Frank Beard, University of Sydney
Pharmacists are vaccinating more and more people, but those shots are not always ending up in your immunisation record, our report out today shows.
This means your records could be incomplete, leading to unnecessary repeat vaccinations, or it could affect your eligibility for government benefits or work.
Incomplete records also mean health authorities cannot accurately monitor vaccination uptake across the population.
And if we have a vaccine for COVID-19 delivered through pharmacies, accurate record keeping will be important for both individuals and health authorities.
Pharmacy vaccination is popular and becoming more so
Our report, by the National Centre for Immunisation Research and Surveillance, shows pharmacy vaccination is becoming more popular.
In 2017, it accounted for 0.1% of all vaccinations reported to the Australian Immunisation Register. However, by 2019, that had risen to 2.7%, the vast majority (95%) of those influenza vaccine.
Pharmacists have also been allowed to give a wider range of vaccines to younger people over recent years. For instance, appropriately trained pharmacists in all states and territories can give:
- influenza vaccine to anyone aged 10 years or over
- measles-mumps-rubella (MMR) or diphtheria-tetanus-pertussis (dTpa) vaccine to anyone aged 16 years or over.
The rules for other vaccines vary depending on the state or territory you live in.
What we found
In NSW and the ACT it’s mandatory for pharmacists to report vaccinations to the Australian Immunisation Register. It’s strongly encouraged in other states and territories.
However, we found substantial under-reporting of pharmacist vaccinations.
Pharmacies are said to have administered over one million influenza vaccinations in 2018. That’s ten times more than the number we found recorded in the Australian Immunisation Register that year.
In 2019, there were reported to be over two million influenza vaccinations in pharmacies, four times more than actually recorded.
Why does this matter?
Under-reporting of pharmacy vaccines is less of an issue for influenza vaccination, which is needed every year. But it is more important for vaccines only needed in one or two doses or at long periods apart, such as the two doses of MMR vaccine.
And as pharmacy vaccination expands to travel vaccines – such as cholera and hepatitis A (which can both now be given by pharmacists in Queensland) – having an accurate immunisation record is important when travel restrictions ease. It’s likely a long time between overseas trips and remembering which vaccinations you’ve had can be difficult.
As pharmacist vaccination expands to include younger ages and vaccines on the National Immunisation Program (the series of vaccinations given at specific times throughout your life) there’s greater potential for confusion if records are not complete. Any unrecorded vaccinations could affect certain government support or access to child care under No Jab No Pay or No Jab No Play policies.
An accurate record of vaccinations can also be important to meet requirements for some university courses and jobs, particularly related to health care.
It’s not just pharmacists
Generally, vaccines given to young children (who are mostly vaccinated in GP clinics) are reliably recorded, but our 2018 report found some reporting errors. So it pays to check.
Reporting of adult vaccinations has been less reliable. Another of our recent reports showed true vaccination uptake for the shingles vaccine, largely given in GP clinics, could be up to twice as high as that recorded in the Australian Immunisation Register.
Many vaccinations given in workplaces – for instance hospitals and commercial providers of workplace influenza vaccination programs – are also not currently captured in the Australian Immunisation Register, although such vaccination providers can now register to report them.
How can you check your immunisation record is accurate?
If you are getting a vaccination from a pharmacist, or any other vaccination provider, you can check they will be reporting it to the Australian Immunisation Register and ask for a paper record of the vaccination.
You can then later request an immunisation history statement, which shows all the vaccinations recorded on the Australian Immunisation Register. You can do this via your Medicare online account (through myGov), the Express Plus Medicare mobile app, the Australian Immunisation Register help line (1800 653 809) or your vaccination provider.
If vaccinations are missing, you can contact the relevant vaccination provider and ask them to update your Australian Immunisation Register record.
What can we do about it?
Ultimately, it shouldn’t be your responsibility to regularly check your immunisation records are accurate and up to date. It should be the responsibility of the vaccination provider to report your vaccinations to the Australian Immunisation Register.
So we recommend further education and training for pharmacists, legislation to make Australian Immunisation Register reporting by pharmacists compulsory in all states and territories; and increasing and improving use of electronic reporting methods.
How about a vaccine for COVID-19?
If a COVID-19 vaccine becomes available, we will likely need a mass immunisation program to vaccinate as many people as possible. Pharmacists may be part of this program. Legislation in Queensland is being amended to allow for this.
Hopefully, by then, we will have addressed some of these issues.
Kaitlyn Vette, Lauren Dalton and Kristine Macartney, from the National Centre for Immunisation Research and Surveillance, contributed to this article.
Frank Beard, Senior Lecturer, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
