Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic

Vaccine. 2018 Nov 12;36(46):7054-7063. doi: 10.1016/j.vaccine.2018.09.040. Epub 2018 Oct 16.


Introduction: During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity.

Methods: We utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.

Results: For an epidemic with a reproductive rate (R0) of 1.30, adding pharmacies with typical business hours averted 11.9 million symptomatic influenza cases, 23,577 to 94,307 deaths, $1.0 billion in direct (vaccine administration and healthcare) costs, $4.2-44.4 billion in productivity losses, and $5.2-45.3 billion in overall costs (varying with mortality rate). Increasing the epidemic severity (R0 of 1.63), averted 16.0 million symptomatic influenza cases, 35,407 to 141,625 deaths, $1.9 billion in direct costs, $6.0-65.5 billion in productivity losses, and $7.8-67.3 billion in overall costs (varying with mortality rate). Extending pharmacy hours averted up to 16.5 million symptomatic influenza cases, 145,278 deaths, $1.9 billion direct costs, $4.1 billion in productivity loss, and $69.5 billion in overall costs. Adding pharmacies resulted in a cost-benefit of $4.1 to $11.5 billion, varying epidemic severity, mortality rate, pharmacy hours, location vaccination rate, and delay in the availability of the vaccine.

Conclusions: Administering vaccines through pharmacies in addition to traditional locations in the event of an epidemic can increase vaccination coverage, mitigating up to 23.7 million symptomatic influenza cases, providing cost-savings up to $2.8 billion to third-party payers and $99.8 billion to society. Pharmacies should be considered as points of dispensing epidemic vaccines in addition to traditional settings as soon as vaccines become available.

Keywords: Economic; Epidemic; Influenza; Pharmacies; Vaccination.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • Disease Transmission, Infectious / prevention & control*
  • Epidemics*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza Vaccines / administration & dosage*
  • Influenza Vaccines / economics
  • Influenza Vaccines / immunology
  • Influenza, Human / economics
  • Influenza, Human / epidemiology*
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Models, Statistical
  • Pharmacies*
  • Treatment Outcome
  • United States / epidemiology
  • Vaccination / economics
  • Vaccination / methods*
  • Vaccination Coverage
  • Young Adult


  • Influenza Vaccines