Hospital Ambulatory Pharmacy Successfully Completes RZV Vaccination Pilot Program

The program administered 60 vaccines to patients referred by their primary care physicians.

Because administration of the recombinant shingles vaccine (RZV) during an outpatient clinic visit is not covered by Medicare Part D, clinicians often must refer patients to receive this important vaccine at an outside pharmacy. – a practice that creates challenges around close monitoring and creates a cost-based approach. challenges.

Researchers at Tufts Medical Center in Boston, Massachusetts, implemented a herpes zoster (HZ) administration program to alleviate these difficulties. The results of the program were shared in a poster presented at the American Society of Health-System Pharmacists 2022 Summer Meetings and Expos in Phoenix, Arizona.

Over a 3-month period (January to March 2022), clinicians working in an adult primary care clinic sent patient referrals for RZV administration to a designated Certified Pharmacy Technician (CPhT) who worked at hospital outpatient pharmacy. The CPhT was responsible for documenting these references; determining patient costs and contacting patients to disclose those costs; and schedule vaccination appointments. Patients were then advised immunized at the HZ Clinic by a pharmacist.

Administration of the RZV vaccine was documented in the patient’s electronic medical record. Patients also completed an 8-question survey to document their experience.

During the 3-month pilot period, 151 outpatient referrals were made; 50 patients received their first dose of RZV and 10 patients received their second. The most common reason a patient was not scheduled was the inability of the CPhT to reach the patient. In the patient survey, 96% of patients responded that their overall satisfaction had improved.

The researchers also hoped to use the proposed pilot program as a way to increase the number of Massachusetts pharmacists meeting immunization criteria by completing an American Council on Pharmaceutical Education (ACPE)-accredited training course, an ongoing certification of CPR and 2 hours of PACE- approved continuing education in immunization every 2 years. Results showed that the number of staff pharmacists who met Massachusetts immunization criteria increased from 2 to 5 pharmacists over the course of the program.

“The expansion of services in the inpatient outpatient pharmacy has benefited the adult primary care population at [Tufts Medical Center] and also improved the ability of clinicians…to confirm that their patients received the [HZ] vaccination,” the researchers wrote. “With the conclusion of a successful pilot period, this program has the potential to expand to serve a larger patient population and offer a greater variety of vaccinations.”


Flaspohler NK. Implementation of a vaccination program against shingles. Presented at: American Society of Health-System Pharmacists 2022 Summer Meetings and Exhibition; June 11-15, 2022; Phoenix, AZ.

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