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Liu S, Durantini MR, Calabrese C, Sanchez F, Albarracin D. A systematic review and meta-analysis of strategies to promote vaccination uptake. Nat Hum Behav 2024; 8:1689-1705. [PMID: 39090405 DOI: 10.1038/s41562-024-01940-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/01/2024] [Indexed: 08/04/2024]
Abstract
Although immunization can dramatically curb the mortality and morbidity associated with vaccine-preventable diseases, vaccination uptake remains suboptimal in many areas of the world. Here, in this meta-analysis, we analysed the results from 88 eligible randomized controlled trials testing interventions to increase vaccination uptake with 1,628,768 participants from 17 countries with variable development levels (for example, Human Development Index ranging from 0.485 to 0.955). We estimated the efficacy of seven intervention strategies including increasing access to vaccination, sending vaccination reminders, providing incentives, supplying information, correcting misinformation, promoting both active and passive motivation and teaching behavioural skills. We showed that the odds of vaccination were 1.5 (95% confidence interval, 1.27 to 1.77) times higher for intervention than control conditions. Among the intervention strategies, using incentives and increasing access were most promising in improving vaccination uptake, with the access strategy being particularly effective in countries with lower incomes and less access to healthcare.
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Affiliation(s)
- Sicong Liu
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
| | - Marta R Durantini
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Calabrese
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Flor Sanchez
- Department of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Dolores Albarracin
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA.
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Gauld NJ, Knapton C, Sinclair O, Grant CC. Promotion and COVID-19 lockdown increase uptake of funded maternal pertussis vaccination in pharmacy: A mixed methods study. PLoS One 2024; 19:e0307971. [PMID: 39208314 PMCID: PMC11361654 DOI: 10.1371/journal.pone.0307971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/12/2024] [Indexed: 09/04/2024] Open
Abstract
Pertussis vaccination is recommended during pregnancy to protect the baby. Pertussis vaccination was initially free to pregnant people through general practice and hospitals in New Zealand, but uptake was suboptimal. In one district funding of maternal pertussis vaccination was widened to community pharmacies in 2016. Eighteen months later promotion to pharmacies, midwives and pregnant people took place. In 2020 and 2021, COVID-19 lockdowns occurred. AIM To explore the effects of promotion and COVID-19 lockdowns on uptake of funded maternal pertussis vaccination in pharmacy, and awareness, use and opinions of promotional elements. METHODS Five years of pharmacy claims data were analysed and 12 pharmacists, 18 people eligible/recently eligible for maternal pertussis vaccination and 11 midwives were interviewed. RESULTS Provision of maternal pertussis vaccination increased during and after promotion. Qualitative data showed that pharmacists valued phone calls with information about maternal pertussis vaccination and recommendations for increasing uptake. Prompted by these calls, some pharmacists contacted midwives to inform them of funded maternal pertussis vaccination in the pharmacy (which midwives appreciated) and recommended pertussis vaccination to pregnant clients. Pharmacy staff reportedly were motivated to recommend this vaccination by being informed about it and having posters displayed in the pharmacy. Pregnant people valued healthcare professionals' conversations about maternal pertussis vaccination, but appeared to be uninfluenced by posters and promotional social media posts about this vaccination. During COVID-19, maternal pertussis uptake in pharmacies increased 31% March to May 2020 (before and during the first COVID-19 lockdown) versus the same time the previous year, then declined. CONCLUSION Promotion appeared to have a sustained effect on uptake of maternal pertussis vaccination in pharmacies. Pregnant people were most influenced by discussions with healthcare professionals. Pharmacists and pharmacy staff increased proactivity with maternal vaccinations after promotion to them. Promotion may need to be repeated over time.
