Vaxxed at the drugstore: Are patients missing out on the benefits of primary care visits?
Key Takeaways
Research shows that pharmacies play a key role in increasing widespread accessibility to vaccines, potentially improving vaccination rates among patients.
Some patients may prefer to get vaccinated at their doctor’s office to first ensure that they’re eligible for a vaccine, and because they may feel more comfortable receiving vaccinations in a familiar, private space.
Regardless of where your patients prefer to vaccinate, high vaccination rates are a positive for public health. Physicians can speak with their patients about the benefits and risks of either option.
When it comes to getting vaccinated, health experts have known for years about the barriers that keep some patients from doing so. A lack of widespread access to vaccines is one particularly worthy of mention, as noted in an article published by the American Journal of Managed Care.[]
The issue of access has fortunately been met with creative solutions in recent years, one of which includes the availability of life-saving vaccines at local and retail pharmacies.
But as patients head to CVS to get their COVID-19 booster or Tdap, are they missing out on the benefits of seeing their primary care physician?
The benefits of pharmacy availability
The role that pharmacists and pharmacies play in supporting the well-being of patients has evolved to include access to immunizations.
According to an article published by Human Vaccines and Immunotherapeutics, 80% of Americans live within 10 miles of a pharmacy.[] On top of that, pharmacies have wide-ranging operating hours, and require patients to jump through fewer hoops to make appointments than a doctor’s office might.
All of these factors converge to create convenient access to vaccines for patients at various points across their lifespan.
The Human Vaccines and Immunotherapeutics authors state that pharmacies and pharmacists play a central role in maintaining community health, due in part to the vaccine access they create.
“Consumer-patients are often satisfied in their experience with pharmacist-providers as vaccinators, making pharmacists a natural partner as public health vaccinators,” they wrote.
"With walk-in or scheduled appointments, pharmacies seek to support the goal of a fully vaccinated family."
— Authors, Human Vaccines and Immunotherapeutics
Not only do pharmacies make immunizations more accessible, but research shows that they improve vaccination rates.
A systematic review published by the Journal of the American Pharmacists Association looked at 14 randomized controlled trials and 79 observational studies on the provision of influenza, pneumococcal, herpes zoster, Tdap, and other vaccines in different settings, such as hospitals, clinics, and pharmacies.[]
Researchers identified a significant increase in immunization rates when pharmacists assumed the role of immunizer, advocator (informing and motivating patients to get vaccinated), or both, when compared with nonpharmacist-involved interventions or usual care.
The authors elaborated on the significance of these findings: “Although the evidence was from high-income countries, mostly from the United States, the positive impact of pharmacists on vaccine uptake suggested the benefit of expanding the scope of pharmacist practice in terms of vaccine administration and immunization advocating activities at a variety of settings at the global scale.”
What do patients miss out on if they get vaccinated at the pharmacy?
We know that pharmacists and pharmacies have played an important role in expanding access to vaccines, but are there any downsides to getting vaccinated in a pharmacy rather than at the doctor’s office? For some, the answer is yes.
A Canadian study surveyed adults on whether they’d consider getting vaccinated in a pharmacy.[]
“No. With any vaccine there is always a risk of having a reaction,” one participant said. “I will always want to be either with a doctor or a nurse or with some professional who knows what to do in the case of a reaction and also close to medical staff and facilities. I don't say that they can't do it, I am just saying I would rather not.”
The Internal Medicine & Pediatric Clinic (IM&PC) in New Albany, Mississippi, expressed similar sentiments in an article on their website.[]
Although vaccines are “overwhelmingly safe,” according to IM&PC, patients may be better taken care of in a doctor’s office than at a pharmacy, should they experience a rare reaction to a vaccine.
This is because doctors have the training to respond to such medical events, while pharmacists do not.
The authors also wrote that, although getting vaccinated in a pharmacy is convenient for some patients, it’s not always ideal to receive vaccinations in a small, public space. “In your doctor’s office, you’ll be in a familiar environment that’s more private, since most immunizations are given in the exam room,” they wrote.
The recent implementation of pharmacy vaccinations prompts another question: Are patients missing out on the benefits of wellness visits by choosing to get vaccinated at their local drugstore?
What can't a pharmacy do?
According to Kara Wada, MD, MDLinx medical advisor, this shouldn’t have to be the case.
“Specifically in my practice, the availability of vaccines at pharmacies has made it much easier for my patients, in large part because my office is not able to offer flu vaccines,” Dr. Wada tells MDLinx.
"Incorporating the pharmacy as part of the picture is another opportunity to reach and care for our patients—but we also need to realize the importance of these regular check ups."
— Kara Wada, MD
A wellness visit encompasses many other elements—health risk assessments, age-appropriate screenings, height, weight, and blood pressure readings, and more—that a quick trip to the pharmacy simply doesn’t.
All in all, Dr. Wada says, doctors and pharmacists can collaborate to create the most effective care models for patients.
“It is important for the medical team to work together and realize each other's strengths and weaknesses. Teamwork is vitally important in healthcare, and ideally, the patient is at the center of this model.”
Employ motivational interviewing with patients
Regardless of where your patients get vaccinated, the fact that they’re willing to is a win.
If they’re not willing to get vaccinated, against, say, COVID-19, you are in a good position to talk with them about why—and perhaps to help them consider the benefits of vaccination.
The CDC states that physicians can employ motivational interviewing—an “evidence-based and culturally sensitive way to speak with unvaccinated patients about getting vaccinated”—when chatting with patients about COVID-19 vaccination.[]
There are four steps of motivational interviewing:
Leading with empathy and embracing collaboration
Asking permission to talk about vaccines
Initiating a motivational interview (help them to process the level of willingness they have to get vaccinated)
Answering any questions the patient may have about vaccines or health
Following these steps in the exam room may influence your patient’s readiness to receive a vaccine. Whether that happens in the clinic at which you practice, or at your patient’s local pharmacy, it is a small victory for public health.
What this means for you
For patients who live far from their doctor or can’t afford a wellness visit, pharmacies are creating accessibility to preventive care by offering vaccinations. Some patients may still prefer to receive a vaccine from their primary care physician in the private familiarity of their doctor’s office. When it comes to getting vaccinated against COVID-19, you may implement motivational interviewing with patients who are on the fence. This could influence your patients’ willingness to get vaccinated, regardless of where they choose to do so.