We Can Address Vaccine Equity

The COVID-19 pandemic has changed certain aspects of our lives forever. New concepts like social distancing, masking and working from home have become a part of our everyday vernacular. We found new ways to provide health care via telehealth, educate our students virtually and shop over the past year.

Unfortunately, the pandemic has also highlighted an issue that the U.S. health care system has struggled with for decades – health disparities and the lack of actionable policy solutions, leading to inequitable health care access and outcomes across the country.

As COVID-19 vaccines continue to be distributed and more Americans are vaccinated every day, the reality is that equitable access to immunization is not yet a reality, according to data published by the American Action Forum earlier this year. It is laudable that policymakers and public health leaders have taken steps to help build vaccine confidence and encourage acceptance, not just to protect against COVID-19 but for all vaccine-preventable diseases. However, there is more that policymakers can do to expand access to health care and specifically vaccination in communities that are home to patients of diverse ethnic and racial backgrounds.

One approach to address this national access issue is to allow the most accessible community health care professionals — pharmacists — to have equal authority with physicians when administering vaccines for all adults and appropriate adolescents in the United States. After all, pharmacists are the most accessible health care professionals in the country: There are more than 67,000 pharmacy locations, which is more than four times the number of Starbucks locations.

Pharmacists are already valuable members of patients’ health care teams and the least costly alternative for immunizations. During the height of the pandemic, pharmacists were also one of the primary health care professionals in the community with direct access to patients on a regular basis. Pharmacies are open in the evening and on weekends, making them easier to reach for those whose work schedules aren’t as flexible.

The data is clear — pharmacists are one of our best assets if we intend to help protect the most vulnerable patients. A study published in 2018 in the Journal of American Medical Association concluded that for Medicare patients, the median number of visits to community pharmacies was significantly higher than encounters with primary care physicians. Another study published in the Journal of Pharmacy Technology examined the experiences of Black Americans with pharmacy-based services. The study’s authors found that an overwhelming number of patients “prefer to receive their vaccinations from a pharmacy, as opposed to their doctor’s office, because it was easier to access the pharmacy of their choice from their residence.” More recently, POLITICO reported based on Federal Emergency Management Agency data that the retail pharmacies are far outpacing the mass vaccination sites in administering the COVID-19 vaccine.

Prior to the pandemic, adult vaccination rates in the United States were well below Healthy 2020 targets set by the U.S. Office of Disease Prevention and Health Promotion. During the pandemic, unfortunately, Centers for Disease Control and Prevention data showed a continued decline in vaccination rates for older adults covered by Medicare. The data is worse among patients with diverse ethnic and racial backgrounds.

As the U.S. Department of Health and Human Services and the CDC set forth new immunization goals for Healthy 2030 to help improve adult immunization rates, policymakers will be wise to address equitable access to immunization through enhancement, expansion and harmonization of state laws governing the practice of pharmacy. Pharmacists should have the authority to administer all U.S. Food and Drug Administration-approved and CDC Advisory Committee on Immunization Practices-recommended vaccines for all adults and appropriate adolescents.

Health care and immunization equity are not only a matter of fairness. These are also important societal goals that can help, for example, to slow the spread of vaccine preventable diseases such as COVID-19 in diverse communities where infections, hospitalizations and deaths have been higher during the pandemic. One of the easiest ways to overcome this barrier is to employ commonsense solutions to get more Americans fully vaccinated through the most accessible community health care professional — the pharmacist.


Robert Popovian is chief science policy officer at Global Healthy Living Foundation and senior health policy fellow at Progressive Policy Institute. Dave Hering is regional president, North America, for Pfizer Vaccines.

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