Pharmacists administering vaccinations...

[pinkyrx]

Just curious... Can pharmacists give vaccinations in your state? If so, can you give them as a student or do you have to wait until after graduation?

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[BuffaloPills]

Pharmacists can give immunizations in NC if they're certified, students cannot. I filled syringes last week for the pharmacist.

 

[firefighter9015]

In KY students become certified at the beginning of 3rd year and can give immunizations after that. Pharmacists also give them.

 

[ButlerPharm.D.]

Pharmacists can give immunizations in Indiana and Ohio.

 

[alwaystired]

In Nevada, pharmacists can give immunizations. Students can also become certified and give them under the supervision of a pharmacist that is certified to give shots. I gave about 50 shots at our last shot clinic.

 

[njac]

In New Mexico certified pharmacists may give immunizations. Starting our first year, students who are CPR certified, have done the blood borne pathogen training, and taken a vaccine workshop can vaccinate.

So for at the hospital, in the school, flu shot clinics 1st years (not yet interns) may give shots.

Once you're an intern (after end of 1st year) you can give shots out in public. I believe it's "under the supervision of a pharmacist"

 

[genesis09]

In Illinois both students and pharmacists can give any immunization to anyone over 14 years of age. You just have to pass the APhA course. We take the course beginning of P-4 year.

 

[JerryPharmD]

In Arizona, only pharmacists can to patients 18 and older. We are able to take the certification class when we are in school, but cannot give shots till we graduate.

 

[twester]

In Colorado, pharmacists and intern pharmacists can administer vaccines provided they've had training. I think the APhA training is the one that most do. As a P2, I've given about 15 vaccinations so far this season.

 

[PharmSDSU]

In South Dakota, P3 students and beyond can give vaccinations.

 

[soyroger]

In California the other P1s and I did out certification a few weeks ago, but haven't given any shots yet. Actually, I'm not sure if we will be administering any vaccinations besides the intranasal influenza (we'll do this as part of our IPPE hours).

 

[Farmercyst]

In California the other P1s and I did out certification a few weeks ago, but haven't given any shots yet. Actually, I'm not sure if we will be administering any vaccinations besides the intranasal influenza (we'll do this as part of our IPPE hours).

At SC they have it built into our coursework in our Pharmacy Practice Class. APha Immunization course is taught concurrently with CPR and immunization labs followed by bloodborne pathogens and Post exposure prophylaxis. Students are allowed to immunize under the supervision of an immunization certified pharmacists. We're actually required to perform at least 2 immunizations within the first semester.

 

[Shmy2008]

Pharmacists can give immunizations in NC if they're certified, students cannot. I filled syringes last week for the pharmacist.

Pharmacy students in NC can give immunizations if they are certified and administering the vaccine alongside a certified pharmacist with a physician protocol.

 

[dragonet]

In CA pharmacy students can administer the flu shot. I know some pharmacy students who went to community pharmacies and gave people their flu shots under the supervision of a pharmacist.

 

[Farmercyst]

In CA pharmacy students can administer the flu shot. I know some pharmacy students who went to community pharmacies and gave people their flu shots under the supervision of a pharmacist.

That's where I did mine. I was in a Sav-on for a flu shot clinic. 8 shots in 2 hours. They did 83 total in 5 hours.

 

[Quiksilver]

Bleeding heart New York is one of only 4 states that do not immunize. we lobby every year for it.....

some day i will be able to poke people with needles, until then.

 

[AmrieRX]

Which are the 4 states that do not allow you to immunize? is NJ one of them?

 

[sandyliu113]

Which are the 4 states that do not allow you to immunize? is NJ one of them?

What about Missouri?

 

[SpirivaSunrise]

Florida was one of them until a few months ago.

 

[sputnik25]

We (P1's) were certified within the first two weeks of school. I have given immuniztions several times since then, it has been fun.

 

[PharmDstudent]

I don't like the idea of it, personally. The combination of needle + patient + pharmacist is a little unnerving. I would hate to get stuck accidentally by a used needle. It would be unlikely, but it still happens.

 

[twester]

I don't like the idea of it, personally. The combination of needle + patient + pharmacist is a little unnerving. I would hate to get stuck accidentally by a used needle. It would be unlikely, but it still happens.

Needle-sticks are preventable. If a healthcare professional is giving injections with non-retractable needles, there's a problem. It's called an OSHA violation. Employers are required by law to provide employees with safer injection equipment. That's not limited to sharps containers, but includes self-sheathing needles.

And if employees/students aren't insisting on these devices - they're just as much at fault.

