Increasingly, pharmacy operators are beginning to realize the value of delivering year-round vaccination services administered by their own pharmacists.

Aside from possible profits, pharmacists are finding that in-house vaccination services are another opportunity to establish their pharmacy as the go-to destination centre for all health care needs. "Your recognition as a health care provider really is elevated in the community," suggested Deborah Faucette, director of pharmacy operations for the NACDS Foundation. "Especially in neighborhoods with underserved populations where there is no clinic or hospital--where physicians may be few and far between."

"The low immunization rates that the CDC and other agencies have uncovered have pinpointed that there's a need for [vaccinations at the pharmacy]," said Carmen Catizone, executive director of the National Association of the Boards of Pharmacy. "The pharmacist remains the most accessible, so having immunization at the pharmacy just seems to fit a major need."

Vaccine programmes could be positioned as a convenience offering, especially if the pharmacy implements a walk-up system where a consumer can receive a vaccination without an appointment.

Also, it's mostly a cash business. "Unfortunately, many insurance companies do not pay for immunizations of a preventative nature, other than [pediatric vaccinations]," Faucette said. "I know some are looking [into covering vaccinations], but they just don't see that immediate bottom-line impact."

However, not all pharmacists can deploy an in-store vaccination programme. Licensure requirements vary by state, and nine states currently do not allow pharmacists to administer immunizations. A few of those states allowing pharmacists to deliver immunizations are in pilot phases, such as New Jersey and Massachusetts, Faucette said.

The NABP has provided many states with legislative models in support of phar-macy immunization programs, Catizone reported. "We've also sent pharmacy groups into the state boards [to testify] that this is an activity that should be supported and not prohibited by the states."

The issue in those states barring pharmacy vaccina-tion programmes is not so much health driven as politically motivated, industry executives in support of such initiatives charged. Among the strongest lobbying groups opposed to pharmacy-delivered inoculations are professional nursing groups, who argue that taking immunizations out of the clinical setting could wreak havoc with record-keeping and negatively impact the quality of health care. "But behind the scenes, the message is that this may affect their reimbursement and the number of patients they may see," Catizone said.

Progress is being made, however. "It doesn't matter who's giving the shot, it's a victory for everybody if we get more people immunized," Faucette said. "Through collaboration we've been able to work together and make a lot of this happen," she said. "We're seeing [pharmacy vaccination programmes] growing exponentially.... There is a role that pharmacy needs to play in order to accomplish the goals as far as getting people immunized."

The nine states currently barring pharmacist-administered vaccines are Arizona, Connecticut, Florida, Maine, New Hampshire, New York, Rhode Island, Vermont and West Virginia.

Flu vaccines are the most recognized of immunization opportunities. And drug stores quite possibly still will need to outsource flu vaccine drives to handle the potential foot traffic. But as the delivery of a vaccination takes about as much time as processing a prescription, pharmacists trained in the practice now can take care of those latecomers who missed the initial drive. What's more, pharmacists now can suggest the service during patient consultations and deliver an on-the-spot inoculation.

The opportunity is not limited to flu shots, however. Indeed, the greatest dollar opportunity can be found in vaccinations not limited to a particular season. "From a standpoint of other immunizations that can be offered year-round, like tetanus or the travel vaccines that are required, that's where it can be much more lucrative. It's a cash business; [travel immunizations are] usually not something that's covered on a health plan," she said. "We tend to focus on the extreme elderly and the pediatric population and forget about everybody else in the middle," Faucette said. There are other year-round vaccination opportunities, as suggested by the Centers for Disease Control and Prevention, including tetanus and diphtheria, a booster shot of which should be administered every 10 years for persons of all ages, and pneumococcal for high-risk groups, such as patients with heart disease, diabetes or liver problems and anyone over the age of 65. Any adult born after 1957 should receive at least one dose of a measles, mumps and rubella vaccination, unless they have a medical contraindication.

- Onlinepharma.co.in