Implementation of a Targeted Technologic Screening Tool to Increase Pneumococcal Vaccine Uptake in Health-System Retail Pharmacies: A Quality Improvement Initiative.

Abstract

Background/Purpose: Pneumococcal vaccination rates among eligible adults are lower than desired. Recently, pneumococcal vaccination guidelines for adults were updated to include new pneumococcal conjugate vaccines (PCV20), taking into consideration age, underlying risk factors, and previous vaccine status. To respond to PCV under-vaccination and help clarify the new guidelines, this project sought to develop a targeted pneumococcal vaccine screening tool and pop-up alert within retail pharmacies across a large health system with the goal of increasing rates of PCV20 vaccination. Methods: A Plan-Do-Study-Act (PDSA) cycle was employed to activate alerts within 24 retail pharmacies for patients indicated to be eligible for PCV20 vaccination. Adult patients who were PCV20 vaccine-naïve, met eligibility requirements, and were due for medication refill were identified through the electronic health record and uploaded to pharmacy software. Pharmacists screened patients for eligibility and inquired about willingness to receive PCV20 vaccine during the upcoming pharmacy visit. Vaccine rates and sociodemographic characteristics were compared before and after the PDSA cycle began, and reasons for patient decline were assessed. Results: Between December 2023 and April 2024, 1821 patients were screened for PCV20 vaccines, with 1369 (75%) patients eligible. Ultimately, 130 patients (9%) received PCV20 through the alert process, yet an additional 285 PCV20 vaccines were administered to additional patients, perhaps due to the intervention's success in promoting the tools such that pharmacists were more comfortable in screening patients for PCV20 vaccinations overall. Overall, the study represented a 140% increase in PCV20 vaccination rates compared to the same period of the previous year. The most common reason for declining vaccination was no interest in vaccines (n=231, 51%). Conclusions: This PDSA cycle demonstrated a vast increase in PCV20 vaccination rates in retail pharmacies across a large health system, indicating the potential utility of integrated technologic screening tools and alerts to increase administration of other routine immunizations.