 

[tussionex]

haha....NY

 

[alwaystired]

Needle-sticks are preventable. If a healthcare professional is giving injections with non-retractable needles, there's a problem. It's called an OSHA violation. Employers are required by law to provide employees with safer injection equipment. That's not limited to sharps containers, but includes self-sheathing needles.

And if employees/students aren't insisting on these devices - they're just as much at fault.

prefilled flu vaccine, you have to use a needle that is not retractable. it sucks, but that's the vaccine we have.

 

[no-see-um]

haha....NY

NY has perhaps the most antiquated pharmacy law out there. For a 'progressive' state, it's definitely not up to date with the times... They'll give drivers licenses to Illegal immigrants before they'll let pharmacists immunize like the rest of the United States. Shows where the priorities are... I love New York, but this is important stuff.

 

[pinkyrx]

prefilled flu vaccine, you have to use a needle that is not retractable. it sucks, but that's the vaccine we have.

Are you talking about Fluarix? We are using needles that have a little cover that you slide down once the injection is given. It covers the needle immediately upon giving the vaccination, so it really does cut down on the risks.

 

[mtgirl]

West Virginia is one of the four states that do not allow it.

 

[pharmacogenomic]

I don't like the idea of it, personally. The combination of needle + patient + pharmacist is a little unnerving. I would hate to get stuck accidentally by a used needle. It would be unlikely, but it still happens.

I've given 2000+ vaccines - everything from influenza to yellow fever along with meningitis, polio, Adacel.....most everything.

The first 10 are unnerving - the rest are easy, altho Yellow Fever is a rough shot to give & receive!

Retractable needles are a must.

I don't use prefilled syringes unless thats the only way I can buy the vaccine.

Rule of thumb - take your time. Don't be rushed. Have a clear route from the pts arm to the sharps container. Put your lot# & exp down before you give the shot. Never put that used syringe down & make sure you don't have anyone between that arm & the sharps container.

Think of how many shots are given in a day all over the country. Drsdn gives 20+ in the mouth daily for over 30 years. He's never had a needle stick, so its all in your technique.

 

[bananaface]

Retractable needles are okay. They make noise when they retract, which bothers some patients. They are also harder to work with when drawing up doses (the needle likes to bend a little to the side) and tend to dull a bit.

 

[Caverject]

Retractable needles are okay. They make noise when they retract, which bothers some patients. They are also harder to work with when drawing up doses (the needle likes to bend a little to the side) and tend to dull a bit.

I had a pt yell at me cause she thought I left the retractable needle in her arm...

 

[Caverject]

I don't like the idea of it, personally. The combination of needle + patient + pharmacist is a little unnerving. I would hate to get stuck accidentally by a used needle. It would be unlikely, but it still happens.

I've been stuck with a used needle...it's not fun even though the odds of transmission are very low

 

[PharmDstudent]

I've been stuck with a used needle...it's not fun even though the odds of transmission are very low

I hope you don't vaccinate any of the lovely porn stars that you admire. That risk of transmission is probably much higher.
Don't they get paid more when they don't wear condoms?

 

[pharmacogenomic]

Retractable needles are okay. They make noise when they retract, which bothers some patients. They are also harder to work with when drawing up doses (the needle likes to bend a little to the side) and tend to dull a bit.

What needle are you using?

I draw up 100 doses before a clinic & don't get any bending. Are you entering at an angle?

How would you know if it dulls? You only use it once & going into a vial then into the epidermis is entirely different....as well as one epidermis from another. Its hard to know if its dull or not - I can't say I've ever experienced that.

The noise shouldn't bother if you use good "technique" - talk with them continuously & they won't hear anything, particularly since they are busy answering your question.

I usually get asked if I've given the shot.

 

[pharmacogenomic]

I had a pt yell at me cause she thought I left the retractable needle in her arm...

A tip to solve this problem & the concern some have that we might reuse needles.....keep one in your pocket in the overwrap.

Either show it to them before or after the injection has been given. Open the overwrap & show them how the needle works. Once they see the needle retracts after administration, they are confident.

Fear is a big motivator & its worth being prepared for that justifiable fear. Wasting a syringe for the trade off for confidence in you is well worth it, IMO.

I have had folks who don't want me to use a multidose vial - for fear of me inadvertantly contaminating the vial (altho the vial lasts the better part of 3-4 hours). For these folks, I use a prefilled pres. free syringe - fewer worries.

 

[Caverject]

I hope you don't vaccinate any of the lovely porn stars that you admire. That risk of transmission is probably much higher.
Don't they get paid more when they don't wear condoms?

I was actually showing someone how to dispose of their lancet in their diabetes meter...of course it got jammed and then I stuck myself cause I wasn't careful. Lesson learned...

