Pharmacist led vaccination rates in opioid addicted obstetric patients

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JACCP Journal of the American College of Clinical Pharmacy


Objective: To evaluate whether patients seen at the Women's and Infants Substance Help Center (WISH) are in compliance with the 2016 Advisory Committee on Immunization Practices (ACIP) recommendations for influenza, tetanus/diphtheria/pertussis (Tdap), pneumococcal-23, hepatitis A, hepatitis B, and human papillomavirus (HPV) vaccines. Methods: In a retrospective cross-section chart review, all patients with at least two WISH visits from September 1, 2014 to January 22, 2017 were included in the analysis. The primary objective evaluated compliance with ACIP recommendations. Data extraction included baseline demographics, patient-specific vaccine indications, and vaccine history. Results: Ninety-nine patients receiving buprenorphine (n = 80), methadone (n = 14), or no therapy (n = 5) from September 1, 2014 to January 22, 2017 were included. On average, patients were 28 years old and had the first visit at 19 gestational weeks (range 6-35). Overall, WISH vaccination compliance was high for influenza (66%) and Tdap (86%) as well as the initial doses of hepatitis A (80%), hepatitis B (77%), and HPV (46%) vaccines. No difference was found between patients receiving buprenorphine and methadone. Patients who had at least 1 pharmacist consultation (n = 90) had significantly higher compliance with the initial doses of hepatitis A (92.1% vs 22.2%, P <.0001) and hepatitis B (86.4% vs 11.1%, P <.0001), and influenza vaccines (71.6% vs 33.3%, P <.0001) compared to those who did not (n = 9). Common reasons for vaccine non-compliance were patient refusal, did not return to the clinic, or missed opportunity by the non-pharmacist healthcare professional. Conclusions: Overall clinic vaccination rates were high and implies that pharmacy intervention significantly increased administration rates for hepatitis A, hepatitis B, and influenza vaccines. Clinical trial registration:,, NCT 03039725.

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