Pharm Report Issue No. 14
Forward Pharmacy’s Pharm Report
Issue XIV
Respiratory Illness Preventing Vaccines are Here!
Influenza (AKA The Flu)
The new flu vaccines have arrived! The CDC recommends all people 6 months of age and older get a flu shot. For those who are 65 years of age or older, the CDC recommends an enhanced flu vaccine (Fluzone High Dose or Fluad), however if these vaccines are not available, it is okay to administer a regular flu shot. It is more important to not miss an opportunity to vaccinate than it is to give an enhanced flu vaccine.
New this year is the CDC saying that solid organ transplant patients 18 to 64 years old who are receiving immunosuppressive therapy may receive an enhanced flu vaccine. For more information, please visit the CDC website.
COVID
New COVID vaccines have also arrived! The CDC recommends everyone 6 months of age and older get the 2024–2025 COVID-19 vaccine. This includes people who have received a COVID vaccine before and people who have had COVID. Moderna, Pfizer, and Novavax have new formulations. For most people, a single dose will be considered up to date, regardless of vaccination status. Exceptions to this are unvaccinated young children and immunocompromised persons.
See Vaccines for Moderately to Severely Immunocompromised People for the most up to date information for this group of people and the CDC website for the full recommendations.
RSV
RSV is a frequent, often unrecognized, cause of severe respiratory illness in adults. Adults at the highest risk for severe RSV illness include older adults, adults with chronic heart or lung disease, adults with weakened immune systems, and adults living in nursing homes or long-term care facilities. CDC estimates that every year, RSV causes approximately 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths among older adults.
New vaccines to help prevent RSV were released last year, but there are updated recommendations for the RSV vaccination this year. The CDC now says all adults who are 75 years of age and older should get a dose of RSV vaccine.
Adults 60 to 74 years of age with the following risk factors should get a dose of RSV vaccine:
- Chronic cardiovascular disease (e.g., heart failure, coronary artery disease, congenital heart disease [excluding isolated hypertension])
- Chronic lung disease (e.g., chronic obstructive lung disease [COPD], emphysema, asthma, interstitial lung disease, cystic fibrosis)
- End-stage renal disease or dependence on hemodialysis or other renal replacement therapy
- Diabetes complicated by chronic kidney disease, neuropathy, retinopathy, or other end-organ damage, or requiring treatment with insulin or SGLT2 inhibitor
- Severe obesity (body mass index of 40 kg/m2 or greater)
- Chronic liver disease (e.g., cirrhosis)
- Neurological or neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness
- Chronic hematologic disorders (e.g., sickle cell disease, thalassemia)
- Moderate or severe immune compromise whether attributable to a medical condition or receipt of immunosuppressive medications or treatment
- Individual lives in a nursing home or other long-term care facility that provides assistance with activities of daily living (excluding independent senior living facilities and retirement communities)
- Individual has other chronic medical conditions or risk factors not listed above that might increase their risk of severe RSV disease
- Individual may be classified as frail
RSV vaccine is given as a single dose once. If the patient already had the RSV vaccine, they do NOT need another dose. For the full recommendations, please visit the CDC website.
RSV vaccination is covered under the Medicare program as a Part D (pharmacy) benefit, so please send your patients that are eligible for this vaccine to their pharmacy where they can get their flu and COVID shots as well and Shingles, Tdap, and Pneumococcal shots.
Many pharmacies operate at a loss when dispensing prescriptions and rely on vaccinations to help keep our doors open. Recommending vaccines be administered at a pharmacy is a great way to support local pharmacies! For more information or to book an appointment, please visit our website.
Prescription Tips
- ForwardHealth (Wisconsin Medicaid, Badgercare) has announced that Ozempic will return to non-preferred drug status effective December 1, 2024, requiring prior authorization, so be on the lookout for PA requests. As a reminder, all drugs in the GLP-1 class are diagnosis-restricted and require diagnosis codes on claims and PA requests.
- ForwardHealth will allow members to receive up to 2 at-home COVID tests at the pharmacy through their pharmacy benefit.
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