Believe it or not, the person behind "Caverject" is nothing like personality of Caverject

 

[PharmDstudent]

Believe it or not, the person behind "Caverject" is nothing like personality of Caverject

???
that's incoherent

 

[bananaface]

What needle are you using?

I draw up 100 doses before a clinic & don't get any bending. Are you entering at an angle?

How would you know if it dulls? You only use it once & going into a vial then into the epidermis is entirely different....as well as one epidermis from another. Its hard to know if its dull or not - I can't say I've ever experienced that.

The noise shouldn't bother if you use good "technique" - talk with them continuously & they won't hear anything, particularly since they are busy answering your question.

I usually get asked if I've given the shot.

I don't remember the brand. It's been a year and I moved cross country and am no longer using that brand currently. You can tell the needle is duller b/c if you have to use a 2nd bottle of vaccine to draw from it's harder to penetrate the rubber with the needle. No angle. You just go in straight and sometimes it flops a bit, like the needle is not firmly in place in the center and it's not sharp enough to go in without more pressure. Crap, I say.

The sound ours made was sort of like a finger snap, hard to miss. I do distract people by talking and all that, but if you don't tell them there will be a sound, they get a little disturbed. I settled for "When you hear a little click, it's already done."

 

[CaliCPhT]

I was actually showing someone how to dispose of their lancet in their diabetes meter...of course it got jammed and then I stuck myself cause I wasn't careful. Lesson learned...

Believe it or not, the person behind "Caverject" is nothing like personality of Caverject

LOL.. nothing like a little Internet anonymity to assist in a new personality. I'm sure you're a stand-up guy. (excuse the pun)

 

[SpirivaSunrise]

Believe it or not, the person behind "Caverject" is nothing like personality of Caverject

I can attest to that...he's actually even more obnoxious in person

 

[PharmDstudent]

I can attest to that...he's actually even more obnoxious in person

Good job Spiriva! I needed the laugh.
There's nothing funny about phenoxybenzamine being a noncompetitive, irreversible alpha-1 and alpha-2 adrenergic blocker that inhibits the reuptake of released norepi by presynaptic nerve terminals. I would rather eat stale bread.
Although, the fact that yohimbine, which is an alpha-2 selective antagonist, has no clinical use is humorous, because it's a fast mover at my part-time retail gig.

 

[no-see-um]

I can attest to that...he's actually even more obnoxious in person

I second that!

 

[OHMAN0125]

In Nevada, pharmacists can give immunizations. Students can also become certified and give them under the supervision of a pharmacist that is certified to give shots. I gave about 50 shots at our last shot clinic.

As a student you may like to do it. But most pharmacists dont get extra pay for doing it, and it just makes the day more busy. So why do it? I used to be (still am I think) a pharmacist and my wife still is. Seems like alot of extra work on top of 300 Rx/day for $0.00

 

[museabuse]

In Arizona, only pharmacists can to patients 18 and older. We are able to take the certification class when we are in school, but cannot give shots till we graduate.

Arizona law is really stupid. Pharmacists cannot give a vaccination without a valid prescription from the patients doctor. So that means if a patient comes in and wants a flu shot you have to fax the dr and get a rx. Seems like a really big hassel... is this how it is in other states or can a pharmacist give a flu shot to someone that walks in right then and there without contacting any dr? If the pt does not have a primary care dr then basically they are out of luck.

That means you can't set aside a time and have a flu shot clinic... however nurses come into the pharmacies all the time and have clinics. Does that make sense?

Even if you get in with a dr and ask if someone comes in can I write an rx under your name and give a flu shot you can't do that because you would have to get a colaborative practice agreement and those are for special situations like coumadin dosing as far as I know you can't get an agreement to perform immunizations because the colabrative practice usually means you are seeing only drs patients usually flu shot clinics are just random people off the street.

So yes arizona does allow pharmacists to do vaccinations but it is very limited and a hassel and not worth it because we still need an rx (obviously only MDs can figure out if we should give someone a flu shot or not)

 

[KARM12]

As a student you may like to do it. But most pharmacists dont get extra pay for doing it, and it just makes the day more busy. So why do it? I used to be (still am I think) a pharmacist and my wife still is. Seems like alot of extra work on top of 300 Rx/day for $0.00

$0.00? Our flu shots have a 60% mark up...far more than we make on most 3rd party Rx's.

 

[PharmDstudent]

$0.00? Our flu shots have a 60% mark up...far more than we make on most 3rd party Rx's.