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Affiliation(s)
- Natalie J. Gauld
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Cath Knapton
- Mid-Central Community Pharmacy Group, Hamilton, New Zealand
| | - Owen Sinclair
- Paediatrics, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Cameron C. Grant
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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Ortega M, Isom C, Place A, Rush J, Boedecker AS, Luchen GG, Pierce G. ASHP Statement on the Community Pharmacist's Role in the Care Continuum. Am J Health Syst Pharm 2024:zxae176. [PMID: 39107053 DOI: 10.1093/ajhp/zxae176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024] Open
Affiliation(s)
| | - Courtney Isom
- Cone Health Community Pharmacy at Wendover Medical Center, Greensboro, NC, USA
| | - Amanda Place
- Ascension St. Vincent Joshua Max Simon Primary Care Center, Indianapolis, IN, USA
| | - Jordan Rush
- System Retail and Outpatient Pharmacy, UNC Health
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Polaris JJ, Eiden AL, DiFranzo AP, Pfister HR, Itzkowitz MC, Bhatti AA. State Medicaid Coverage and Reimbursement of Adult Vaccines Administered by Physicians and Pharmacists. AJPM FOCUS 2024; 3:100252. [PMID: 39070136 PMCID: PMC11279260 DOI: 10.1016/j.focus.2024.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Introduction Effective from October 2023, federal law requires Medicaid programs to cover all recommended adult vaccines administered by physicians with no cost sharing for all eligibility groups. However, uniform coverage does not always translate to optimal uptake. Rather, other factors such as Medicaid reimbursement rates influence vaccine access and ultimately patient uptake. This study reviewed Medicaid policies to understand vaccine coverage and reimbursement, for both physicians and pharmacists, in all 50 U.S. states; Washington, DC; and Puerto Rico (collectively referred to as states). Methods Between March and September 2022, the researchers reviewed states' public Medicaid policies regarding adult vaccines, focusing on the service of injectable vaccine administration and 3 products: hepatitis A, 9-valent human papilloma virus, and 23-valent pneumococcal polysaccharide. Results Among 50 states with available data, 7 (14%) restricted Medicaid coverage for hepatitis A, 9-valent human papilloma virus, and/or 23-valent pneumococcal polysaccharide administered by physicians, and 15 (30%) did so for pharmacists. Median physician reimbursement rate was below the private sector rate for hepatitis A (89%) and 9-valent human papilloma virus (94%) but above the rate for 23-valent pneumococcal polysaccharide (108%). Median physician reimbursement for vaccine administration during an office visit was $11.86; the median pharmacist administration fee was $10.67. Conclusions Although federal law now requires all state Medicaid programs to cover, without cost sharing, all recommended adult vaccines administered by physicians, equitable vaccine access may be hindered by state coverage restrictions for pharmacists and by relatively low reimbursement rates relative to Medicare and commercial coverage for both physicians and pharmacists.
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Udoh A, Ernawati D, Ikhile I, Yahyouche A. Pharmacists' Willingness to Offer Vaccination Services: A Systematic Review and Meta-Analysis. PHARMACY 2024; 12:98. [PMID: 39051382 PMCID: PMC11270253 DOI: 10.3390/pharmacy12040098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Pharmacy-based vaccination (PBV) services increase coverage and enhance access to lifesaving vaccines. This systematic review assessed the proportion of pharmacists willing to offer PBV services. PubMed/MEDLINE, CINAHL, EMBASE and Scopus electronic databases were searched from inception to identify relevant literature. Google scholar and other sources of grey literature was also searched. The literature findings were synthesized narratively, and via a random-effects meta-analysis. Risk of bias was evaluated using nine quality assessment criteria adapted from the Joanna Briggs Institute checklist for prevalence studies. The review protocol is registered on PROSPERO (REF: CRD42021293692). In total, 967 articles were identified from the literature search. Of this, 34 articles from 19 countries across 5 WHO regions were included in the review. No article from the Western Pacific WHO region was identified. Most of the included studies (n = 21, 61.8%) showed an overall low risk of bias. None showed a high risk of bias. Pooled willingness for PBV services was 69.45% (95% CI: 61.58-76.33; n total pharmacists = 8877), indicating that most pharmacists were willing to offer the service, although nearly a third were not. Pharmacists' willingness was highest in the Americas (71.49%, 95% CI: 53.32-84.63, n pharmacists = 3842) and lowest in the African region (58.71%, 95% CI: 45.86-70.46, n pharmacists = 1080) although the between-group difference was not statistically significant across the WHO regions (Q = 3.01, df = 4, p < 0.5567). Meta-regression showed no evidence (R2 = 0%, p = 0.9871) of the moderating effect of the type of vaccine assessed, PBV service availability, sampling technique and the study risk of bias. These findings show that most pharmacists are willing to offer PBV services; however, strategies that will enhance greater involvement in service provision are needed.
