States' pharmacist immunization authority and the impact on adult influenza vaccination rates

Pharmacist-provided vaccinations are cost effective, readily accessible, and support the efforts of our nation's public health goals. Pharmacist authority to administer vaccines varies state by state, and these authorities may have an impact on state influenza vaccination rates.

To analyze the impact of varied state pharmacist immunization authorities on adult and older adult influenza vaccination rates for the 2018-2019 influenza season.

Using data from the Behavioral Risk Factor Surveillance System, multiple logistic regression was performed to determine how pharmacist state immunization authority predicts influenza vaccination. Immunization authority was categorized into one of 3 mutually exclusive groups: independent authority, statewide protocol or standing order, or collaborative practice agreement (CPA).

Results in the overall adult population showed a statistically significant lower adjusted odds of influenza vaccination in states with independent authority (0.937, 95% CI [0.889-0.986]) or statewide protocol or standing order (0.947, [0.906-0.990]), versus CPAs. In the older adult population, there was not a statistically significant difference in immunization between states with independent authority and those with CPA.

Although pharmacists are authorized to administer influenza vaccines, other factors (e.g., resources, service offerings, social determinants) including administrative barriers in pharmacist immunization authority are possibly limiting increases in influenza vaccination rates.