Vaccinations administered during off-clinic hours at a national community pharmacy: implications for increasing patient access and convenience

Abstract

Purpose: Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience.

Methods: We retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am-6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours.

Results: During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions.

Conclusions: A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience.

Keywords: Immunizations; after-hours care; infectious diseases; pharmacy; vaccines.

Figure 1

Hourly distributions of vaccinations. Source: Walgreens pharmacy claims data, August 2011 through July 2012.

Figure 2

Vaccinations with the greatest proportion administered during off-clinic hours. Tdap = tetanus, diphtheria, and acellular pertussis; HPV = human papillomavirus; hepatitis = hepatitis A and/or B. ^a Vaccines for polio; measles, mumps, and rubella (MMR); meningitis; pneumonia; rabies; herpes zoster (shingles); and Japanese encephalitis. Source: Walgreens pharmacy claims data, August 2011 through July 2012.