Intent to provide the influenza vaccination to children ages 6-18 years: An analysis of law implementation by community pharmacies

Abstract

Objective: The objective of this quality improvement (QI) project was to identify if there were discrepancies in the ages of children for whom pharmacists at community pharmacies would offer vaccinations. Arizona law changed in 2011 allowing pharmacists to immunize children ages 6 years and older. Not offering vaccine services could impact patient access to care. Methods: Chain pharmacies (n = 5; labeled A, B, C, D, E) with the most locations within metropolitan Tucson and all independent pharmacies (n = 4) were selected for inclusion. Researchers called each pharmacy and requested to speak to the pharmacist and asked a series of standardized questions to determine if a 6-year-old child could receive an influenza vaccination at their store. Responses were documented using a standardized data response form. Yates chi2 test was performed to determine group differences (i.e., chain vs. independent and between chains). An alpha of 0.05 was selected a priori. This QI project did not meet the federal definition of research and institutional review board approval was not required per university guidelines. Results: Ninety chain and four independent pharmacies were contacted over 2 months. Eleven percent of the pharmacists responding at chain pharmacies (10 of 90) and 25% at independent pharmacies (1 of 4) indicated a 6-year-old child could be vaccinated at their store. Seven of the 10 pharmacists who indicated vaccination availability for a 6-year-old child were from one chain (chain D). Response differences were detected between independent and chain pharmacists (P <0.001) and between chains (P <0.001). Common reasons for not offering vaccinations included liability and mistaking corporate policy for state law. Conclusion: Pharmacists sampled were aware of legislative amendments regarding vaccination of children ages 6 years and older but had assorted levels of understanding of specific guidelines. Utilizing the full extent of vaccine legislation allows pharmacists to impact patient care.