Influenza Activity and Vaccine Effectiveness During the 2021-2022 Season

Influenza viruses typically circulate in the Northern Hemisphere during the winter and spring, but they occasionally can circulate more during the summer months, as did the 2009 H1N1 pandemic strain

The Burden of Vaccine-Preventable Diseases in Adults

The CDC reports that a low trend for influenza, human papilloma virus (HPV), pneumococcal, hepatitis B (for health care providers), and herpes zoster vaccinations continues to persist among adults.4 These poor vaccination rates could be attributed to gaps in insurance coverage, personal beliefs, and disparities in access to vaccines. As a result, the burden of vaccine-preventable diseases translates into significant social, public health, and economic costs within our society

Back-to-School Immunizations

Further, in 2012, more than 41,000 pertussis cases and 18 deaths due to pertussis were reported to the CDC, also the largest number of cases in the United States since 1959.2 Most vaccine-preventable diseases are contagious and can be serious in children and adults with whom they have contact. Therefore, it is important that school-aged children are up-to-date on all annual immunizations prior to each school year

Authority and Scope of Vaccination: How States Differ

Despite all this, vaccine rates still fall short of desirable goals, such as those outlined in the Healthy People 2020 national initiative.7 Although the CDC and APhA promote the “immunization neighborhood” concept, meaning all appropriate professions should coordinate, communicate, and collaborate to increase immunization rates, challenges are still evident for pharmacies.8 One major factor is the variability in state laws and regulations that govern vaccine administration by pharmacists.5 Significant regulation differences limit which vaccines are permitted, which age groups of patients can be immunized, and which practice model pharmacists may operate under.

2018-2019 ACIP Immunization Updates: Highlights for Pharmacists

Vaccinations have significantly reduced the burden of infectious diseases, preventing almost 6 million deaths worldwide.1,2 In the United States, vaccines have led to a decrease in incidence of vaccine-preventable illness, mortality, and disease sequelae.3 Despite the proven benefit of vaccines, misinformation and failure to vaccinate has led to outbreaks of vaccine-preventable diseases. As of December 29, 2018, 372 cases of measles (from 17 outbreaks) and 2251 cases of mumps were reported in the United States in 2018.4,5 These outbreaks support the need for continued education of patients and active immunization by pharmacists

Drug Interactions with Antimalarial Medications in Older Travelers: A Clinical Guide

Increasingly older adults are traveling to international destinations with malaria as a present risk. Surveillance systems indicate that older adults are more likely to suffer severe complications from malaria. The role of health care providers in selecting an appropriate medication for chemoprophylaxis or treatment of malaria in adults becomes more difficult as older adults undergo physiologic changes that alter the pharmacokinetic and pharmacodynamic nature of medications potentially causing increased drug interactions, adverse events, and altered drug action. A comprehensive literature search from 1970 to present, with a focus on the last 10 years, was conducted on drug interactions, pharmacokinetic and pharmacodynamic effects on antimalarials in adults. It was determined that due to pharmacodynamic and pharmacokinetic changes in older adults, especially renal and cardiovascular, special attention should be given to this population of travelers in order to minimize the likelihood of adverse events or altered drug efficacy. Antimalarial-disease interactions in older adults can occur more often due to QT prolongation, exacerbation of hypoglycemia, decreased renal elimination, and decreased hepatic metabolism. Older antimalarials have well documented drug-drug interactions. Tafenoquine, a new antimalarial, requires G6PD screening like primaquine and monitoring of new potential drug interaction with MATE1 and OCT2 substrates. While drug-drug interactions in older travelers may occur more often as a result of poly-pharmacy, data does not indicate adverse reactions or decreased drug efficacy is greater compared with younger adults. Overall, with the exception of recently approved tafenoquine, much is known about antimalarial drug and disease interactions, but new drugs are always being approved, requiring travel health providers to understand the pharmacokinetics and pharmacodynamics of antimalarial drugs to predict the impact on safety and efficacy in travelers. This guide provides travel health providers with valuable insights on potential outcomes associated with drug interactions in adults and recommended monitoring or drug regimen modification

Characteristics and Predictors of Patient Care Performed by Clinical Department Chairpersons at U.S. Schools of Pharmacy

