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Pharmacist-Administered Vaccinations Should Be Here to Stay

Pharmacists and pharmacist technicians have administered hundreds of millions of vaccinations during the pandemic, but federal emergency authorization for their wider role could end soon. States should make it permanent.

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Marvin Wainwright, pharmacist in charge at Boyd's Pharmacy of Medford, N.J., administers the Moderna COVID-19 vaccine.
(Patti Sapone/TNS)
In August 2020, the U.S. Department of Health and Human Services (HHS) amended the national Public Health Emergency (PHE) declaration related to COVID-19 to allow pharmacists and pharmacist technicians to administer recommended vaccines to a wider swath of the population. Delays in routine medical care due to lockdowns during the early months of the pandemic had resulted in a sudden and alarming decline in vaccination rates. With many physicians’ offices closed at the time and nearly 90 percent of Americans living within five miles of a pharmacy, expanding the ability of pharmacists to administer more vaccinations had swiftly become a public health imperative.

This change, which remains in effect today, was a wise move. In the past 18 months, hundreds of millions of COVID-19 and other vaccine doses have been administered in pharmacies. In a new study, my co-authors and I document that seniors and people living in poverty who may otherwise lack access to health-care services and facilities may benefit the most. While the Public Health Emergency may be temporary, the ability of pharmacists and pharmacist technicians to administer vaccines should be permanent. State policymakers can play a vital role in making that happen.

Early in the pandemic, the Centers for Disease Control and Prevention (CDC) had documented the notable decline among routine vaccinations for children. Low rates of adult vaccination have persisted for years, but COVID-19 clearly worsened the problem. As HHS noted in its declaration, “The United States must turn to available medical professionals to limit the harm and public health threats that may result from decreased immunization rates.”

Pharmacists have delivered. More than 245 million COVID-19 vaccines have been administered via a partnership between the federal government and retail pharmacy partners. This accounts for more than 40 percent of the COVID-19 vaccines administered in the U.S., though the proportion is growing: As of December 2021, pharmacies were administering more than two-thirds of COVID-19 vaccines. And the impact extends beyond COVID-19. For example, CDC data show that 40.4 million people have received a flu vaccine at a pharmacy during the 2021-22 flu season, compared with 30.8 million at a physician's office.

The opportunity to get vaccinated at a pharmacy is especially important for people who lack health insurance or easy access to providers. Our study, conducted by the Global Healthy Living Foundation and funded by the American Disease Prevention Coalition, finds that in communities where more than 30 percent of households live in poverty, the number of pharmacies is 15 percent higher than the number of doctors’ offices, and the gap widens even farther when compared to the physician offices that seek immunization reimbursement through Medicare Part D plans, which cover approximately 48 million older beneficiaries.

In addition to having more locations, pharmacies in these communities offered nearly double the number of hours for immunizations: 128,860 hours at 1,894 pharmacies compared with 65,840 at 1,646 physician offices. These extended hours can be critical for people without paid-leave benefits or access to child care who need to make vaccine appointments during nontraditional work hours or on weekends.

The current national Public Health Emergency runs through July 15, but there is no guarantee it will be extended past that date. Fortunately, some states have already acted; Florida, Georgia and Illinois have adopted legislation during the pandemic to ensure that pharmacists’ ability to administer all recommended vaccines will remain permanent, even when the PHE ends.

But too many states still have laws restricting the ability of pharmacists to administer certain vaccines to certain populations, and those laws will once again be in effect when the PHE is lifted. It is essential that states act now to expand the authority of pharmacists and pharmacist technicians to administer all vaccines authorized for emergency use by the Food and Drug Administration, approved by the FDA or recommended by the CDC.

It is important to remember that during the height of the COVID-19 pandemic, pharmacies were the health-care settings in the community with the most direct access to patients, especially as hospitals and emergency rooms reached or exceeded maximum capacity and many health-care offices and clinics temporarily closed. A return to a less accessible and less equitable vaccination policy should not be an option. Every American should have the opportunity to get vaccinated against life-threatening diseases regardless of geography, income or health insurance status.

Ensuring that pharmacists and pharmacist technicians in all 50 states have the same vaccine administration authority as their physician peers would help lay the groundwork for a better, stronger and more equitable health-care system for all.

Robert Popovian is the chief science policy officer at the Global Healthy Living Foundation, senior health policy fellow at the Progressive Policy Institute and visiting health policy fellow at the Pioneer Institute. He holds a doctoral degree in pharmacy and a masters in pharmaceutical economics and policy.



Governing's opinion columns reflect the views of their authors and not necessarily those of Governing's editors or management.
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