Vaccinations Administered During Off-Clinic Hours at a National Community Pharmacy: Implications for Increasing Patient Access and Convenience

Abstract

PURPOSE Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience. METHODSWe retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am-6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours.RESULTS During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions.CONCLUSIONS A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, accessed a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience.

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“…In this era of growing healthcare expenditure, the cost of vaccination may impose a financial burden on the government budget. Hence, the benefit of getting vaccines at a community pharmacy will remarkably reduce this pressure on the government budget and have many advantages over other healthcare settings, including but not limited to: extended opening hours, easy access to professional knowledge, convenient locations without requiring an appointment or waiting, and do not charge visit fees [27,28]. In general, several barriers have been identified as the factors that can contribute to the low immunization rate in any age of adult population and setting.…”

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“…Expanded access to immunizations through pharmacy-based programs was demonstrated in a recent study, which showed that 1,906,352 of 6,250,402 immunizations (30.5 percent) administered over a oneyear period at a large national pharmacy chain occurred during evenings, weekends, or federal holidays, when traditional settings for vaccine delivery were not accessible. 14 Another study showed that after receiving flu shots at a large national pharmacy chain, patients with risk factors for pneumococcal pneumonia subsequently received immunizations for this condition at a significantly higher rate than the traditional care benchmark (4.88 percent versus 2.90 percent). 15 The public health value of pharmacy-based immunization programs in "raising awareness and increasing access to vaccines" was recognized in a 2013 letter from the Department of Health and Human Services to the pharmacist community.…”