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Affiliation(s)
- Arit Udoh
- Faculty of Health & Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Desak Ernawati
- Department of Pharmacology and Therapy, Universitas Udayana, Denpasar 80234, Bali, Indonesia;
| | - Ifunanya Ikhile
- School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Asma Yahyouche
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
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Norman G, Kletter M, Dumville J. Interventions to increase vaccination in vulnerable groups: rapid overview of reviews. BMC Public Health 2024; 24:1479. [PMID: 38831275 PMCID: PMC11145854 DOI: 10.1186/s12889-024-18713-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/25/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE Groups which are marginalised, disadvantaged or otherwise vulnerable have lower uptake of vaccinations. This differential has been amplified in COVID-19 vaccination compared to (e.g.) influenza vaccination. This overview assessed the effectiveness of interventions to increase vaccination in underserved, minority or vulnerable groups. METHODS In November 2022 we searched four databases for systematic reviews that included RCTs evaluating any intervention to increase vaccination in underserved, minority or vulnerable groups; our primary outcome was vaccination. We used rapid review methods to screen, extract data and assess risk of bias in identified reviews. We undertook narrative synthesis using an approach modified from SWiM guidance. We categorised interventions as being high, medium or low intensity, and as targeting vaccine demand, access, or providers. RESULTS We included 23 systematic reviews, including studies in high and low or middle income countries, focused on children, adolescents and adults. Groups were vulnerable based on socioeconomic status, minority ethnicity, migrant/refugee status, age, location or LGBTQ identity. Pregnancy/maternity sometimes intersected with vulnerabilities. Evidence supported interventions including: home visits to communicate/educate and to vaccinate, and facilitator visits to practices (high intensity); telephone calls to communicate/educate, remind/book appointments (medium intensity); letters, postcards or text messages to communicate/educate, remind/book appointments and reminder/recall interventions for practices (low intensity). Many studies used multiple interventions or components. CONCLUSION There was considerable evidence supporting the effectiveness of communication in person, by phone or in writing to increase vaccination. Both high and low intensity interventions targeting providers showed effectiveness. Limited evidence assessed additional clinics or targeted services for increasing access; only home visits had higher confidence evidence showing effectiveness. There was no evidence for interventions for some communities, such as religious minorities which may intersect with gaps in evidence for additional services. None of the evidence related to COVID-19 vaccination where inequalities of outcome are exacerbated. PROSPERO REGISTRATION CRD42021293355.
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Affiliation(s)
- Gill Norman
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Maartje Kletter
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jo Dumville
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Haems M, Lanzilotto M, Mandelli A, Mota-Filipe H, Paulino E, Plewka B, Rozaire O, Zeiger J. European community pharmacists practice in tackling influenza. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100447. [PMID: 38707787 PMCID: PMC11068921 DOI: 10.1016/j.rcsop.2024.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
Background In many European countries, flu vaccination coverage rates are below the 75% target. During the COVID-19 pandemic, many pharmacists around Europe were involved as vaccine administrators and demonstrated positive results in improving vaccine uptake. This paper explores the challenges, accomplishments, and best practices of various European pharmacists' associations in administering vaccines and positively contributing to public health. Methods Eight pharmacists representing various associations from different countries across Europe (Italy, Belgium, Poland, Portugal, France, and Germany) convened to discuss their role as vaccination providers, the advantages, and strategies for improvement, and to identify barriers and gaps in the vaccination administration process, especially focusing on the administration of seasonal flu vaccines. Results Currently, 15 European countries allow community pharmacists to dispense and administer flu vaccines. Among the ones that attended the meeting, Portugal initiated the flu immunization program at the pharmacy earliest, before the COVID era, but in other countries, the process started only in the last couple of years. Initial hesitancy and reluctance by other HCPs or institutions were overcome as the pilot projects showed positive and cost-effective public health results. Today, pharmacists are considered crucial professional figures to provide immunization services against COVID-19, the flu, and other vaccine-preventable diseases, and pursue important public health goals.Key takeaways to enhance the pharmacist's role in providing immunization services against vaccine-preventable diseases include improving interaction with policymakers and the public, generating real-world evidence highlighting public health benefits, and ensuring ongoing professional education and training for pharmacists. Conclusion Vaccinating pharmacists are gaining recognition of their role and the benefits derived from their broader involvement in the healthcare system, including immunization programs. Further efforts are needed in each country for an adequate recognition of the profession and a broader utilization of pharmacy services to exploit the benefit of immunization, especially against the flu.
