Impact of Community Pharmacy Vaccination Services on Respiratory Vaccine Coverage of Patients Taking Immunosuppressive Medications in Quebec, Canada.

Abstract

Objective: Immunocompromised patients are at increased risk of bacterial and viral respiratory infections and related complications. Available vaccines against these infections are the most effective tools in preventing complications. Community pharmacist vaccination service is evolving in many countries, and they could present an opportunity to improve vaccination coverage in this population. This study aims to describe how community pharmacists are involved in vaccinating high-risk (immunocompromised) populations.

Methods: This retrospective study included vaccination information of patients who received chronic immunosuppressive therapy among those who were taking selected chronic medications from community pharmacies in Montreal, Canada, from January 2020 to September 2023. Immunosuppressive therapy was categorized as either corticosteroids or immunosuppressive drugs or the combination of corticosteroids with one or two immunosuppressive drugs. Data were available from all private pharmacies through the Quebec Association of Pharmacists Owners database. Descriptive statistics are used for data analysis.

Findings: Of the total number of 4,114,528 patients who were taking selected chronic medications from community pharmacies, 611,789 (14.8%) were taking immunosuppressives. Prednisone/prednisolone was the most commonly administered drug in this population (345,744 [8.4%]). Most of these patients are aged over 50 years (484,827 [79.2%]). A total of 409,171 (66.8%) co-administered at least one other drug. The vaccination rate was highest for influenza (142,877 [23.3%]) and lowest (23,532 [3.8%]) with the pneumococcus vaccine. Patients younger than 25 had the lowest vaccination rate with three respiratory vaccines. Vaccination rate decreased after the pandemic with all three vaccines in our study population.

Conclusion: Vaccination rates of patients taking chronic immunosuppressive drugs in community pharmacies are low. These rates are worse than rates for other high-risk groups from the same database. This represents a missed opportunity for pharmacists to encourage this high-risk population to vaccinate proactively.