1 Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA.
2 Department of Health Policy and Management, Texas A&M University, College Station, TX, USA.
Public Health Rep. 2018 Jan/Feb;133(1):55-63. doi: 10.1177/0033354917742117. Epub 2017 Dec 19.
One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15.
Using information from the Centers for Disease Control and Prevention's (CDC's) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states' laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups.
Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non-patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states.
Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue.
增加青少年对人乳头瘤病毒(HPV)疫苗的接种率的策略之一是利用药剂师。我们的目标是:(1)使用公共可用的数据库描述美国药剂师接种 HPV 疫苗的法定和监管权限;(2)讨论现行法律状况如何影响实现《2020 年健康人》中为 13-15 岁青少年接种 80%HPV 疫苗的目标。
利用疾病控制与预防中心(CDC)公共卫生法律项目数据库中的信息,我们确定了截至 2016 年 1 月 1 日生效的州法律,赋予药剂师接种疫苗的权力。我们使用标准化分析算法来确定各州的法律:(1)授权药剂师接种 HPV 疫苗;(2)要求第三方授权药剂师管理;(3)限制药剂师向特定年龄组的患者接种 HPV 疫苗。
在 50 个州和哥伦比亚特区中,有 40 个州的法律明确赋予药剂师向患者接种 HPV 疫苗的权力,但只有 22 个州的法律授权药剂师为 11 或 12 岁的青少年(即 CDC 推荐的年龄组)接种疫苗。有 5 个州赋予药剂师处方权,有 32 个州根据一般(非患者特定)第三方授权(例如,持照的医疗保健提供者)或 3 个州的患者特定第三方授权赋予药剂师权力。
大多数州仅允许药剂师为 11 岁或 12 岁以上的男孩和女孩接种 HPV 疫苗,这可能会阻碍实现《2020 年健康人》HPV 疫苗接种目标。应努力加强药剂师在解决这一公共卫生问题方面的作用。