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Affiliation(s)
- Marleen Haems
- Koninklijk Oost-Vlaams Apothekersgild (KOVAG, Royal Society of Pharmacists of East Flanders), Brouwerijstraat 1, 9031 Ghent, Belgium
| | - Mauro Lanzilotto
- Federazione Nazionale dei Titolari di Farmacia Italiani (Federfarma, National Federation of the Italian Pharmacy Owner), Via Emanuele Filiberto 190, 00185 Rome, Italy
| | - Andrea Mandelli
- Federazione degli Ordini dei Farmacisti Italiani (FOFI, Federation of the Orders of Italian Pharmacists), Via Palestro 75, 00185 Rome, Italy
| | - Hélder Mota-Filipe
- Faculty of Pharmacy of the Universidade de Lisboa (FFUL), Avenida Professor Gama Pinto, 1649-003 Lisbon, Portugal
| | - Ema Paulino
- Associação Nacional das Farmácias (ANF, National Association of Pharmacies), Rua Marechal Saldanha 1, 1249-069 Lisbon, Portugal
| | - Beata Plewka
- Pharmacy Practice Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
| | - Olivier Rozaire
- Union Régionale des Professionnels de Santé Pharmaciens Auvergne Rhône Alpes (URPS AuRA, Regional Union of the Healthcare Professionals, Pharmacists, Auvergne Rhône Alpes), rue Garibaldi 194B, 69003 Lyon, France
| | - Jens Zeiger
- Marketing Verein Deutscher Apotheker (MVDA, Marketing Association of German Pharmacists), Emil-Hoffmann-Straße 1a, 50996 Cologne, Germany
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Odebunmi OO, Wangen M, Waters AR, Ferrari RM, Marciniak MW, Rohweder C, Wheeler SB, Brenner AT, Shah PD. Colorectal cancer screening knowledge among community pharmacists: A national survey. J Am Pharm Assoc (2003) 2024:102130. [PMID: 38796158 DOI: 10.1016/j.japh.2024.102130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) screening can reduce CRC morbidity and mortality. Community pharmacies could be a viable option for delivering home-based CRC screening tests such as fecal immunochemical tests (FITs). However, little is known about community pharmacists' knowledge about CRC screening guidelines. OBJECTIVE We assessed community pharmacists' knowledge about CRC screening to identify education and training needs for a pharmacy-based CRC screening program. METHODS Between September 2022 and January 2023, we conducted an online national survey of community pharmacists practicing in the United States. Responders were eligible if they were currently-licensed community pharmacists and currently practiced in the United States. The survey assessed knowledge of national CRC screening guidelines, including recommended starting age, frequency of screening, different screening modalities, and follow-up care. Using multiple linear regression, we evaluated correlates of community pharmacists' level of CRC screening knowledge, defined as the total number of knowledge questions answered correctly from "0" (no questions correct) to "5" (all questions correct). RESULTS A total of 578 eligible community pharmacists completed the survey, with a response rate of 59%. Most community pharmacists correctly answered the question about the next steps following a positive FIT (87%) and the question about where a FIT can be done (84%). A minority of community pharmacists responded correctly to questions about the age to start screening with FIT (34%) and how often a FIT should be repeated (28%). Only 5% of pharmacists answered all knowledge questions correctly. Community pharmacists answered more CRC screening knowledge questions correctly as their years in practice increased. Board-certified community pharmacists answered more CRC screening knowledge questions correctly compared to those who were not board-certified. CONCLUSION To ensure the successful implementation of a pharmacy-based CRC screening program, community pharmacists need to be educated about CRC screening and trained to ensure comprehensive patient counseling and preventive service delivery.
