Getting Patients Immunized Against Pneumonia Is Important

With all the talk about COVID-19 vaccines and flu season approaching, it is almost easy to forget the importance of the pneumonia vaccine. The good news is that pneumonia vaccinations are increasing. According to the National Health Interview Survey, from 2000-2018¹:

• percentage of adults aged 65 to 74 years who had ever received pneumonia vaccine increased from 48% to 64.8%,
• percentage of adults aged 75 to 84 years who had ever received pneumonia vaccine increased from 59.5% to 74.9%, and
• percentage of adults 85 years and older who had ever received pneumonia vaccine increased from 56.4% to 76.3%.

What Is Pneumonia?

Pneumonia is a lung infection involving 1 or both lungs. Pneumonia causes the air sacs of the lungs to fill with pus or fluid. Symptoms vary in severity, depending on factors such as cause of the infection, the patient’s age, and other medical conditions. Bacteria (usually Streptococcus pneumoniae in the United States) are the most common cause of pneumonia, which can occur on its own or secondary to a viral infection. Pneumonia may be viral or fungal. Fungal pneumonia occurs more often in patients who are immunocompromised or have other chronic health problems.²

Available Vaccines and Scheduling

The CDC’s Advisory Committee on Immunization Practice (ACIP) recommends vaccination to prevent pneumococcal disease (any illness caused by S pneumoniae). There are 2 vaccines available in the United States^5,6:

• pneumococcal conjugate vaccine (PCV) 13 (Prevnar 13; Pfizer)—pneumococcal conjugate vaccine for intramuscular (IM) or subcutaneous injection; prevents pneumonia caused by Spneumoniae serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, and 33F8

ACIP recommends the following for pneumococcal vaccination^5,6:

• PCV13 for all children under 2 years, individuals 2 or older with certain medical conditions, and adults 65 or older who are not immunocompromised and do not have a cerebrospinal fluid leak or cochlear implant
• PPSV23 for all adults 65 or older, individuals aged 2 to 64 years with certain medical conditions, and adult smokers aged 19 to 64 years

Regimens vary based on individual circumstances. For adults 65 and older who are not immunocompromised and do not have a cerebrospinal fluid leak or cochlear implant, a standard regimen is 1 dose of PCV13 first, followed by 1 dose of PPSV23 at least 1 year later.

Pneumococcal vaccine 20-valent (Prevnar 20; Pfizer) was approved by the FDA in June 2021 and is anticipated to be available in August 2021. The ACIP is expected to meet in October to review recommendations for vaccination.⁹

Getting Patients Vaccinated

Globally, pneumonia kills more children younger than 5 each year than any other infectious disease.¹⁰ About 50,000 individuals die due to pneumonia each year; most are adults.¹⁰

Pharmacists have the resources and knowledge to provide vaccines to patients who need them. What are some ways we can help get the word out to our patients? Bruce Kneeland is an independent pharmacy specialist based in Prescott, Arizona, and host of the popular Pharmacy Crossroads podcast. He has helped independent pharmacies for over 40 years.

Kneeland is a longtime advocate of pharmacy immunizations. Kneeland acknowledged that some pharmacists may be apprehensive about conflicts with physicians. He recommends finding ways to assure physicians that the goal is not to steal patients but to provide a critical service

that pharmacists are qualified to deliver. “Reach out to key physicians in your immediate area and let them know you’re vaccinating,” Kneeland said. “Explain that you are trained, have the infrastructure to support vaccine administration, and you look forward to cooperating with them to help people get the vaccines they need.”

Pharmacists may also contact their key technology partners to find out how they can identify who needs a specific vaccination by accessing their state’s Immunization Information System, Kneeland said. From there, pharmacists can approach targeted patients with a quick consult in person, asking, “Have you gotten your pneumonia shot yet?”

According to Kneeland, patients often require time to consider the need for vaccination. Pharmacists should not be discouraged if a patient visits the pharmacy 2 or 3 times before agreeing to receive the vaccine. Pharmacists can also send text messages, emails, or snail mail to targeted patients about the importance of the pneumonia vaccine, suggesting that they ask to speak with the pharmacist on their next visit.

Importantly, pharmacists should become comfortable talking to patients who may be in a hurry or are unsure why they need a particular vaccine, Kneeland said. Keeping up with available vaccines and new ones on the market helps pharmacists stay current and able to address patients’ questions Kneeland also suggests setting up a designated area for vaccine administration in the pharmacy.

Bridget Hanna, CPhT, a marketing consultant for independent pharmacies in the United States and Canada, noted that pharmacists can utilize various marketing platforms and resources to develop a successful plan for promoting the pneumonia vaccine. “To effectively educate patients on these topics, you need to create content on multiple platforms,” Hanna explained.

“Social media is an extremely effective way to deliver your message to multiple target audiences. You need to create different forms of content to provide information on the vaccine,” Hanna said.

She suggests live videos, educational posts, webinar events, and links to the pharmacy’s website or to a PDF with important information. Hanna also recommends strategically placed in-store signage, printed material, newsletters, bag stuffers, and email marketing. “This brings awareness to the vaccine and lets patients know that your pharmacy can provide a solution by vaccinating patients,” she explained.

Keeping the community and patients updated, educated, and supported is of utmost importance. “The more you communicate with your patients and community with this information, the more you build trust and loyalty, resulting in long-term retention,” she added.