To boost vaccination rates, empower pharmacy technicians

The U.S. Department of Health and Human Services (HHS) recently issued nationwide guidance allowing qualified pharmacy technicians and state-authorized pharmacy interns to administer childhood vaccines, COVID-19 vaccines, and COVID-19 tests. The new policy represents an important step forward as the country anxiously awaits a coronavirus vaccine.

The guidance comes at a time when routine childhood inoculation rates are down, testing is nowhere near where it should be, and potentially hundreds of millions of people are going to need to be vaccinated against COVID-19 before the country can return to any semblance of normalcy. In anticipation of a new vaccine coming online, policymakers face a critical task: creating a regulatory environment that enables rapid delivery to an apprehensive American public.

The support staff at pharmacies can play a critical role here. Technicians and interns are employed in a variety of settings, including retail and institutional environments, as well as sometimes working in a telemedicine context. They often play a customer-facing role, filling prescriptions and collecting and maintaining accurate medical records, but they also assist pharmacists behind the scenes with activities such as preparing medications, maintaining inventory and other operational tasks.

The roles and duties of these support staff were already expanding, even before the pandemic hit and put added strain on the health care system. That’s not especially surprising given that both pharmacy technicians and interns undergo specialized training and have, or are working towards, certification or specialized degrees. When support staff can safely take on more responsibilities, pharmacists themselves are freed up to do more — such as, in some cases, making use of increased prescribing authority. By improving the internal division of labor within the pharmacy, more customers can access pharmacy services more quickly and at reduced costs. The result is a win-win for patients.

One recent study looked at laws pertaining to whether pharmacy technicians can perform inoculations. The authors found that a majority of states — 41 — directly or indirectly prohibit the administration of immunizations by pharmacy technicians. Additionally, as of 2016, 32 states dictate a pharmacist-to-pharmacy technician ratio, which caps the number of support staff a licensed pharmacist can oversee at any given time, often including interns.

The new HHS guidance will override some state restrictions related to vaccinations — at least temporarily. However, the country needs long-term solutions, and a few states are already paving a path forward.

Idaho, Rhode Island, and Utah are examples of states to recently allow pharmacy technicians to administer vaccinations, and there is evidence their approach works.

Allowing technicians to take on these responsibilities has been perceived to improve workflow within the pharmacy, as well as morale. Supervising pharmacists have generally been found to have favorable views about having an immunization-trained technician on staff. Another study found that pharmacy technicians have been successful at screening patients to see if they have been immunized and then following up with those who have not, with the result being an increase in provided immunizations.

Washington and Idaho were ahead of the curve when it comes to their pharmacist-to-technician ratio requirements. Both eliminated their ratio requirements before the pandemic hit, leaving them better prepared for the current emergency. Now, other states are playing catch-up, relaxing unnecessary health care rules in the midst of a crisis, with technician and intern ratio requirements among them.

The new HHS guidance is the latest development in an ongoing trend towards empowering America’s health care workforce. Pharmacy technicians and interns are capable of safely performing vaccinations with reasonable levels of supervision. When a Covid-19 vaccine becomes available, let’s makes sure they can hit the ground running. That means eliminating any barriers that stand in their way.

James Broughel is a senior research fellow and Yuliya Yatsyshina is a program manager for Academic & Student Programs with the Mercatus Center at George Mason University. They are coauthors of the policy brief “Relax Pharmacy Regulations to help with COVID-19 Testing and Treatment.”