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Thomas D, Abdalla A, Hussein S, Joury J, Elshamy A, Khalifa S, Saleh Z. Pharmacists' readiness and willingness to vaccinate the public in United Arab Emirates community pharmacies: A cross-sectional study. F1000Res 2024; 12:292. [PMID: 38774308 PMCID: PMC11106594 DOI: 10.12688/f1000research.131153.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
Background Pharmacist-administered vaccination is currently implemented in many countries worldwide. It has contributed to increased vaccine access and vaccine uptake. This observational cross-sectional study assessed community pharmacists' willingness, and readiness to administer vaccines to the public in the United Arab Emirates (UAE) and relate it to national and international policies on vaccination. Methods This research was an online survey of 24-questions that was made available to community pharmacists via social media and WhatsApp. The survey was open for six weeks (from April to June 2022). Descriptive and inferential analysis was performed. Results The questionnaire was completed by 374 of 575 (65%) respondents. More than half (64.2%) of the respondents agreed or strongly agreed that pharmacists should be able to vaccinate and 68.4% responded that they were willing to administer vaccines if local regulations allowed them to vaccinate. Most (81.8%) expressed willingness to complete training required to be able to administer vaccines in their pharmacies. Logistic regression showed that pharmacists defined as having high readiness were significantly more willing to undergo all essential training to start a vaccination service in their pharmacies than were pharmacists with poor readiness (OR 2.647; 95% CI: 1.518-4.615; p=0.001). High readiness was also significantly associated with agreement on safety of pharmacy-based vaccination (p=0.027). Conclusions The majority of community pharmacists surveyed showed readiness to commence pharmacy-based vaccination services. Those with high readiness characteristics are amenable to receiving essential training and consider that vaccination in the community pharmacy setting would be safe.
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Affiliation(s)
- Dixon Thomas
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Saeed Hussein
- Global Medical Solutions, Abu Dhabi, United Arab Emirates
| | - Jean Joury
- Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | - Amin Elshamy
- Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates
| | - Sherief Khalifa
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Ziad Saleh
- Al Ain Pharmacy Group, Al Ain, Abu Dhabi, United Arab Emirates
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Mastrovito B, Lardon A, Dubromel A, Nave V, Beny K, Dussart C. Understanding the gap between guidelines and influenza vaccination coverage in people with diabetes: a scoping review. Front Public Health 2024; 12:1360556. [PMID: 38706547 PMCID: PMC11066301 DOI: 10.3389/fpubh.2024.1360556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024] Open
Abstract
Background Diabetes affects millions of people worldwide, making them more vulnerable to infections, including seasonal influenza. It is therefore particularly important for those suffering from diabetes to be vaccinated against influenza each year. However, influenza vaccination coverage remains low in this population. This review primarily aims to identify the determinants of influenza vaccination in people with diabetes (T1D or T2D). Secondly, it aims to assess main recommendations for influenza vaccination, vaccine effectiveness, vaccination coverage, and how education and pharmacists can encourage uptake of the vaccine in the diabetic population. Methods A scoping review was conducted in January 2022 to systematically review evidence on influenza vaccination in people with diabetes using data from PubMed, Science Direct, and EM Premium with terms such as "Diabetes mellitus," "Immunization Programs," "Vaccination," and "Influenza Vaccines." Quality assessment and data extraction were independently conducted by two authors. Disagreements between the authors were resolved through discussion and consensus, and if necessary, by consulting a third author. Results Of the 333 records identified, 55 studies met the eligibility criteria for inclusion in this review. Influenza vaccination was recommended for people ≥6 months. Despite effectiveness evidence showing a reduction in mortality and hospitalizations in people with diabetes vaccinated vs. non-vaccinated ones, very few studies reported a coverage rate ≥ 75%, which is WHO's target objective. Determinants such as advanced age, presence of comorbidities and healthcare givers' advice were associated with increased vaccination uptake. On the contrary, fear of adverse reactions and concerns about vaccine effectiveness were significant barriers. Finally, education and pharmacists' intervention played a key role in promoting vaccination and increasing vaccination uptake. Conclusion Influenza vaccination coverage in people with diabetes remains low despite recommendations and evidence on vaccine effectiveness. Motivators and barriers as well as several socio-demographic and clinical factors have been identified to explain this trend. Efforts are now needed to increase the number of diabetics vaccinated against influenza, mainly through education and the involvement of healthcare givers.
