Pharmacist assessments and care to improve adult vaccination rates: A report from project IMPACT vaccine confidence.

Background: Neglect of vaccination needs among adults results in a needless burden of hospitalization, suffering, and death. America's community pharmacists deliver a substantial portion of adult vaccinations, yet many Americans still have unmet vaccination needs.
Objectives: This study evaluated rates of vaccine contraindications, acceptance, and willingness to be vaccinated among ambulatory adults.
Practice Description: This was a prospective, multisite, multistate, observational study conducted in three waves between October 2021 and August 2023.
Practice Innovation: Pharmacists conducted comprehensive vaccination need assessments.
Evaluation Methods: The primary outcomes were numbers of vaccination needs per participant and vaccinations administered, scheduled, or declined.
Results: Pharmacists identified a mean of 1.8-2.2 unmet vaccination needs per adult assessed, more than in pilot studies. Participants had already received 61%-74% of vaccinations recommended for them hence 26%-39% of needs were unmet at baseline. The leading vaccination needs were COVID-19, influenza, zoster, tetanus-containing, and pneumococcal vaccines. From a baseline mean of 59.1% for these five vaccinations, pharmacists increased the mean percentage vaccinated to 73.2%. When an option for scheduling future vaccination was added to the process, declinations dropped from 46%-18%.
Conclusion: This study provides insight into adult vaccine acceptance, willingness, and declination behaviors not described elsewhere. Offering options for future vaccination reduced declination rates. Pharmacists resolved substantial proportions of adult vaccination needs. The signal that apportioning adult vaccines needed, but not received on day of assessment, across several months could help resolve unmet vaccination needs warrants additional research, especially with the rising number of vaccines recommended for adults.
Competing Interests: Disclosure Benjamin M. Bluml and Jonathan B. Little are employed by the APhA Foundation. Scott A. Hamstra and Lisa L. Tonrey are consultants to the APhA Foundation. Aaron J. Bonham is an employee of the University of Michigan. John D. Grabenstein serves as a volunteer board member for the APhA Foundation. He serves as consultant to the APhA Foundation for this manuscript. He reports receiving honoraria for consulting with CSL Seqirus, Takeda, Valneva, and VBI Vaccines. The authors have no other disclosures to declare and no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, gifts, stock holdings or honoraria.
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