Drug stores turn away walk-in flu shots as they struggle with pharmacy worker shortages

Nathan Bomey
USA TODAY

When Sarah Tuttle visited a Rite Aid with her 7- and 14-year-old children this month, she figured they’d be able to get walk-in flu shots, as they always have.

Not this time. She could tell by the pharmacy worker's expression. 

“She looked at me with this totally harried face and said, ‘We’re not doing walk-ins,’” Tuttle said of the employee she encountered in Seattle. “People peeled out of the line. It was clearly not just us.”

Tuttle and others are running into an unexpected side effect of the pandemic: walk-ins turned away because of staff shortages at pharmacies.

Pharmacies are struggling to find workers, much like restaurants, retailers and other employers facing labor shortages as the pandemic drags on.

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Among independent pharmacists, nearly 9 in 10 “can’t find pharmacy technicians,” and nearly 6 in 10 “can’t find front-end employees to run the cash register, track inventory and manage other basic store operations,” according to a survey conducted in May by the National Community Pharmacists Association.

As a result, drugstores are falling behind on flu shots. 

About 11.5 million adults got a flu shot at a pharmacy through Oct. 9. That's down 34% from 17.4 million during the same period in 2020, according to the Centers for Disease Control and Prevention.

Doctor's offices do a better job keeping pace. The number of flu shots administered at those locations was 7 million, down 13% from 2020.

With fewer pharmacists and technicians, some pharmacies say "no" to people walking in for flu shots. They've shortened their hours to fill prescriptions since they don't have enough people to run the pharmacy. 

This flu season could strain hospitals dealing with COVID-19 patients.

Experts fear that the flu season could be worse than usual since most people don’t have any immunity from the winter of 2020-21, when seasonal influenza virtually disappeared amid social distancing and mask wearing.

Pharmacists and drugstore chains also deal with a huge increase in duties, including coronavirus tests, vaccine shots and boosters.

The nation had about 315,000 pharmacists and 415,000 pharmacy technicians as of May 2020, according to the Bureau of Labor Statistics. Both positions are empowered to administer flu shots.

“Like most pharmacies and retailers, Rite Aid is experiencing some staffing challenges in different regions,” spokesman Brad Ducey said in an email. “Our pharmacy teams are working hard to address high demand for COVID-19 vaccinations and testing amid the nationwide labor shortage. As a result, customers may experience slightly longer wait times for vaccinations.”

He said, “Appointments are recommended to limit wait times,” but “we continue to accommodate walk-in appointments for flu shots at all Rite Aid stores.”

USA TODAY documented instances of other stores turning away patients for walk-in flu shots, including the nation’s two largest drugstore chains: CVS and Walgreens.

When Tuttle’s Rite Aid turned her away, her husband called the Fred Meyer store’s pharmacy: Appointments were required, and none was available for several days.

They called Walgreens: Appointments were required, and none was available for several days.

Finally, while visiting a CVS, they used the chain's app to make an appointment in the store. They got their pokes.

But not before the person ahead of them in the line was turned away.

“It was startling,” said Tuttle, 44. “I was just like, I can wait five more minutes if that means you can vaccinate this lady.”

Drugstores advertise free flu shots Aug. 19, 2020, in New York. This year, an appointment may be required.

Worker shortages

At locally owned drugstores, pharmacist-owners often need to work more hours to fill the staffing void in the industry, said Douglas Hoey, a pharmacist and CEO of the NCPA. Some work up to 70 hours a week, he estimated, in part because of the extra demands of administering COVID-19 shots and coronavirus tests.

“The workload at the pharmacies is greater,” he said. “We could use more help.”

Large chains have hired additional employees, paying them more, but there’s only so much they can do, said Mike Johnston, CEO and founder of the National Pharmacy Technicians Association. 

“There’s not the supply available to meet the demand right now,” he said. “The situation we’re in right now, there’s not enough money you can throw at this problem.”

Flu shot appointments

Hoey acknowledged there’s “a bigger emphasis on scheduling” appointments this year. It’s “not required by most of our members, but it is very helpful if the patient schedules their appointment.”

Research suggests that patients are unlikely to make an appointment to get a flu shot without someone proactively scheduling it for them. A Rutgers University study in 2017 showed that only 5% of patients in a medical practice made an appointment to get one on their own.

Elizabeth Arnold, a traveling nurse based in the Dallas-Fort Worth area but working at a hospital in Charlottesville, Virginia, didn’t schedule a flu shot after she decided to get it. She is required to be vaccinated for her job.

She planned to get inoculated on her off-day when she was turned away for a walk-in flu shot at a CVS pharmacy inside a Target store.

“There was nobody there,” said Arnold, 34. “The gal was like, ‘Yeah, no, you have to have an appointment.’ I was like, ‘Please, can we just do this real quick, we could have had this done already when we started the conversation.’ She was like, ‘No, sorry.’”

The next available appointment? Two days later.

She ended up scheduling a shot when she was back home in Texas for a brief stint.

“I couldn’t believe it,” she said. “They shouldn’t have an announcement at the door saying, ‘Flu shots are available, they’re free, would you like your flu shot today.’”

Arnold said she's concerned that people who aren’t determined to get a flu shot won’t try a second time if they’re turned away. 

“Someone is not going to take time out of their day for a 10-minute slot and go all the way up to the store to get it done. They’re just not going to do it,” she said.

CVS spokesman Joe Goode said the company recommends making an appointment for vaccines.

“If it turns out there isn’t an appointment available, the CVS Pharmacy staff can help assist the patient in finding an available appointment, at another local pharmacy or another day, depending on availability,” he said in an email.

He acknowledged that the company faces a “tight retail labor market” that may “result in minor staffing issues and minimal service disruptions.”

CVS, he said, has moved to “deploy teams to support stores that are understaffed” and make “decisions about hours and workflow process” while raising wages and implementing technology to smooth operations.

Pharmacies face extra demands

Pharmacies are not crying wolf, said Arun Sundaram, a corporate analyst at CFRA Research who has studied Walgreens and Rite Aid. They genuinely lack staff as they face increased workloads.

“The labor issue in pharmacy is exacerbated by the fact that these pharmacies have been given little to no lead time in our response to fighting this pandemic,” Sundaram said.

For example, he said, the federal government authorized COVID-19 booster shots for certain Americans. Drugstores handle a greater share of those shots than they did in the early going of the vaccine rollout when public health departments played a greater role, Sundaram said.

“These pharmacists, these pharmacy techs – they’re voicing the same concerns of all other industries. They’ve been working day in, day out since the pandemic started. They want better pay, they want better benefits as well,” he said.

CVS and Walgreens announced plans to raise their starting wages to $15 an hour. That could help them attract more cashiers, alleviating pressure on pharmacists and technicians to help customers check out.

Walgreens offered a signing bonus of up to $1,250 for full- or part-time pharmacy technicians through the end of October to help support the administration of vaccines, coronavirus tests and other pharmacy duties. It created a position, pharmacy operations manager, to lead technicians and improve workflow.

At Walgreens, “for the best experience,” customers are encouraged to make appointments for flu shots and other vaccines, including COVID-19, Walgreens spokesperson Fraser Engerman said in an email.

In some cases, Walgreens pharmacies may reduce their hours because of staffing challenges, he said.

“Our store team will direct customers, as appropriate, to the nearest Walgreens for their prescription needs, care and support, to help ensure continuity for our patients,” he said.

Contributing: Shari Rudavsky and Alexandria Burris, Indianapolis Star

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