Pharmacist impact on pneumococcal vaccination rates through incorporation of pharmacist-led opportunistic inpatient vaccination intervention

Background

Pneumococcal disease continues to be a large source of morbidity and mortality despite the availability of effective prevention via immunisation and treatment measures.

Aim

To assess the impact of a pharmacist-led opportunistic inpatient pneumococcal vaccination intervention on overall 13-valent pneumococcal conjugate vaccine (13vPCV) rates in eligible hospitalised subacute patients, aged 70 years and above.

Method

This study was a pre- and post-intervention study conducted across two study sites at Monash Health, a large metropolitan health service in Victoria, Australia. Phase 1 (pre-intervention, August–October 2022) involved auditing the vaccine-eligibility of patients on admission and subsequent administration during inpatient stay. Phase 2 (intervention phase, October–December 2022) implemented the pharmacist-led opportunistic inpatient pneumococcal vaccine intervention. Following screening, identified vaccine-eligible patients were recommended to the treating physician via verbal discussion and Microsoft Teams for consideration of vaccination administration in hospital. The proportion of eligible patients vaccinated was compared between the pre-intervention and intervention groups. This project was exempt for ethics approval due to the local policy requirements that constitute research by the Monash Health Human and Research Ethics Committee (Reference no: RES-22-0000-454Q). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's Ethical considerations in quality assurance and evaluation activities; auditing the percentage of vaccine-eligible and non-vaccinated patients did not require written consent per local requirements; and it is standard practice to obtain verbal consent, followed by documentation on electronic medical records, for inpatient vaccinations. Informed consent was obtained from participants via verbal consent after the distribution of written medical information on the 13vPCV, as well as verbal information provided by the medical team.

Results

A total of 360 patients were included in the study. Overall, 139 (77.2%) patients in the pre-intervention and 143 (79.4%) patients in the intervention phase were eligible for vaccination (non-vaccinated with age indication). The proportion of patients receiving inpatient 13vPCV was higher in the intervention group compared to the pre-intervention group (43.4 vs 2.2%, p < 0.001).

Conclusion

The results indicate that incorporating a pharmacist-led opportunistic inpatient pneumococcal vaccination intervention can significantly increase pneumococcal vaccination in hospital.