The Effect of Expanded Pharmacist Prescriptive Authority on COVID-19 Vaccine Rates

Background: Recent legislatures have granted expanded prescriptive authority to pharmacists with a collaborative practice agreement with a physician. This authority could include prescribing tobacco cessation products, birth controls, and antivirals for COVID-19. Although closely associated with providing preventative measures for COVID-19 in the forms of testing and vaccinations, the relationship between pharmacist prescriptive power and rate of COVID-19 vaccination remains unexplored. The objective of the study is to determine the association between pharmacist prescriptive authority and the rate of COVID-19 vaccinations between neighboring counties along state lines of states with differing laws on this prescriptive power. Methods: States with expanded pharmacist prescriptive authority include: New Mexico, Oregon, Idaho, Florida, California, North Carolina, Montana, New York, Iowa, Massachusetts, and Ohio. Counties are selected if the center of the county is within 30 miles from a state border that divides a state with expanded pharmacist prescriptive authority from a state without. Monthly vaccination data from January 2021 to December 2021 was acquired from the Centers for Disease Control and Prevention and linear regression was performed and state-border-pair fixed effects was used as a control. Results: The estimated effect of expanded prescriptive authority is an increase of five percentage points in the share of the adult population that completed the initial COVID-19 vaccine series. Conclusion: The relationship between pharmacist prescriptive authority and increased COVID-19 vaccination rates is statistically significant. The results showed that allowing pharmacist to have prescriptive powers could potentially aid in reducing vaccine hesitancy for future pandemics.