Closing the Immunization Gap: Using the RE-AIM Framework to Assess a Pharmacy-Led Initiative Lauren Mikell, Courtney E. Gamston, Greg Peden, Kimberly Braxton Lloyd Auburn University Clinical Health Services -Auburn, AL
Background/Purpose: Vaccinations are critical to prevent illness and complications, while reducing the burden on the healthcare system. Despite these known benefits, immunization uptake in Alabama remains low. Triggered in June 2025 by the CDC’s expanded recommendation for Respiratory Syncytial Virus (RSV) vaccination to individuals aged 50–59 years old with risk factors, an employer-based pharmacy implemented a targeted initiative to close immunization gaps in individuals identified based on pharmacy dispensing records and immunization history.
Methodology: In a one closed-door pharmacy, dispensing records in combination with Alabama Immunization Patient Registry with Integrated Technology (ImmPRINT) were used to assess the need for immunization. In alignment with recommendations for RSV vaccine receipt, patients aged 50 to 74 years taking an SGLT-2 inhibitor, sacubitril/valsartan, insulin, or maintenance inhaler, and those aged 75 and older were identified and reviewed for need for immunization. Patients who had not received their recommended vaccinations were contacted via telephone and invited to the pharmacy for vaccination. Informed by the results, a second round of identification and review was completed for patients aged 50 to 59 years that had not received a pneumococcal immunization through the pharmacy. The RE-AIM implementation science framework was utilized to assess the implementation of this process. Outcomes included Reach: the number of patients identified, reviewed, and contacted; Effectiveness: the number and percentage vaccinated, number and types of vaccines administered; and Implementation: adherence to the protocol and opportunities for improvement.
Results: From August 2025 to March 2026, 363 identified patients were reviewed. A total of 1,291 vaccines were identified as due. Contact was attempted for 284 patients, with 131 successfully contacted (46.1%). Among those reached, 63 (22.2%) expressed that they were either not interested in vaccination or not interested in receiving their vaccines at the clinic and 36 (12.6%) patients reported intention to call the clinic later to schedule their vaccinations. Out of the 252 vaccines recommended to patients via phone, 113 were accepted. As of April 1st, 52 vaccines have been administered in the clinic.
Conclusions: This method was effective for identifying individuals with gaps in immunization receipt. However, the rate of filling those immunization gaps remains low. Over 40% of patients were unreachable via telephone, necessitating investigation of other models of informing patients of their immunization needs. The ability to contact patients to convey the need for vaccination and provide education simultaneously may aid in increasing rates of immunization and strengthen engagement with the service.
