Shared decision-making for vaccines

Area of Science:

• Public Health
• Immunization Practices
• Patient-Centered Care

Background:

• Shared decision-making (SDM) involves collaboration between healthcare providers and patients in selecting treatments.
• The Advisory Committee on Immunization Practices (ACIP) incorporated SDM into its 2019 recommendations for 9-valent human papillomavirus (9vHPV) and 13-valent pneumococcal conjugate (PCV13) vaccines.
• While familiar to physicians, SDM for vaccines offers new engagement avenues for pharmacists and student pharmacists.

Purpose of the Study:

• To highlight the integration of shared decision-making into recent adult vaccination guidelines.
• To emphasize the role of pharmacists in facilitating SDM for vaccine selection.
• To advocate for the broader application of SDM across various ACIP-recommended vaccines.

Main Methods:

• Review of updated ACIP recommendations from June 2019.
• Analysis of specific vaccine guidelines for adult populations (9vHPV and PCV13).
• Discussion of the collaborative process in vaccine administration.

Main Results:

• 9vHPV vaccine administration via SDM is recommended for unvaccinated individuals aged 27-45 years.
• PCV13 vaccine administration via SDM is recommended for adults aged 65+ without specific conditions (immunocompromise, cochlear implants, CSF leak) and who haven't received it previously.
• SDM enhances patient engagement in vaccine decisions, particularly for pharmacists.

Conclusions:

• Shared decision-making is a key component of updated ACIP recommendations for 9vHPV and PCV13 vaccines in specific adult populations.
• Pharmacists can leverage SDM to improve patient understanding and uptake of recommended adult immunizations.
• The SDM approach should be extended to other vaccines benefiting non-high-risk individuals as per CDC and ACIP guidance.