Impact of Pharmacist Immunization Authority on Seasonal Influenza Immunization Rates Across States

Clin Ther. 2017 Aug;39(8):1563-1580.e17. doi: 10.1016/j.clinthera.2017.07.004. Epub 2017 Aug 7.


Purpose: The goal of this study was to investigate the impact on immunization rates of policy changes that allowed pharmacists to administer influenza immunizations across the United States.

Methods: Influenza immunization rates across states were compared before and after policy changes permitting pharmacists to administer influenza immunizations. The study used Behavioral Risk Factor Surveillance System (BRFSS) survey data on influenza immunization rates between 2003 and 2013. Logistic regression models were constructed and incorporated adjustments for the complex sample design of the BRFSS to predict the likelihood of a person receiving an influenza immunization based on various patient health, demographic, and access to care factors.

Findings: Overall, as states moved to allow pharmacists to administer influenza immunizations, the odds that an adult resident received an influenza immunization rose, with the effect increasing over time. The average percentage of people receiving influenza immunizations in states was 35.1%, rising from 32.2% in 2003 to 40.3% in 2013. The policy changes were associated with a long-term increase of 2.2% to 7.6% in the number of adults aged 25 to 59 years receiving an influenza immunization (largest for those aged 35-39 years) and no significant change for those younger or older.

Implications: These findings suggest that pharmacies and other nontraditional settings may offer accessible venues for patients when implementing other public health initiatives.

Keywords: immunizations; influenza; pharmacy services; vaccines.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Immunization / trends
  • Immunization Programs / trends*
  • Influenza Vaccines*
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Pharmacists*
  • Professional Role*
  • Seasons
  • United States
  • Young Adult


  • Influenza Vaccines