Dear Colleague,
It’s been a busy week on the COVID front that is going to translate into a busy fall as flu season approaches. Here are some things to consider about each of this week’s announcements and how they may impact clinical and business aspects of your practice.
Immunocompromised patients should receive a third mRNA COVID vax dose – The first question I asked and maybe you did too: Which patients are defined as “immunocompromised?” CDC provided some additional clarity under “Who Needs An Additional COVID-19 Vaccine?” and in calls with health care organizations including NCPA. There are seven million patients who are immunocompromised. Importantly, the definition of immunocompromised is not rigid. CDC has advised that patients who believe they are immunocompromised must attest that they believe they are. For pharmacists who give a third dose to patients who have attested they are immunocompromised it is recommended that you document the patient’s attestation for audit purposes (here’s an example of one state’s attestation form) and record why the patient believes they are immunocompromised. For example, the patient might have recently been undergoing chemotherapy or is taking a biologic that can suppress their immune system. CDC emphasized that the recommendation for immunocompromised is for a third primary series shot, not a booster shot, however, a few days later the CDC announced …
mRNA booster shots starting Sept. 20 — The Biden administration is planning for booster shots to be recommended for all adults eight months after they have completed the COVID series of mRNA vaccines. This is big news for pharmacies watching the calendar. Looking back eight months from Sept. 20 to January and February 2021, it was mostly the LTC and over-65-year-old populations that were able to access the vaccines. Independents in many states had limited access to vaccines and by the time supply began to flow more freely, LTC patients had been vaccinated via Walgreens or CVS, and many seniors had been herded into mass vaccination sites. That’s not the case this time around. Plus, the Medicare and most Medicaid COVID vaccination reimbursement rates did not increase until March 15—after most Medicare patients had already been vaccinated. Now those patients will need a booster and, this time, they can be vaccinated at your pharmacy.
LTC employee COVID vax requirements — In yet another COVID-related announcement in a busy week for the Biden administration, news broke that CMS would announce that all LTC personnel will be required to get vaccinated, or the facility will lose Medicaid and Medicare funding. Does that include consultant pharmacists or pharmacy delivery personnel? It may. NCPA is looking into that question and how else pharmacy may be impacted.
Flu season — The post-eight-month period for mRNA COVID shots will end for many patients smack dab in the middle of flu season. The CDC says it is OK to give a COVID shot and a flu shot at the same time. Pharmacies will have the opportunity to promote the availability of flu and COVID shots as a “one and done” visit to their local pharmacy. Workflow, staff training, vaccination storage space, and patient scheduling will be important considerations. Predictions about this flu season are all over the map. Some say the flu season will be worse because it was so light last year, so people didn’t build up resistance. Trying to get an advance preview of the flu season by looking at the southern hemisphere’s winter season, Australia’s flu season was unbelievably low, but they have been in lockdown longer than the U.S. So, will flu season be worse or better than normal? It’s a coin flip, but one way for patients to hedge their bet is to get a flu shot. Where better than your pharmacy?
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
