Vaccine underreporting rife in pharmacy

vaccine vaccination needle

More vaccines were reported by three pharmacy banner groups in 2019 than recorded on the AIR by all pharmacy providers that year, new data shows

Pharmacists are substantially under-reporting vaccine administration, a new National Centre for Immunisation Research and Surveillance report has shown.

Between 2016 and 2019, there were 576,780 pharmacist vaccinations recorded with the Australian Immunisation Register – the majority of which (78%) took place in 2019.

Pharmacist vaccinations accounted for 1.2% of the total encounters recorded in AIR from all providers over the 4 years and for 2.7% in 2019.

However, data from the AIR and stakeholder interviews for the study have suggested “substantial” underreporting of pharmacist vaccinations to AIR.

“Of the pharmacies that are registered with jurisdictions as offering vaccination services, the data from 1 July 2018 to 30 June 2019 indicate that only half are supplying valid vaccination data to AIR,” the report concluded.

“From stakeholder interviews, more vaccines were reported to have been administered in 2019 by three banner groups combined than were recorded in AIR for all pharmacy providers in that year.

“In addition, pharmacy peak bodies have reported that over 1 million influenza vaccinations were administered in pharmacies in 2018 and over 2 million in 2019 –10 and 4 times more than those reported to AIR, respectively.”

Anthony Tassone, Victorian branch president of the Pharmacy Guild, highlighted that the NCIRS report “also made note that there are gaps in recording in the AIR patient records amongst other immunisers and professions, and uptake can take some time from first introduction”.

“The Guild fully supports the use of AIR and recommends community pharmacies record the vaccination services they deliver for patients,” he said.

“This is not only best practice, but also strengthens the case for pharmacists practising to their full scope of practice and training in being able to deliver a wider range of vaccinations to a more people in the community, including younger patients – along with having consistent and wide spread access to the National Immunisation Program.”

He said the Guild will continue to invest in technology and innovation such as GuildLink to assist its members and their teams in delivering quality health care.

The study found that the number of reported pharmacist vaccinations increased every year during the period, with 25 in October to December 2016 and 14,464 in 2017 (the first full year studied), moving up to 449,719 in 2019.

“The significant uptake by the public to pharmacist immunisations, particularly during the COVID pandemic where access to influenza vaccinations may have been challenging if medical centres were not conducting face-to-face consultations – is nothing short of a success story,” Mr Tassone said.

“It’s also a clear indication of the crucial role and not fully tapped opportunity that community pharmacies bring in helping increase overall vaccination rates in the community.”

The study also found that some reported pharmacist vaccinations were outside the profession’s scope of practice: “Some reported pharmacist vaccinations involved a vaccine (n=487) and/or administration to an age group (n=519) that are not permitted in any jurisdiction.”

Overall, the highest number of pharmacist vaccinations was reported in Victoria (147,757) and the highest rate in Western Australia (5,182 per 100,000 population).

The highest number of pharmacist vaccinations was in those aged 50–59 years (24.3%) and the highest age-specific rate was in those aged 60–64 years (5,515 per 100,000).

A majority of reported pharmacist vaccination encounters occurred in major cities (62.2%), while the highest rate was seen in regional areas (3,077 per 100,000).

As for the type of vaccine administered, most pharmacist vaccinations were for influenza (545,928; 94.7%). Other vaccines administered included diphtheria-tetanus-pertussis (4,6%), meningococcal ACWY(0.6%)and measles-mumps-rubella (0.1%).

The report made a number of recommendations to improve pharmacist vaccination data in AIR, including further education of pharmacists and increasing and improving use of electronic reporting through practice software systems that integrate directly with AIR.

NCIRS is currently undertaking a further study to better understand the barriers to, and enablers of, pharmacist vaccination reporting and to more accurately estimate the current completeness of pharmacist vaccination reporting to AIR. 

Read the full report here.

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