By Tina Sharma / For The Herald
COVID-19 has posed unprecedented challenges in global public health and economic devastation. As a result, the public and private sector have invested in a number of pharmaceutical projects that are progressing through preclinical and human trials at an unprecedented pace to yield a safe and effective vaccine.
As a pharmacist who has led multiple clinical initiatives, I know pharmacists are uniquely positioned to be front-line agents of public health; particularly in administering and providing education on its safety and efficacy once the vaccine is discovered.
Unfortunately, there are barriers pharmacists might encounter that could make widespread vaccination difficult.
Today, nearly 9 out of 10 Americans live within five miles of a pharmacy, providing individuals a safe, convenient and accessible alternative to visiting a hospital or clinic for their prescriptions.
Pharmacies also play a vital role in providing education, recommendations and administering lifesaving vaccinations to their customers. As part of our education, all accredited pharmacy programs require students to obtain an immunization certification; and are trained on the Centers for Disease Control and Prevention’s (CDC) national immunization standards and recommendations.
In fact, pharmacists are proven to play a critical role in flattening the curve of pandemics.
A Johns Hopkins University study found that in 2013, an additional 4.1 million adults were vaccinated because of pharmacists’ efforts. These additional vaccinations are estimated to have resulted in 81,000 to 134,000 fewer adult influenza infections that year.
Furthermore, the study found that pharmacies administering flu vaccinations during a severe epidemic could avert up to 23.7 million symptomatic cases, preventing up to 210,228 deaths and saving $2.8 billion in direct medical costs, and $99.8 billion in overall costs.
Extrapolating such an impact for COVID-19 immunizations, it’s clear pharmacists efforts could lead to a significant reduction in not only the morbidity and mortality associated with the disease but also in direct and indirect costs.
However, current regulatory barriers to pharmacy vaccinations could actually prevent pharmacists from widely distributing vaccines for the novel coronavirus.
Across the U.S., there is a wide variation in pharmacists’ authorities to administering vaccinations. Each state is different. This can range from age restrictions on the recipients of the vaccine to appropriate regulatory approval dictating a pharmacists’ ability to administer.
For example, the California State Board of Pharmacy requires a vaccination to be both FDA approved and eligible by the Advisory Committee on Immunization Practices (ACIP) for administration by a pharmacist. The ACIP approval can take up to six months or more to complete once a vaccine is discovered and approved by the FDA.
Additionally, there are reimbursement barriers that could prevent access. Pharmacists have cited difficulty in being reimbursed for some services as a top challenge during previous public health emergencies, which can prevent pharmacists’ efforts to administer vaccinations and keep their license up-to-date.
These barriers, — along with other restrictions that may prevent immunization with a vaccine —should be addressed prior to the availability of the vaccine to ensure that there is adequate time to communicate any changes to existing regulations or laws and minimize confusion when the vaccine becomes available.
One initial step, for example, would be for the Centers for Medicare and Medicaid Services (CMS) and private payers to take steps to ensure that pharmacists receive a fair reimbursement for their services and even incentivize pharmacies to vaccinate to ensure patients are receiving care.
As scientists continue working around the clock to develop a COVID-19 vaccine, all aspects of the health care system must come together to develop a cohesive, multi-faceted vaccination strategy as soon as it hits the market.
More than ever, pharmacists are ready to play their part. It’s now up to decision-makers to ensure we are able to do so effectively.
Dr. Tina Sharma, a doctor of pharmacy, is a regional clinical services manager for Walmart. Her region covers Washington state.