	0.001
Tdap	17%	1.7%	<0.001
HPV	6.3%	1.7%	0.4

 

Conclusion: Compliance with the CDC immunization recommendations improved with implementation of a pharmacist driven assessment; however, rates are still low signifying a need for additional pharmacist intervention such as development of a collaborative practice agreement.