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Pediatric vaccination in pharmacies is not associated with delayed well-child visits among commercially insured
Shiven Bhardwaj1, Nina Galanter2, Lucas A Berenbrok3
1The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA 98195, United States.
Insights
Pharmacy vaccinations for children do not delay well-child visits. Children receiving vaccines at pharmacies had similar odds of timely well-child visits compared to those vaccinated in primary care settings.
Area of Science:
- Public Health
- Pediatric Medicine
- Health Services Research
Background:
- Pediatric vaccination rates in the U.S. are below national targets.
- Expanding pharmacy-based vaccinations is proposed to increase immunization coverage.
- Concerns exist that pharmacy vaccinations may displace essential well-child visits.
Purpose of the Study:
- To evaluate the association between vaccination setting (pharmacy vs. primary care) and the likelihood of a timely well-child visit for children aged 4-17.
- To address concerns regarding potential negative impacts of pharmacy-based pediatric immunizations on routine healthcare maintenance.
Main Methods:
- Retrospective cohort analysis using commercial claims data from 2016-2019.
- Conditional logistic regression models were employed to analyze the data.
- A timely well-child visit was defined as occurring within 12 months (primary) or 15 months (secondary) of the prior visit.
Main Results:
- No significant difference in the odds of a timely well-child visit was observed between children vaccinated at pharmacies and those vaccinated in primary care settings.
- The majority of the study sample (95%) received influenza vaccine(s) as their index vaccination.
- Findings indicate that pharmacy-based vaccinations do not lead to missed or delayed well-child visits.
Conclusions:
- Parents choosing pharmacy-based pediatric vaccinations for insured children are not forgoing well-child visits.
- Pharmacy-based vaccinations may even be associated with a higher likelihood of obtaining timely well-child visits.
- Policies supporting expanded pharmacy-based pediatric vaccinations can contribute to improved immunization rates without compromising routine child healthcare.
Abstract:
Pediatric vaccination rates in the United States lag national goals. Policies that expand pharmacy-based vaccinations among children could help improve vaccination rates. Opponents argue, however, that such policies will result in delayed or missed well-child visits as most children receive routine vaccinations in primary care settings. We evaluated the likelihood of having a timely well-child visit following a routine vaccination in pharmacies and primary care settings among children aged 4-17 years. We conducted a retrospective cohort analysis with commercial claims data from 2016-2019, using conditional logistic regression models. A timely well-child visit was defined as one within 12 months after a preceding well-child visit for primary analysis and 15 months for secondary analysis. Approximately 95% of the sample consisted of children with influenza among their index vaccine(s). The odds of having a timely well-child visit were similar between children who received vaccines in pharmacies and those who received them in primary care settings. Findings suggest that guardians or parents who choose pharmacy-based pediatric vaccinations for their commercially insured children do not forgo well-child visits and may actually be more likely to obtain a timely well-child visit. Extending pharmacy-based vaccinations to patients of all ages can help improve pediatric vaccination rates.
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