The aim of this paper is to review pharmacy laws and regulations, pharmacist training, clinic considerations, and patient care outcomes regarding pharmacy-based travel health services in the United States. Pharmacists and pharmacies in the United States are highly visible and accessible to the public, and have long been regarded as a source for immunization services. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services, including routine and travel vaccinations, as well as medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. A literature review was undertaken to identify published articles on pharmacist- or pharmacy-based travel health services or care in the United States. The results of this paper show that pharmacists can help to increase access to and awareness of the need for these services to ensure that patients remain healthy while traveling abroad, and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be made to ensure that they have the necessary training, education, and skill set in order to provide this specialty level of care, and that their practice setting is optimally designed to facilitate the service. While there is little published work available on pharmacy or pharmacist-provided travel health services in the United States, outcomes from published studies are positive, which further supports the role of the pharmacist in this setting.

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs using the limited demographic and health history available from the screening forms. Descriptive statistics are presented, characterizing patient demographics and health condition-based recommendations, and the percentage of patients in a pharmacy population that may have potential indications for additional vaccines. Data were collected from 8669 pharmacy vaccine screening forms. Using the patient’s date of birth on the screening form, 10% (n = 759) and 34.6% (n = 2615) of patients receiving vaccines at the pharmacy may be indicated for the zoster, or both the zoster and pneumococcal vaccines, respectively. Screening form questions that inquire about medical history are also able to identify 13.9% (n = 977) of patients with a potential need for pneumococcal vaccines. Our data indicate that pharmacists can identify potential immunization opportunities proactively by using their immunization screening form, not only to identify contraindications, but also indications.

Pretravel consultation by healthcare providers (HCPs) with travel medicine expertise can mitigate travel-related health risks. This analysis aimed to understand US-based HCPs' pretravel consultation educational gaps, priorities, barriers, and opportunities. An electronic survey was conducted May-June 2024, using a convenience sample of HCPs identified through the Med Learning Group and travel specialists from the International Society of Travel Medicine and American Society of Tropical Medicine and Hygiene. In total, 205 HCPs completed the survey, including physicians (50 %), nurse practitioners (19 %), nurses (12 %), pharmacists (11 %), physician associates (7 %). Most (66 %) provided pretravel consultations and only 21 % held formal travel medicine certification. HCPs not providing pretravel consultation were less comfortable with traveler's diarrhea self-treatment, malaria chemoprophylaxis, altitude illness prevention, yellow fever, Japanese encephalitis, rabies, and typhoid vaccination management. The most desired topics for education were travel vaccinations (94, 46 %), travel medicine insurance (89, 43 %), and altitude illness prevention (86, 42 %). Major barriers to providing pretravel consultation were lack of clarity about reimbursement (110, 54 %), lack of insurance coverage (89, 43 %), and inability to stock travel vaccines (73, 36 %). Top interventions suggested to increase access to and awareness of pretravel consultation included primary care physician education and community outreach. Most HCPs were interested in pretravel educational opportunities, but comfort varied by experience and certification, highlighting need for targeted training, especially for primary care providers. Top barriers were insurance coverage for pretravel consultation and access to travel vaccines, underscoring critical gaps in the US healthcare system.

Pharmacists and pharmacies are highly visible and accessible to the public and have long been regarded as a source for immunization services in the United States. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services including routine and travel vaccinations and medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. As a result, pharmacists can help to increase access to and awareness of the need for these services to insure that patients remain healthy while traveling abroad and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be undertaken that ensures that they have the necessary training, education, and skill set in order to provide this specialty level of care and that their practice setting is optimally designed to facilitate this service. Outcomes from studies that have evaluated pharmacy-based travel health services are positive, which further supports the role of the pharmacist in this setting. Therefore, the purpose of this paper is to highlight United States pharmacy laws and regulations, pharmacist training, travel clinic considerations, and patient care outcomes from pharmacy-based travel health services.

: Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because data-reporting cadences, reliability, and availability vary, we organized structured activities and convened an expert panel to compare these resources and evaluate their strengths and weaknesses. We provide a synthesis of the expert panel discussion and provide recommendations on how to improve chikungunya surveillance and risk communication to travelers. Assessing outbreak risk requires using multiple local and international reporting resources because no single resource contains all of the necessary information. The panelists identified several challenges regarding chikungunya surveillance and outbreak reporting: inadequate chikungunya surveillance infrastructure and diagnostic capacity; varying case definitions; limited understanding of the local health care context; inadequate awareness of chikungunya in health care settings; and restricted or delayed access to real-time surveillance data. As chikungunya risk increases worldwide, greater attention and resources are needed to improve timely, sensitive, and specific diagnostic testing and rapid communication to health care workers and travelers, particularly in resource-poor regions where outbreaks occur.