Background Clinical pharmacy or pharmacy practice departments at schools of pharmacy are usually composed of practicing pharmacy specialists. There is little known about the requirements for and frequency of patient care provided by clinical department chairpersons. The primary objective of this study was to determine the likelihood that pharmacy practice chairs engage in patient care. A secondary objective was to identify those factors predicting chairperson participation in patient care activities. Methods A brief 22-item adaptive response survey was sent to clinical department chairpersons at schools of pharmacy in the United States. Initial identification of chairs came from the American Association of Colleges of Pharmacy (AACP) with verification by school websites. Surveys from schools without a clinical chairperson (or similar position) were excluded, as were surveys from schools with Ph.D. department chairpersons from blended departments (ie, Clinical with Outcomes/Policy Sciences). Results Of the 128 eligible schools\u27 department chairpersons, 113 completed the surveys (88.3% response rate). Forty-four (38.9%) chairs reported that they maintain an active clinical practice even though 103 (91.1%) report it is not required. Factors that had a significant association with clinical practice were clinical service being an expectation (P = .0004), having a practice prior to becoming chairperson (P = .001), having a higher clinical service expectation (P \u3c .0001), and having a lower administrative percentage (P = .0003). Age, rank, and academic track were not significant predictors. Of those with clinical practice, sites included community (45.4%), acute care (38.6%), primary care (4.5%), and other settings (11.4%). A majority of those with practice reported providing direct patient care (81.8%) or indirectly via supervision of students or other trainees (61.4%). Conclusions Most schools of pharmacy do not require clinical department chairpersons to maintain a patient care practice, but many still choose to practice. Those that practiced before becoming a chairperson and have a lower administrative burden are more likely to continue to provide patient care

New Vaccines in the Pipeline 2019

Before clinicians can administer a vaccine in the United States, the FDA must approve and license it. Investigators conduct extensive research leading up to this process, typically testing a vaccine in thousands of patients over 6 to 7 years or longer. Even with large sample sizes and rigorous study designs, rare adverse effects may be missed. For example, RotaShield, the first vaccine for rotavirus, was withdrawn from the market in 1999, despite being tested in more than 10,000 patients. Postmarketing surveillance demonstrated that a rare, yet serious, risk of intussusception was linked to the vaccine, and the FDA determined that the vaccine’s risks outweighed its benefits

Use of Virtual Games for Interactive Learning in a Pharmacy Curriculum

Background and purpose: To evaluate student pharmacists’ attitudes and satisfaction toward playing educational virtual games in the classroom. Educational activity and setting: The study setting was playing virtual games in the classroom setting. First year student pharmacists participated in two Mimycx quests in the Healthcare Communication and the Psychiatry/Neurology courses. Students were randomly assigned into teams and worked together to complete the assigned quest games. Completion of the pre- and post-quest questionnaires via Qualtrics was voluntary. Findings: A total of 79 student pharmacists played the Mimycx quests. Only 66 students completed both pre- and post-quest questionnaires. Students indicated their familiarity with game concepts related to the virtual environment and avatars used in the study. The change in their attitudes and satisfaction about the Mimycx virtual learning experience was significant between the two learning time points. Discussion and summary: The use of virtual gaming technology could enhance student pharmacists’ learning and engagement in the classroom. Students benefitted from increased familiarity with virtual, educational gaming concepts in their experiences with Mimycx although no statistically significant differences were found regarding their attitudes toward communication and teamwork

Implementing Pharmacy-Based Travel Health Services: Insight and Guidance from Frontline Practitioners

PURPOSE In California, the passage of SB493 in July of 2013 was a milestone in advancing pharmacy practice. Among other things, the new legislation allows pharmacists to provide routine immunizations without a protocol and furnish medications for international travelers for conditions not requiring a diagnosis. When developing a pharmacist-run travel health service, consideration must be given to multiple important factors, including pharmacist training, physician partnership, logistics, from scheduling to documentation, and the resources necessary to provide a travel health service.5 This article sets out to provide guidance and insight to pharmacists seeking to implement a travel health service. SUMMARY Travel health requires providers with knowledge regarding epidemiology, transmission, and prevention of travel-associated infectious diseases, a complete understanding of vaccine indications and procedures, and prevention and management of noninfectious travel-associated health risks. Pharmacists seeking to implement travel health services need to seek out appropriate resources for pharmacist training, workflow and logistical considerations, and travel health-specific resources to optimally provide this service. CONCLUSION The traveling population is at significant risk for travel-related diseases, but only a small number actually get the advice, vaccines and medications they need. With the passage of SB493 in California, the 40,000 registered pharmacists and 6,000 pharmacies across California could provide the essential access, convenience and expertise that a growing traveling population needs to stay healthy while abroad. Whether in a community pharmacy or ambulatory care clinic, pharmacists must ensure they can provide or arrange for personalized, comprehensive travel health services