Resolution 4: Immunizations

Introduced by: George L. Bradley, DO – Delegate, Gaston County Medical Society

Referred to: Reference Committee No. 1 – Timothy M. Beittel, MD, Chair

WHEREAS, immunizations are an important part of preventative health care, and physicians are trained in the administration of immunizations; and

WHEREAS, retail stores including pharmacies do not have access to 24 hour interventions and adverse effects could be detrimental and possibly life-threatening to patients; and any adverse effects of immunizations given elsewhere would then need be addressed by a physician, who has inadequate information as to the specific vaccine given, the technique (good or otherwise) of administration, and who may have to deal with a substantial delay in care; and

WHEREAS, many children only present to the physician for routine preventative visits when due for immunizations; and

WHEREAS, young and older patients not keeping visits for routine preventative visits is counterproductive; therefore be it

RESOLVED, that the North Carolina Medical Society opposes the administration of immunizations by pharmacists or other non-physicians in locations not having a physician in attendance. (policy)

Fiscal Note: No additional funding above current resources estimated. Current resources will be allocated based on the priorities of the Society and the NCMS budget.

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7 Comments

  • freeman jackson MD

    Access issues outweigh concerns for follow-up/improper technique.

    Good training programs for pharmacists can combat this effectively.

    A central registry is paramount.

  • While we understand the spirit of this resolution and remain concerned about efforts to expand pharmacists scope in this arena, we cannot support this resolution as written. Pharmacists currently are permitted to administer influenza, pneumonia and zoster vaccines under certain circumstances. The NC Medical Society, along with the NC Pediatric Society and the Academy have all worked diligently on this very issue. Our three associations have recommended — as outlined in existing NC General Statutes and as done in the past — that the three appropriate boards (Medical Board, Pharmacy Board, Nursing Board) study the issue to determine what, if any, immunizations are appropriate to administer in a pharmacy. We believe this is the most appropriate venue for further study of this issue. These comments come on behalf of the NCAFP Delegation to the House of Delegates by Dr. Brian Forrest, Dr. Shannon Dowler and Dr. Tom White.

  • Sandra Brown

    I too oppose this resolution for the same reasons given above. In addition, I have heard from many primary care acquaintances that administering vaccines is a money losing service for them. There is no reason why we should obligate them to provide immunizations if other resources have figured out how to do it in a cost effective manner. The greater issue is tracking immunizations and we do need a central vaccine registry.

  • Michelle jones

    While I agree / support this resolution, I do recognize the shortage of primary care providers in all areas of the state. We also need to realize that childhood immunizations are accompanied by developmental exams which pharmacists are not trained to do. Adults also get screenings for other illnesses such as high blood pressure. We should work to make it easier for providers to give immunizations (Better reimbursement for dedicated staff) and eliminate the need for pharmacists to give immunizatios.

  • Frank Smeeks, MS, MD, MBA

    I oppose this resolution. If we were to survey our hospitals, hospital owned medical groups, and private physicians we would find the immunization rate abysmal. The fact remains that convenience is the number one predictor of increased immunization rates. Remember what a difference it made in the hospitals when the roving carts were implemented to give workers on all shifts immunizations because the workwell clinics only operated from 9 to 5? Very few if any will wait 2 hours in the waiting room with sick patients to get a flu shot from, oh, the PA or Nurse practitioner….

  • Robert Monteiro, MD

    I oppose this resolution. It would restrict access. In the event of a pandemic where mass immunizations would need to take place, such a policy would be problematic. The slippery slope is in the ever expanding scope of immunizations the pharmacists as seeking to deliver. Therefore we must continue to monitor the types of services that pharmacists and others want to provide.

  • Dale Fell

    I oppose this resolution. Access is a huge issue across the state, but especially in the western part of the state. Our estimate is that in the eighteen western counties, we are at least 140 primary care physicians short.

    Immunization a are very important and expanding access by allowing pharmacists to administer them far outweighs the risk in my opinion. Few primary care offices are open 24 hours daily and the patient is advised by the answering service to go to the ED where the physician has no information from the primary care office.

    What’s the difference?