Yeah, $0 unless you own an independent pharmacy. It's just more stress if you're salaried or hourly without any type of commission, and since I'm not the type to drool over work parties, I'd be bitter too.
The chains just need to set up shot clinics in their area. That could really help the pharmacist who's filling more than enough scripts to stay busy.

 

[OHMAN0125]

Yeah, $0 unless you own an independent pharmacy. It's just more stress if you're salaried or hourly without any type of commission, and since I'm not the type to drool over work parties, I'd be bitter too.
The chains just need to set up shot clinics in their area. That could really help the pharmacist who's filling more than enough scripts to stay busy.

Yupyup

 

[pharmacogenomic]

As a student you may like to do it. But most pharmacists dont get extra pay for doing it, and it just makes the day more busy. So why do it? I used to be (still am I think) a pharmacist and my wife still is. Seems like alot of extra work on top of 300 Rx/day for $0.00

Well - first, we don't get paid by the rx - mostly on salary/hourly, etc....

If the rx count increases, so does our labor model - we get more staff to compensate - really no busier than any other day, particularly since the actual rx can be run anytime - it doesn't have to be run at the time you give the injection.

From the public health perspective, it is more available at a pharmacy than anywhere else. Just try to get into see a physician for a URI & you wait 5 days in my area (fortunately long enough for the URI to resolve), so a flu shot appt is waaaaay down there on the list of "needs to be seen" pts.

In my area, there are no nurses to give the injections. We have a huge shortage of nurses, so pharmacists do them.

Flu shots are a huge money maker for the corporation/pharmacy, altho the individual pharmacist doesn't make any more money.

Its also a way to get out there & talk to your patients about all sorts of things. You'd be surprised what comes up in that conversation. You build trust, credibility, reinforce accessibiliity & frankly spend the time with the patient the physician can't/won't.

As for students in CA giving them - yes they can, after training & certification. But, actually giving them will depend on whatever contractual arrangement the pharmacy/corporation has with the school. At that point, it becomes a matter of liability coverage the school carries for the student in an out-of-school setting. If I have an intern on a rotation, they can do it under my supervision. But, if I have an intern who is just working & not on a rotation, no they cannot, even if its the same intern. It gets complicated, but has to do with what our contract with the school is & whose liability coverage applies.

For pharmacists administering - be sure your liability coverage extends to injections - not all do. Even more important for those who don't carry their own coverage - make sure your employer liability covers extended services like these.

 

[OHMAN0125]

Well - first, we don't get paid by the rx - mostly on salary/hourly, etc....

If the rx count increases, so does our labor model - we get more staff to compensate - really no busier than any other day, particularly since the actual rx can be run anytime - it doesn't have to be run at the time you give the injection.

From the public health perspective, it is more available at a pharmacy than anywhere else. Just try to get into see a physician for a URI & you wait 5 days in my area (fortunately long enough for the URI to resolve), so a flu shot appt is waaaaay down there on the list of "needs to be seen" pts.

In my area, there are no nurses to give the injections. We have a huge shortage of nurses, so pharmacists do them.

Flu shots are a huge money maker for the corporation/pharmacy, altho the individual pharmacist doesn't make any more money.

Its also a way to get out there & talk to your patients about all sorts of things. You'd be surprised what comes up in that conversation. You build trust, credibility, reinforce accessibiliity & frankly spend the time with the patient the physician can't/won't.

As for students in CA giving them - yes they can, after training & certification. But, actually giving them will depend on whatever contractual arrangement the pharmacy/corporation has with the school. At that point, it becomes a matter of liability coverage the school carries for the student in an out-of-school setting. If I have an intern on a rotation, they can do it under my supervision. But, if I have an intern who is just working & not on a rotation, no they cannot, even if its the same intern. It gets complicated, but has to do with what our contract with the school is & whose liability coverage applies.

For pharmacists administering - be sure your liability coverage extends to injections - not all do. Even more important for those who don't carry their own coverage - make sure your employer liability covers extended services like these.

Public health wise it's a good idea. But you gotta understand in Long Island where you do ~400 Rx in one day by urself with 1 tech and 1 cashier the added burden to give shots is BS without more pay. Prolly one reason why RPh's cant give shots in NY, most school admins push it but many more retail RPh are against it.

 

[genesis09]

At the pharmacist flu shot clinics I've been to, they normally have one or two pharmacists doing the shots, and another one doing regular work. If you do it my appointment, they normally try for a non-busy time.

 

[alwaystired]

At the pharmacist flu shot clinics I've been to, they normally have one or two pharmacists doing the shots, and another one doing regular work. If you do it my appointment, they normally try for a non-busy time.

yep, appointment at a slow time. after dark at my elderly store....