Pharmacist-Driven Pediatric Vaccine Recommendation and Implementation Service

Background: The Advisory Committee on Immunization Practices recommends improving efforts to vaccinate hospitalized children; however, immunizations are oftentimes only administered in primary care settings. We piloted a pharmacist-driven vaccine recommendation service to increase immunization of hospitalized pediatric patients. Methods: In this prospective cohort study, a pharmacist reviewed the vaccine histories of all immunocompetent patients ages two months to six years hospitalized Monday through Friday in the month of February 2024. If catch-up vaccines were needed, the pharmacist facilitated ordering the immunization(s) to be administered prior to discharge. Intervention data was reported as the number of patients reviewed, percentage of patients who received one or more childhood vaccine(s) in the hospital, and the amount of pharmacist time spent. Results: A total of 130 patients were included, of which 87 (67%) were determined to be up-to-date on immunizations. Among 43 patients eligible to receive a vaccine, 15 patients (35%) received at least one immunization prior to discharge, and a total of 42 vaccines were administered. The median pharmacist time spent per patient obtaining vaccination history and discussing vaccination with the family was 11 minutes and two minutes, respectively. Conclusions: The results of this study confirm that under-vaccination in hospitalized pediatric patients is common, with over 30% of patients missing one or more vaccines. In this study, pharmacist intervention resulted in successful administration of 42 immunizations prior to discharge. Including pharmacists in efforts to improve vaccination of hospitalized children could be considered to decrease the burden of review on inpatient providers and to close the gap on missed immunizations.