By Ken Lutes
You may have seen postings in grocery and drug stores announcing the availability of shots for flu or shingles. But did you know pharmacists immunize adults and children for many other diseases, such as polio, measles, tetanus and whooping cough?
In the late 1990s, the state of Colorado began to allow pharmacists to administer immunizations. Since that time, programs like the one at Regis University’s School of Pharmacy have required its students not only to learn about the science of medications but also to apply those skills in a clinical setting.
Doctors Christine Feltman and Robert Haight are assistant professors at Regis who share a passion for teaching students and for sharing information about the expanding role pharmacists play in today’s world of medical science.
Feltman says that people might be surprised to know just how deep the pharmacist’s clinical knowledge is.
“The stereotype is that pharmacists are tucked away in the back, just counting out pills by fives and labeling pill bottles, but that’s not the case. The pharmacist can also fill in gaps in education the patient might have regarding the full extent of a medicine’s attributes.”
Haight brings to Regis his specialty of leadership and assessment, to assure that students are learning what they should be learning.
“I teach pharmacy students about leadership and management. Not only business leadership, but also how they can lead by counseling patients and be a leader among peers. Working in the pharmacy, you’re also working with techs and other pharmacists.”
Because many immunizations impact children, Haight and Feltman also work with an immunologist, who examines cost savings to society – both indirect costs and direct costs, such as emergency-room visits.
Most Colorado counties belownational average for immunizations
Both Haight and Feltman stress the importance of vaccinations, but they also recognize that some people don’t want their children immunized for personal or religious reasons.
“In those instances,” Feltman said, “it’s important to be respectful of that position, to ask what are their fears and concerns that are holding them back and see if we can provide them with the information needed to help them better understand why these vaccine-preventable diseases need to be controlled.”
Haight added that student coursework includes teaching students how to talk to patients who are vaccine-hesitant.
“We have to build a relationship based on respect for that person’s position,” Feltman said. “If it’s for a medical or religious reason that’s not going to be changed, we can’t judge a person for that.”
“We are seeing an increase in mumps,” Haight said. “Where we had seen six to seven cases, now there about 70 per year. Immunization rates in Colorado could be higher.” “Pertussis (whooping cough) is another vaccine-preventative disease that has spiked,” Feltman said.
According to a report by the Colorado Children’s Immunization Coalition, medical costs for preventable diseases cost the state of Colorado $35 million in 2015; and nearly 25 percent of Colorado kids have not had recommended vaccines.
Sometimes misinformation can persuade people not to have their children vaccinated. Haight said there was a study released a while back that said vaccinations were the cause of autism.
“That study has since been retracted, but the media latched onto that at the time, and people still think it’s true.”
Feltman knew in high school that she wanted a career in pharmacy.
“My father is also a pharmacist. I was passionate about patient care from the beginning, and I thought, ‘How will I impact patients and take care of people?’”
She received her Pharm.D. from the University of Colorado School of Pharmacy in 2005 and began her career with Target (Target pharmacies were recently bought out by CVS). Although she had been trained to provide immunizations, Target pharmacists were not then administering them; rather, they had nurses coming in to provide shots to patients.
The role of pharmacists as clinicians
A couple years into her role at Target, Feltman and four colleagues set up the pharmacist-led program for providing immunizations for the entire Target company.
“We piloted it in Colorado in our pharmacies, then went into Minnesota and expanded it across the nation,” she said.
Feltman said that Colorado began allowing pharmacists to issue immunizations in the late 1990s; at that time they could only administer to adults.
“We have evolved to a point under Colorado state law that says pharmacists can provide immunizations for any age, including babies. But corporations – Walgreens, CVS and others – can set their own minimum age limits. “CVS is currently three years old and up. Safeway is four and up.”
“Our pharmacy curriculum is designed to teach our students to become clinicians. We don’t diagnose – that’s what physicians are for – so how do we help to complement a given medical situation? Our students are required to not only understand what happens to the body but also to understand the classifications of medicines and how those medicines work in the body to correct the issue.”
Recently, Colorado passed a law that permits pharmacists to prescribe smoking-cessation products and oral contraceptives, Haight said. At this point, pharmacists can otherwise only manage self-care medications by providing information about what over-the-counter remedies might be best to treat a given problem.
Feltman and Haight are passionate about educating the public about pharmacists and how they can be utilized as part of the health care team and provide what patients sometimes need to more successfully manage their chronic diseases. The next time you pass the pharmacy inside your local grocery store, they advise, stop a moment to consider what medical information you might need.
While it may be true, as Feltman says, that we don’t walk around in the grocery store and think, “Gosh, I wonder how I’m doing on my immunizations,” she and Haight would like to alter that mind-set and encourage folks to ask about the other immunizations that are available to them.