Getting vaccinated at pharmacies works: It could soon disappear

In December, the United States marked the two-year anniversary of the first COVID-19 vaccination. These vaccines have been incredibly successful: 3.2 million deaths averted, 18.5 million hospitalizations prevented and $1.15 trillion saved, according to one report. We are forever indebted to the scientists who developed them.

But as two healthcare professionals, we know that even the safest and most effective vaccines are worthless if they don’t go into arms. That was the principle behind one of the most thoughtful strategies put in place during the pandemic: expanding the ability of pharmacists and pharmacist technicians in all 50 states to administer more vaccines to more people. A new study from IQVIA Institute for Human Data Science and the Global Healthy Living Foundation (GHLF) — where one of us is the chief science officer — documents the overwhelmingly successful impact of placing pharmacies at the center of COVID-19 and other recent vaccination efforts. Federal and state policymakers must ensure that this critical component of our healthcare system remains in place permanently. 

In August 2020, provisions authorized by the Public Readiness and Emergency Preparedness (PREP) Act were written into the COVID-19 Public Health Emergency. Under these provisions, pharmacists and the pharmacist technicians they supervise are permitted to administer COVID-19 vaccinations to everyone ages 3 and up, flu vaccines to all adults and all recommended pediatric vaccines for children ages 3-18. These vaccines can be administered without a prescriber order, even in states with laws limiting pharmacies from offering certain vaccinations to particular populations. At the time, COVID-19 vaccines were still months away from being authorized, but health officials smartly realized that prioritizing accessibility was necessary to ensure success. 

This strategy has worked wonders. Nearly 300 million COVID-19 vaccine doses have been administered via the Federal Retail Pharmacy Program, a public-private partnership that provides participating pharmacies (now numbering more than 41,000 locations) with COVID-19 vaccines directly from the federal government, which in turn are administered at no cost to individuals. This program vastly expanded vaccine distribution beyond temporary facilities, public health outlets and physician medical offices and clinics. 

The IQVIA/GHLF study finds that outside of temporary and public health sites, approximately 90 percent of COVID-19 shots were administered at pharmacies between the first quarter of 2021 and the second quarter of 2022, with the remaining 10 percent administered at physician offices or clinics. 

The study also shows pharmacies are increasingly becoming a go-to source for vaccinations more broadly:

• Nearly 90 percent of vaccines commonly administered to adults were offered at pharmacies as opposed to non-pharmacy medical settings in both 2021 and 2022, compared to 50-60 percent in 2018 and 2019. 
• There was a 30-40 percent increase in pharmacy claims for flu vaccines between 2018/19 and 2020. That progress has continued during the current flu season, during which we have experienced extraordinarily high levels of influenza across the country: more than 40 million flu vaccinations have been administered at pharmacies during the 2022-23 season, compared to 26 million at physician medical offices.
• The share of adult human papillomavirus (HPV) vaccines given at pharmacies increased from between 5-8 percent in 2018 to between 13-21 percent in 2021. 
• These trends generally remain consistent irrespective of gender, race and income.

Several factors explain why connecting vaccines and pharmacies makes a lot of sense. More than 90 percent of people in the United States live within 5 miles of a community pharmacy, which is likely why most people prefer to get vaccinated at those locations. A previous GHLF study commissioned by the American Disease Prevention Coalition found that pharmacies have more locations and significantly more operating hours for vaccination than physician practices in low-income communities. This is a critical consideration for people who may not have paid time off from work or accessible child care during business hours. 

In red states and blue states alike, policymakers are recognizing the positive health and economic connections between pharmacies and vaccines and responding in kind. Since 2021, 16 states have broadened vaccination authority, and 14 have granted permanent vaccine authority to pharmacy technicians. That progress is welcome.    

Yet despite this record of success, we’re on the cusp of backsliding. The PREP Act provisions are scheduled to expire next year. If that happens, the consequences will be felt most acutely in  25 states where authority for pharmacist-administered vaccines has not yet been made permanent. That means state laws restricting the ability of pharmacists to administer certain vaccines to certain populations will return. With rates of recommended immunizations slipping among children and remaining stubbornly low for adults, our ability to improve those trend lines will be significantly hampered. 

Fortunately, the fix is simple: Make it easier, not harder, for people to continue getting vaccinated at pharmacies. States should enact laws that provide pharmacists and pharmacist technicians with authority to administer all Food and Drug Administration (FDA)- approved and/or Advisory Committee on Immunization Practices (ACIP)- recommended vaccines. Doing so will protect lives, reduce suffering, save money and make our healthcare system more equitable. 

As a nation, we are fortunate to now be in a far different — and far better — place regarding the pandemic. But with hundreds of people still dying from COVID-19 every day, flu hospitalizations remaining high, and other vaccine-preventable diseases making unwelcome returns, we should double down on what works. The ability to get a life-saving vaccine at a pharmacy shouldn’t depend on the state in which we live. Rather, it should be a permanent cornerstone of all current and future vaccination campaigns. 

Kevin Ban, MD, is the chief medical officer at Walgreens. Robert Popovian, PharmD, MS is the chief science policy officer at the Global Healthy Living Foundation, senior health policy fellow at the Progressive Policy Institute, and visiting health policy fellow at the Pioneer Institute.