November 1, 2020

by Matt Merical

The current COVID-19 pandemic has upended the status quo in healthcare. While a number of these changes have damaged industries, the federal recognition of this public health crisis has led to a number of positive healthcare changes. Suddenly, cost reduction and infection prevention were not the only issues in the public eye; barriers addressing public health concerns were placed in the spotlight of bureaucratic vision. Visible under this new light included the public’s access to vaccinations by pharmacists, specifically pediatric vaccinations.

Pharmacists Play Key Role in Immunizing Children

In September 2020, the U.S. Department of Health and Human Services (HHS) authorized pharmacists and student pharmacists to order and administer vaccinations for children as young as 3 years of age. While this move was applauded by pharmacy organizations, other professions have questioned this move. According to the current CDC vaccination schedule, this may allow pharmacists to provide up to 11 unique vaccinations just at the age of 3 years old alone (including “catch up” schedules and patients in specific high-risk groups), as well as vaccinations that are a part of the core immunization series for children and adolescents above the age of 3 years.

It allows more access to vaccinations, which will in turn may increase vaccination rates by providing parents with more convenient options when taking care of their children.
Medical organizations have posited that this move hinders their provision of care. Some have even suggested that pharmacists are not qualified individuals to provide these vaccinations. In reality, neither of these are true concerns. The removal of this age restriction allows pharmacists to become true partners in creating “immunization neighborhoods.” It allows more access to vaccinations, which will in turn may increase vaccination rates by providing parents with more convenient options when taking care of their children. This is of particular concern considering that childhood vaccination rates have fallen in children during the coronavirus pandemic as healthcare has moved more toward a telehealth model. The pharmacist’s role has not changed; family medicine and pediatric practitioners will continue to provide direct medical oversight of a child’s growth, development, and health concerns.

Additionally, immunizing pharmacists and student pharmacists receive more training than most other healthcare professionals regarding immunization administration. To reiterate the most important part of the HHS announcement, not all pharmacists will be permitted to provide these vaccinations. All pharmacists and student pharmacists who wish to participate in this service must complete up to 20 hours of intensive immunization-specific training, including skills validation and training of pediatric vaccinations. Each immunizing pharmacist must also maintain active CPR certification. This entry barrier, and an individual’s comfort level in providing this care, then becomes the market-based standard for determining which pharmacists may provide vaccination services. Immunizing pharmacists are eager and willing to provide expanded access to vaccinations and have completed the training needed to provide care to this special population.

Pharmacy Technician Administration of COVID-19 Vaccines and COVID-19 Testing

The coronavirus pandemic and the potential for a COVID-19 vaccine have led to additional federal guidance involving pharmacy technicians in the response. Just days ago, the HHS also authorized state-licensed and qualified pharmacy technicians and student pharmacists to administer childhood vaccines, including a COVID-19 vaccine once available, along with COVID-19 testing. This was included as part of the Public Readiness and Emergency Preparedness (PREP) Act. While these moves are even more controversial that the previous expansions by the HHS discussed above, there are a number of stipulations that must be met in order for pharmacy technicians to perform these duties. These include state board of pharmacy oversight, proper pharmacist ordering and supervision, and adequate training and skills validation. The bottom line is that pharmacists and pharmacy staff are recognized as key health care team members in the response to the coronavirus.

American healthcare must adapt to pressure and innovate. It is often the rapidly-changing public needs that provide us all opportunities to work together to provide excellent care. This can and should be a driving force toward a truly integrated, comprehensive, and collaborative health care system. Further allowing pharmacists and pharmacy staff to work at the height of their license and incentivizing the care team to utilize the expertise of a pharmacist are significant steps forward toward this goal.

Matt Merical is a student pharmacist at the Cedarville University School of Pharmacy. He completed his B.S. in molecular and cellular biology at Cedarville University, focusing research time supporting faculty in signal transduction and antibody medication therapies. His current interests include the advancement of pharmacy practice and collaboration in the healthcare setting for the promotion of patient advocacy and care.



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