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Affiliation(s)
- Brice Mastrovito
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Alexia Lardon
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Amelie Dubromel
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Viviane Nave
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Karen Beny
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Claude Dussart
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
- EA 4129 P2S Parcours Santé Systémique, Claude Bernard University Lyon 1, Lyon, France
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Jones CH, Jenkins MP, Adam Williams B, Welch VL, True JM. Exploring the future adult vaccine landscape-crowded schedules and new dynamics. NPJ Vaccines 2024; 9:27. [PMID: 38336933 PMCID: PMC10858163 DOI: 10.1038/s41541-024-00809-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
Amidst the backdrop of the COVID-19 pandemic, vaccine innovation has garnered significant attention, but this field was already on the cusp of a groundbreaking renaissance. Propelling these advancements are scientific and technological breakthroughs, alongside a growing understanding of the societal and economic boons vaccines offer, particularly for non-pediatric populations like adults and the immunocompromised. In a departure from previous decades where vaccine launches could be seamlessly integrated into existing processes, we anticipate potentially than 100 novel, risk-adjusted product launches over the next 10 years in the adult vaccine market, primarily addressing new indications. However, this segment is infamous for its challenges: low uptake, funding shortfalls, and operational hurdles linked to delivery and administration. To unlock the societal benefits of this burgeoning expansion, we need to adopt a fresh perspective to steer through the dynamics sparked by the rapid growth of the global adult vaccine market. This article aims to provide that fresh perspective, offering a detailed analysis of the anticipated number of adult vaccine approvals by category and exploring how our understanding of barriers to adult vaccine uptake might evolve. We incorporated pertinent insights from external stakeholder interviews, spotlighting shifting preferences, perceptions, priorities, and decision-making criteria. Consequently, this article aspires to serve as a pivotal starting point for industry participants, equipping them with the knowledge to skillfully navigate the anticipated surge in both volume and complexity.
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Affiliation(s)
| | | | | | - Verna L Welch
- Pfizer Inc, 66 Hudson Boulevard, New York, NY, 10001, USA
| | - Jane M True
- Pfizer Inc, 66 Hudson Boulevard, New York, NY, 10001, USA.
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Sayyed SA, Kinny FA, Sharkas AR, Schwender H, Woltersdorf R, Ritter C, Laeer S. Vaccination Training for Pharmacy Undergraduates as a Compulsory Part of the Curriculum?-A Multicentric Observation. PHARMACY 2024; 12:12. [PMID: 38251406 PMCID: PMC10801567 DOI: 10.3390/pharmacy12010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
In order to increase vaccination rates, the Government of Germany introduced vaccination against influenza and COVID-19 into the regular care administered by pharmacists. However, vaccination training is yet not integrated into the German pharmacy curriculum. Therefore, the Institute for Clinical Pharmacy and Pharmacotherapy in Duesseldorf had developed an innovative vaccination course using high-fidelity simulation for students. To investigate the acceptance further, the course was carried out at three different German universities (Bonn, Duesseldorf, Greifswald). Students were asked to give their self-assessment before and after and satisfaction only after the training course. Responses from 33 participants from the University of Bonn, 42 from the University of Duesseldorf and 49 from the University of Greifswald were analyzed. Every participant at the respective universities showed a significant increase in their self-assessment and indicated a high level of satisfaction with the course. The results also did not differ significantly between the respective universities. Consequently, the results lead to the hypothesis that the satisfaction of pharmacy students with this kind of training using high-fidelity simulation is very high and attractive, and can be recommended for other German universities. The integration of such vaccination training into the German pharmacy curriculum might be a future step.
