Expansion of pharmacist vaccinations

Another Australian state has expanded the scope of pharmacist-administered vaccinations this month, meaning pharmacists can help to protect the community against more infectious diseases like meningococcal.

Since 1 August, pharmacists in Western Australia (WA) can now administer additional vaccines to those aged 16 years and over against dTpa (diphtheria, tetanus, and pertussis), MMR, (measles, mumps and rubella) and meningococcal (ACWY).

‘I am delighted at our WA Minister for Health the Hon. Roger Cook’s announcement that will see trained pharmacists administering MMR, dTpa and meningococcal ACWY vaccinations,’ said Dr Fei Sim, Senior Pharmacy Lecturer at Curtin University, PSA WA Branch President, and recent recipient of the PSA ECP of the year award. 

‘This great news came after the announcement in June this year which lowered the pharmacist-administered influenza vaccination age restriction from 18 years down to 10 and above. These are excellent initiatives of the WA Government to protect more of those who live in or are travelling to WA against vaccine-preventable diseases,’ she said.

Meningococcal is a rising threat in Australia,^1,2 and globally there have been outbreaks of measles.³ Dr Sim said the role of pharmacists as vaccinators helping ensure herd immunity is now more important than ever.

‘We’re talking about opportunistic vaccination with these diseases. We are encouraging people who are normally healthy to get the vaccine,’ Dr Sim said. 

‘Healthy people don’t think about vaccines or going to their GP, but community pharmacists can reach these people, considering the convenience, the accessibility, and the credibility of pharmacists. We’re leveraging the convenience, and in most cases,  it will be a more cost-effective way to get someone vaccinated.’ 

Preventing meningococcal disease

While Neisseria meningitidis is a common respiratory tract commensal, it has the potential to cause invasive meningococcal disease, typically presenting as septicaemia and meningitis.

Incidence is relatively low in Australia, but cases have been increasing recently, with five serogroups – A, C, W, Y and B – accounting for the majority of cases. According to the Federal Health Department, Australia sees 1.1–1.5 cases of invasive meningococcal disease per 100,000 people.² 

Cases of the disease have been steadily increasing since 2013. In 2017, cases in Australia hit 1.5 per 100,000, the highest incidence since 2007.⁴

While pharmacist-administered vaccination for meningococcal disease is only available to people 16 and over, the meningococcal ACWY vaccine is available under the National Immunisation Program for infants (12 months) and adolescents (14–16 years). 

The vaccine is suitable for anyone who wants to be protected against the meningococcal disease, but especially those at higher risk of contracting the disease or of suffering severe complications. 

‘People who are immunocompromised, babies, young children, adolescents, and those living in close quarters, for instance, or people who have regular contact with such groups,’ said Dr Sim.

While side effects such as injection site reactions, fever, lethargy, and headache can occur with the vaccine, Dr Sim said it’s important for pharmacists to remind people that the benefits of vaccines outweigh any minimal chance of patients experiencing a serious adverse effect. 

‘Of course, pharmacists should always advise patients to come back to the pharmacy or see their GP if they notice any adverse effects or experience any symptoms post-vaccination which worry them,’ Dr Sim said.

Improving public health

As pharmacists are Australia’s most accessed health professionals,⁴ Dr Sim said they play an important role not only in vaccine administration, but also increasing the community’s health literacy. 

‘Pharmacists have regular contact with the community and play an important role in this public health issue, increasing the community’s awareness about the importance of vaccinations and, in this case, providing advice regarding the meningococcal vaccine and encouraging vaccination uptake,’ Dr Sim said.

Pharmacy administered vaccines have been steadily growing in Australia, with different states and territories allowing progressively more vaccines to be administered by appropriately trained community pharmacists.

Tasmania has extended its meningococcal ACWY vaccine program through 2019, with community pharmacists also able to administer vaccines. By September 2018, 47% of the state’s eligible cohort had been vaccinated under the program.⁶

‘We should really leverage the convenience that community pharmacists can offer to deal with such public health issues, and I think the other states should follow WA’s lead. We are one nation. Why should people in other parts of Australia not have the same level of access?’ Dr Sim said. 

‘I’m a big advocate for a national approach to achieve consistency, but it is great to see WA leading the way with this important initiative.’ 

Complete PSA’s Immunisation Update 2019 for a comprehensive overview of the influenza, diphtheria-tetanus-pertussis and measles-mumps-rubella vaccines:
https://my.psa.org.au/s/detail/a110o000007wImR

References

1. Government of Western Australia Department of Health. Statewide notifiable diseases weekly report. At: https://ww2.health.wa.gov.au/Articles/F_I/Infectious-disease-data/Statewide-notifiable-diseases-weekly-report
2. Sharma K, Chiu C, Wood N. Meningococcal vaccines in Australia: a 2019 update. Aust Prescr. 1 August 2019. At: https://www.nps.org.au/australian-prescriber/articles/meningococcal-vaccines-in-australia-a-2019-update
3. The Department of Health. Measles Outbreaks 2019. April 2019. At: https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-measles-outbreaks-2019.htm
4. The Department of Health. Meningococcal Disease. April 2019. At: https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-meningococcal-W.htm
5. The Pharmacy Guild of Australia. Submission to the Legal and Social Issues Legislation Committee, Inquiry into Community Pharmacy in Victoria. 2014. At: https://www.parliament.vic.gov.au/images/stories/documents/council/SCLSI/Community_Pharmacy/Submissions/Sub_13_Pharmacy_Guild_of_Australia_30062014.pdf
6. Tasmanian Government Department of Health and Human Services. Department of Health Meningococcal ACWY Immunisation Program. September 2018. At: https://www.dhhs.tas.gov.au/menw/home/2018_tasmania_meningococcal_acwy_immunisation_program_-_progress_report_one