Impact of Clinical Pharmacists on Pneumococcal Vaccination Rates in a Military Medical Center

Pneumococcal infections continue to be a significant cause of morbidity and mortality in the elderly and high risk population in the United States (US) (Plotkin, Orenstein, & Offit, 2012). Despite the fact that a pneumococcal vaccine has been available since the 1970s, vaccination rates for pneumococcus remain lower than desired. The Centers for Disease Control and Prevention’s Immunization Practices Advisory Group recommends a vaccine series of PCV13 and PPSV23 for all persons over 65 years of age and adults 19 to 64 years of age with high risks conditions (Tomczyk et al., 2014). A review of pneumococcal vaccination rates at Womack Army Medical Center (WAMC) showed opportunities for improvement, with pneumococcal vaccination rates for ORYX® (The Joint Commission performance measure) at 41% and Healthcare Effectiveness Data and Information Set (HEDIS) (National Committee for Quality Assurance performance measure) at 20%. A pilot immunization initiative at WAMC demonstrated that clinical pharmacists were able to increase pneumococcal vaccination rates. Opportunities to improve pneumococcal vaccination rates in the WAMC patient population are identified. The Department of Defense (DoD) implemented the Patient Centered Medical Home (PCMH) concept, which recognizes the importance of pharmacists to conduct comprehensive medication therapy management services. Military clinical pharmacists are considered healthcare extenders and are credentialed providers with prescribing privileges. They are in the optimal position to influence public health and improve utilization of pneumococcal vaccines in PCMH settings. Barriers that keep high-risk beneficiaries from obtaining pneumococcal vaccinations and healthcare providers from recommending and administering the vaccines are identified. Clinical pharmacists can work with multidisciplinary healthcare teams and hospital leaders to address most of the identified barriers. Despite the positive trends, more work is needed to standardize the way clinical pharmacists order and document the pneumococcal vaccines, and to spread clinical pharmacists’ immunization efforts to other PCMHs at WAMC.Master of Public Healt