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Immunization access through pharmacies located in low income, medically underserved areas
Immunization access through pharmacies located in low income, medically underserved areas
Tuesday, November 18, 2014
Introduction: We conducted a 2012 telephone survey assessing the number of immunizing pharmacies in the Omaha Nebraska metropolitan area and immunizations offered. We surveyed all licensed pharmacies (104) providing general pharmacy services to the public. This data was analyzed to assess service availability based on geographic economic characteristics.
Methods: We assessed the number of immunizing pharmacies located in medically underserved areas, and in zip codes by percent of population living below the federal poverty limit. Microsoft Access was utilized for data entry; statistical analysis was conducted in IBM SPSS Statistics Version 20.
Results: A total of 84 (80%) licensed pharmacies provided immunization services. All immunizing pharmacies provided trivalent influenza vaccine (TIV), while substantial proportions also provided other commonly recommended adult immunizations: PPSV23 (79%), Shingles (77%), and TdaP (64%). In 16 zip codes with the lowest level of poverty (< 10% FPL), 88% of surveyed pharmacies (43/49) offered immunizations. Among 13 zip codes having moderate levels of poverty (10 – 24% FPL), 74% of pharmacies (34/46) offered immunizations. In 9 high poverty zip codes (25%-63% FPL), 78% of pharmacies (7/9) offered immunizations. Immunizing pharmacies (86%) were generally located in designated medically underserved areas (MUAs) for high poverty zip codes, compared to 18% and 5% in moderate and low poverty areas, respectively. Immunizing pharmacy distribution was 0.24, 0.23, and 0.57 per square mile, for geographic areas with low, moderate or high poverty levels, respectively. The distribution was 1.64, 1.68 and 0.81 per 10,000 population, respectively, by increasing poverty level. Immunizing pharmacies in areas with the highest poverty levels were most likely to provide vaccines beyond influenza, while pharmacies in moderate and low poverty areas offered these vaccines at similar rates: Pneumococcal: 86%, 79%, 77%; Shingles: 100%, 77%, 74%; and Tdap: 86%, 62%, 63%, respectively.
Conclusions: Pharmacies in zip codes with lowest levels of poverty were most likely to immunize. There was a similar proportion but lower number of immunizing pharmacies in low versus moderate poverty areas. There were more pharmacies available per square mile in high poverty areas, there was also higher population density. Thus, these pharmacies potentially served larger numbers of patients compared to those in lower poverty areas. Immunizing pharmacies in high poverty areas were more likely to provide commonly recommended adult vaccines compared to the other two areas. Pharmacies constitute an excellent access point for adult immunizations, with similar or higher geographic availability in high versus lower poverty areas for this metropolitan area.
Methods: We assessed the number of immunizing pharmacies located in medically underserved areas, and in zip codes by percent of population living below the federal poverty limit. Microsoft Access was utilized for data entry; statistical analysis was conducted in IBM SPSS Statistics Version 20.
Results: A total of 84 (80%) licensed pharmacies provided immunization services. All immunizing pharmacies provided trivalent influenza vaccine (TIV), while substantial proportions also provided other commonly recommended adult immunizations: PPSV23 (79%), Shingles (77%), and TdaP (64%). In 16 zip codes with the lowest level of poverty (< 10% FPL), 88% of surveyed pharmacies (43/49) offered immunizations. Among 13 zip codes having moderate levels of poverty (10 – 24% FPL), 74% of pharmacies (34/46) offered immunizations. In 9 high poverty zip codes (25%-63% FPL), 78% of pharmacies (7/9) offered immunizations. Immunizing pharmacies (86%) were generally located in designated medically underserved areas (MUAs) for high poverty zip codes, compared to 18% and 5% in moderate and low poverty areas, respectively. Immunizing pharmacy distribution was 0.24, 0.23, and 0.57 per square mile, for geographic areas with low, moderate or high poverty levels, respectively. The distribution was 1.64, 1.68 and 0.81 per 10,000 population, respectively, by increasing poverty level. Immunizing pharmacies in areas with the highest poverty levels were most likely to provide vaccines beyond influenza, while pharmacies in moderate and low poverty areas offered these vaccines at similar rates: Pneumococcal: 86%, 79%, 77%; Shingles: 100%, 77%, 74%; and Tdap: 86%, 62%, 63%, respectively.
Conclusions: Pharmacies in zip codes with lowest levels of poverty were most likely to immunize. There was a similar proportion but lower number of immunizing pharmacies in low versus moderate poverty areas. There were more pharmacies available per square mile in high poverty areas, there was also higher population density. Thus, these pharmacies potentially served larger numbers of patients compared to those in lower poverty areas. Immunizing pharmacies in high poverty areas were more likely to provide commonly recommended adult vaccines compared to the other two areas. Pharmacies constitute an excellent access point for adult immunizations, with similar or higher geographic availability in high versus lower poverty areas for this metropolitan area.
Learning Areas:
Other professions or practice related to public healthProtection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Learning Objectives:
Describe two public health benefits associated with community pharmacies providing recommended adult immunizations.
Keyword(s): Immunizations, Pharmacists
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am an academic pharmacist who has conducted research on access to immunizations through pharmacy practice. I teach and conduct professional education and research in the area of immunizations.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
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