The effect of a prescription order requirement for pharmacist-administered vaccination on herpes zoster vaccination rates

Vaccine. 2019 Jan 21;37(4):631-636. doi: 10.1016/j.vaccine.2018.12.003. Epub 2018 Dec 15.

Abstract

Objective: To determine the effect of a prescription order requirement for pharmacist-administered zoster vaccination on zoster vaccination in adults aged 60+.

Methods: A 50-state law review of statutes and regulations regarding pharmacists' ability to administer the zoster vaccine with/without a prescription order was performed. States were classified as prescription order required or not required as of January 1, 2014. Data on adults aged 60+ were obtained from the 2014 Behavioral Risk Factor Surveillance System (BRFSS). Chi-square tests and multilevel logistic regression models with and without propensity scores methods were used.

Results: Of the 50 states, 39 and the District of Columbia did not require a prescription order. After propensity score matching, zoster vaccination rates for adults ages 60 and older were significantly higher in states that did not require a prescription order (23.0% vs 21.1%, p = 0.0022). The propensity score-matched multilevel logistic regression model for adults aged 60+ found modestly higher odds of HZ vaccination for states that removed the prescription order requirement (OR 1.17, 95% CI 1.01-1.35). Similar estimates were found across other methodologies employed and age strata, although statistical significance varied.

Conclusions: Prescription order requirements are associated with HZ vaccination rates. By removing a prescription order requirement, states may be able to promote increases in HZ vaccination in adults aged 60+.

Keywords: Complex survey data; Herpes zoster; Pharmacy; State policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Behavioral Risk Factor Surveillance System
  • Chi-Square Distribution
  • Community Pharmacy Services
  • Cross-Sectional Studies
  • Female
  • Herpes Zoster / prevention & control*
  • Herpes Zoster Vaccine / administration & dosage*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Pharmacists*
  • Prescriptions*
  • Propensity Score
  • United States
  • Vaccination / legislation & jurisprudence
  • Vaccination / methods*

Substances

  • Herpes Zoster Vaccine