New HHS Plan Allows Pharmacists to Administer Childhood Vaccines

As COVID-19 began its march across the country in mid-March, many pediatrician’s offices scaled back operations or shut down entirely as stay-at-home orders were put in place. Predictably, this led to a dramatic decrease in the number of routine vaccinations administered during annual well-child visits in the months of March and April. 

Thus, the US Department of Health and Human Services will authorize pharmacists to administer routine childhood vaccines, similar to the way the flu shot is offered each year. The goal is to avoid a spike in preventable diseases like measles, polio, and rubella.

Benefits of the HHS Plan

There are clear benefits to the plan, says Nancy Lyons, BSPharm, MBA, CDE, Chief Pharmacist, Health Mart. “It all centers around solving the problem for the patients. In this case, it applies to the children and families who are at greater risk because of the decrease in childhood immunization rates. The government’s decision to use an available resource—pharmacists and pharmacy interns—to lend a hand and help solve a serious national health problem is simple.”

Other benefits Lyons outlines include the following:

1. Convenience: Ninety percent of Americans live within five miles of a pharmacy. This is even more important in rural and underserved areas where the pharmacist might be the only healthcare provider nearby.
2. Reliability: Pharmacists have been conveniently providing immunizations for more than 25 years, and routinely administer more than 1/3 of the annual influenza vaccines.
3. Availability: Before HHS issued the Third Amendment, they surveyed medical practices participating in the Vaccines for Children Program and found that some practices had closed, had reduced hours and may not reopen soon. They also found that 21.3% of the practices they surveyed thought it was not likely that the practice would be able to accommodate new patients who needed to make up vaccine doses.

Drawbacks of the HHS Plan

Despite this, there are many who vehemently oppose such a plan, including, notably, the American Academy of Pediatrics. The organization’s main concerns are centered around what is lost when pediatrician appointments are skipped. They argue that’s likely to happen if vaccinations are easily obtained at a local pharmacy.

AAP Opposition

The AAP stresses the importance of yearly pediatrician visits for children under 18, stating, “In-person visits should occur whenever possible and are necessary for vital services like comprehensive physical exams; laboratory testing; hearing, vision and oral health screenings; fluoride varnish and immunizations.”

Joe Sellers, President-Elect of the Medical Society of the State of New York says, “This is a completely unnecessary move on the part of Health and Human Services and will cause further chaos in getting children properly immunized. Pediatrician’s offices are safe places to receive vaccinations, and most importantly, parents and children already have an established relationship with their pediatrician. 

“Taking children out of the medical home where they are able to get immunized, get screened for developmental milestones, and get the medical care that they need, will only lead to a further fragmentation of a child’s health care.”

Another potential ramification of moving childhood vaccinations outside of the umbrella of routine pediatric care centers around recordkeeping. Anytime a child receives a vaccine at their pediatrician’s office, the vaccine registry is updated, which then becomes part of a child’s health history (it’s what’s presented to schools that require up-to-date vaccine records prior to admission, for example). 

But if a child gets some vaccinations at a pharmacy and others at his pediatrician’s office, there isn’t a system currently in place to ensure there’s no duplication of effort or worse, vaccines that are missed altogether.