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The Perfect Flu Storm: New Jersey Lowers Minimum Age for Pharmacists to Administer the Influenza Vaccine

ID-100228288A few months ago I started dating this woman from the greater Philadelphia region. Needless to say, she’s amazing – full of spunk, sass, and strong character (and she’s quite beautiful too!). Our relationship has gotten to the point that, as men, we internally shudder to contemplate – meeting her family. Although I met them in not the most desirable circumstances, I met her sister, to which my girlfriend forewarned me about. Sure enough, her hype about her sister was dead-on. As soon as she found I was from New Jersey, the grilling came. Although my defenses prove to be of no benefit to me (but a comical scene for her dad), I enjoyed the humor and am glad to be a resident of New Jersey. Yes, we have circles and jug-handles; yes, we go by exits and drive obnoxiously; and yes, we ARE stronger than the storm. As a pharmacist licensed in New Jersey, I now have one more reason to be grateful for being licensed in New Jersey – the recent signing of A-3251/S-2567.

When I checked my e-mail a few days ago, I was elated to find out that Governor Christie signed the above bill into law. So what, another law? Yes, but one that will prove to be beneficial for New Jersey citizens during the next flu season. Presently, New Jersey pharmacists can administer flu vaccines to anyone over the age of 18; A-3251/S-5267 has now reduced the minimum age to 7. Any patient under 18 receiving the flu vaccine from pharmacists must obtain parental consent; furthermore, pharmacists may immunize patients between 7 and 11 pursuant to a prescription from an authorized prescriber.

After reading about this bill, I have considered this bill and would like to offer several thoughts:

1. I’m delighted to see New Jersey legislators noticing the manifold benefits pharmacists play in offering immunizations. Aside from convenience (i.e. walk-in without setting up an appointment), pharmacists continue to be one of the most trusted professionals based on a Gallup study conducted in 2012. Moreover, New Jersey requires pharmacists to complete an immunization program endorsed by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). In 1996, the American Pharmacists Association (APhA) rolled out their immunization program which the CDC and ACIP endorsed. In this 20 credit-hour course, pharmacists are educated about vaccinations, immunology, disease-preventable vaccines, how to safely administer vaccines, recordkeeping requirements, and more. This program sponsored by APhA establishes pharmacists as equally competent as physicians. Along with completing this program, New Jersey pharmacists are to complete 2 continuing education credits every biennial license period in immunizations in order to maintain their immunization license.

2. As mentioned in the e-mail, New Jersey is now the first state to lower the minimum age requirement to that extent. I consider this aspect a major legislative success for pharmacists in relation to immunizations. The signing of A-3251/S-2567 can prove to be mutually beneficial for pediatric healthcare providers, their patients and caregivers, and their communities. Instead of parents having to schedule an appointment with their pediatrician or primary care physician, they can now consider having pharmacists provide these immunizations. With that advantage, however, there are some other factors to consider.

3. Some states have patient-age limitations based on the minimum age of states that pharmacists can administer vaccines to. Prior to Christie’s signing, anyone 18 and over can receive an immunization administered by a pharmacist in New Jersey. Although the minimum age requirement for patients receiving the flu vaccine is now reduced, are pharmacists ready to take on administering vaccines to children and adolescents? They may be competent in administering flu vaccines to adults – even those who are deftly afraid of needles! But what about children who are prone to be more fidgety or express their fright towards needles and getting a shot? What about the risk of a liability? Are pharmacists ready to take on that challenge? Training pharmacists to safely administer flu vaccines to pediatric patients is mandatory; the sooner that pharmacists can be trained in pediatric immunization administration, the better prepared pharmacists are in administering flu vaccines to pediatric patients.

4. I’m slightly confused about how pediatric patients between 7 and 11 years of age are to receive a prescription for receiving a flu vaccine. Can parents simply walk into their doctor’s office and request that prescription? Will there be a separate protocol for pediatric patients receiving the flu vaccine? I suppose only time will tell how pediatric patients between 7 and 11 will receive these prescriptions?

5. Although lowering the minimum age requirement means a higher volume of patients and profit, how will A-3251/S-5267 affect workflow efficiency? Adjudicating flu vaccines is done similarly to prescriptions through a third party provider, but there are more stringent recordkeeping requirements for flu vaccines. Training pharmacy technicians in assisting pharmacists with recordkeeping and adjudicating flu vaccine prescriptions is necessary in order to uphold workflow efficiency, patient safety and privacy, and customer satisfaction. Furthermore, from a corporate standpoint, this may put corporate in an uncomfortable but necessary position to have another pharmacist at least staff for a few hours in order to uphold workflow efficiency (especially for pharmacies that have one pharmacist on during the whole day like yours truly).

6. While upholding the risks for New Jersey pharmacists in relation to administering flu vaccines to patients 7 years old and older, this can have tremendous benefit. If done correctly, my hope is New Jersey legislators noting the vital role pharmacists play as providing immunizations to pediatric patients 7 years old and older. If New Jersey legislators permit pharmacists to administer any vaccine to any patient 7 years old and older, this means pharmacists can administer the MCV4 vaccine for meningitis (and again when they turn 16), the three-dose regimen of HPV vaccine, and the Tdap vaccine. Pharmacists can register on the New Jersey Immunization Information System and track proper compliance to patients receiving any vaccine; placing pharmacists in this position will result in a higher completion rate of adolescents receiving the HPV vaccine regimen, and a higher quality of life for our youngest patients.

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Last Updated February 2014
Image courtesy of Sura Nualpradid / FreeDigitalPhotos.net

Brian J. Catton, Pharm.D. (6 Posts)

Brian Catton is a dual-licensed pharmacist in New Jersey and Pennsylvania, pursuant to obtaining his third pharmacist license in Washington DC. He is currently a member of the New Jersey Pharmacists Association and the Pennsylvania Pharmacists Association. His specialties include hypertension, hyperlipidemia, diabetes, medication therapy management, pain management, and public relations. He recently accepted an offer to practice pharmacy outside the Cherry Hill, NJ region.


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