Promoting Wisconsin Influenza Vaccine Equity Through Pharmacy Engagement

Wisconsin's influenza immunization rates are below public health goals, with only 38% of residents vaccinated during the 2022-2023 season. Rates vary by race, sex, ethnicity, and geography. The COVID-19 pandemic demonstrated that pharmacists are well-positioned to address vaccine rates and disparities. Similar efforts are needed to address influenza, another respiratory disease associated with substantial morbidity and mortality.

Influenza vaccination data for the 2022-2023 season were obtained from the Wisconsin Immunization Registry and analyzed by demographic and geographic subgroups to determine the proportion of immunizations administered at pharmacies. Three focus groups assessed factors affecting pharmacies' role in promoting influenza vaccine equity. Qualitative data were analyzed using thematic content analysis.

Of the 38% of Wisconsin residents vaccinated, 30.6% received their immunization at a pharmacy. Vaccination rates were higher among females than males (44% v 34%), with similar proportions vaccinated at a pharmacy (29.5% females v 29.4% males). Residents aged 18 to 49 years and 50 to 64 years had lower vaccination rates than those aged > 65 (26.7%, 39.6%, and 81.1%, respectively) and lower proportions vaccinated at a pharmacy (7.1%, 13.2%, and 35.8%, respectively). Differences in vaccination rates and pharmacy use were observed across racial and ethnic groups, with most groups showing lower rates compared to White residents. Qualitative results identified barriers such as vaccine burnout, billing and insurance issues, red tape and staffing shortages; promotors included trusted messengers and improved access/outreach.

Discrepancies in influenza vaccination rates by sex, age, and race/ethnicity persist in Wisconsin. Identifying barriers and promotors at the patient and immunizer levels can inform actionable recommendations to improve vaccine rates and promote equity.