• Assessing Adherence to the Tetanus, Diphtheria and Pertussis Vaccination Guidelines at a Federally Qualified Health Center Before and After a Clinical Pharmacist Intervention

      Kennedy, Amy; O'Brien, Dawne; Santa-Cruz, Ashley; Kennedy, Amy; College of Pharmacy, The University of Arizona (The University of Arizona., 2014)
      Specific Aims: Tetanus, diphtheria, and pertussis are diseases, which are preventable through proper vaccination. In spite of the availability these vaccines, however, there has recently been a surge in the number of pertussis cases in the United States. The objective of this study is to determine provider adherence to tetanus, diphtheria and pertussis guidelines set forth by the Advisory Committee on Immunization Practices in a primary care setting before and after a clinical pharmacist intervention. Methods: A retrospective cohort of chart reviews was conducted between January 1 – September 30, 2013 to determine immunization adherence to tetanus, diphteria, and pertussis vaccination guidelines. A clinical pharmacist then preformed a series of cross-sectional chart reviews as an intervention. Following the intervention, a retrospective chart review was conducted to evaluate if Tdap vaccination rates improved between March 17-23, 2014. Main Results: Overall immunization rates greatly improved following the intervention (p<0.0001; x2=44.988). For non-pregnant adults between the ages of 19-64 the vaccination rate improved from 26% to 61.1% (p<0.0001; x2=47.07). A statistically significant improvement was not seen in the groups with patients 65 or older or pregnant women (p>0.05). Tdap vaccination status was appropriately evaluated and vaccinations given by primary doctors improved from 17.7% to 61.2% and those prescribed by nurse practitioners improved from 22.4% to 56.3%. Conclusion: Intervention by a Clinical Pharmacist helped improve overall provider adherence to the tetanus, diphteria, and pertussis vaccination guidelines.
    • Litigation and Vaccination Manufacturer Security Price Returns

      Skrepnek, Grant; Herbert, Shane; College of Pharmacy, The University of Arizona (The University of Arizona., 2005)
      Objectives: To quantify the initial short-term market response of product liability litigation in appellate courts against vaccine manufacturers between 1987 and 2003. Methods: This project used a retrospective data analysis. The study analyzed appellate court decision found searching the legal research section of Lexis-Nexis® between 1987 and 2003. A single index market model was used to examine an event window of (-1, +1) and calculate a cumulative abnormal return for one of three categories; outcome in favor of the plaintiff, outcome in favor of the defense, or case dismissal. Results: Overall, this study investigated vaccine-related litigation. Thirty-three lawsuits were found involving 12 separate parent companies and ultimately lead to 82 separate incidences. A majority of the cases involved litigation concerning thimerisol (n =12, 36%). Following inclusion and exclusion criteria for the appellate court rulings, 9 cases were in favor of plaintiff, 10 cases were in favor of the defense, and 14 cases were dismissed. Appellate rulings favoring the plaintiffs were found to be negative and statistically significant, with cumulative abnormal returns equaling -1.39% during the (-1,+1) event window (p < 0.05). The mean cumulative abnormal returns for rulings favoring the defense or case dismissals were statistically insignificant at 0.49% and -0.29%, respectively Implications: Product liability litigation against vaccine manufacturers can produce significant negative short-term security price returns, which can be a disincentive for corporations to invest in vaccine development and production.