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Affiliation(s)
- Shahzad Ahmad Sayyed
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Florian Andreas Kinny
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Ahmed Reda Sharkas
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Holger Schwender
- Mathematical Institute, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Ronja Woltersdorf
- Institute of Pharmacy, Department of Clinical Pharmacy, University of Bonn, 53121 Bonn, Germany
| | - Christoph Ritter
- Institute of Pharmacy, Department of Clinical Pharmacy, University of Greifswald, 17489 Greifswald, Germany
| | - Stephanie Laeer
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
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13
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Waters AR, Meehan K, Atkins DL, Ittes AH, Ferrari RM, Rohweder CL, Wangen M, Ceballos RM, Issaka RB, Reuland DS, Wheeler SB, Brenner AT, Shah PD. How pharmacists would design and implement a community pharmacy-based colorectal cancer screening program. PREVENTIVE ONCOLOGY & EPIDEMIOLOGY 2024; 2:10.1080/28322134.2024.2332264. [PMID: 38881823 PMCID: PMC11177275 DOI: 10.1080/28322134.2024.2332264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background Distributing CRC screening through pharmacies, a highly accessible health service, may create opportunities for more equitable access to CRC screening. However, providing CRC screening in a new context introduces a substantial implementation challenge. Methods We conducted 23 semi-structured interviews with community pharmacists practicing in Washington state and North Carolina about distributing fecal immunochemical tests (FIT) to patients in the pharmacy. The Consolidated Framework for Implementation Research (CFIR) was used to guide analysis. Results Pharmacists believed that delivering FITs was highly compatible with their environment, workflow, and scope of practice. While knowledge about FIT eligibility criteria varied, pharmacists felt comfortable screening patients. They identified standardized eligibility criteria, patient-facing educational materials, and continuing education as essential design features. Pharmacists proposed adapting existing pharmacy electronic health record systems for patient reminders/prompts to facilitate FIT completion. While pharmacists felt confident that they could discuss test results with patients, they also expressed a need for stronger communication and care coordination with primary care providers. Discussion When designing a pharmacy-based CRC screening program, pharmacists desired programmatic procedures to fit their current knowledge and context. Findings indicate that if proper attention is given to multi-level factors, FIT delivery can be extended to pharmacies.
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Affiliation(s)
- Austin R Waters
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27510, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Katherine Meehan
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle, WA 98109, USA
| | - Dana L Atkins
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98109, USA
| | - Annika H Ittes
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, WA 98109
| | - Renée M Ferrari
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Catherine L Rohweder
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Mary Wangen
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Rachel M Ceballos
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Rachel B Issaka
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, WA 98109
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
- Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine. Seattle, WA, 98195, USA
| | - Daniel S Reuland
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27510, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27510, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Alison T Brenner
- Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27510, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27510, USA
| | - Parth D Shah
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, WA 98109
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
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14
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Aldajani FN, Aldosari M. Pharmacist-led vaccination services in the Middle East. J Pharm Policy Pract 2023; 16:171. [PMID: 38155347 PMCID: PMC10755951 DOI: 10.1186/s40545-023-00664-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023] Open
Abstract
Successful Vaccine uptake relies heavily on the effectiveness of vaccination services. Expanding the scope of pharmacists' involvement in vaccination services can significantly improve vaccination coverage. The level of pharmacists' engagement in immunization services varies globally. The aim of this paper is to describe the current role of pharmacists in vaccination services in the Middle Eastern countries. The provision of vaccination services by pharmacists in the region has evolved notably in recent years. The extent of pharmacists' involvement in immunization services varies from one country to another in the region. They play a more active role in the delivery of vaccinations, not only facilitating but also administering vaccines. Future studies on pharmacist-led vaccination services in these countries are necessary to assess the value of the expanded practice of pharmacists in this field, especially due to the scarcity of evidence.
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Affiliation(s)
- Faten Naif Aldajani
- Pharmacy Department, Alnakheel Medical Center, Al Mahdyah, 7222, Riyadh, Saudi Arabia.
| | - Mohammed Aldosari
- Pharmacy Department, Alnakheel Medical Center, Al Mahdyah, 7222, Riyadh, Saudi Arabia
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15
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Rahim MHA, Dom SHM, Hamzah MSR, Azman SH, Zaharuddin Z, Fahrni ML. Impact of pharmacist interventions on immunisation uptake: a systematic review and meta-analysis. J Pharm Policy Pract 2023; 17:2285955. [PMID: 38205195 PMCID: PMC10775721 DOI: 10.1080/20523211.2023.2285955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Background Under-utilisation of immunisation services remains a public health challenge. Pharmacists act as facilitators and increasingly as immunisers, yet relatively little robust evidence exists of the impact elicited on patient health outcome and vaccination uptake. Objective To evaluate the influence of pharmacist interventions on public vaccination rate. Methods SCOPUS, PubMed, and Web of Science were searched from inception to April 2023 to retrieve non- and randomised controlled clinical trials (RCTs). Studies were excluded if no comparator group to pharmacist involvement was reported. Data extraction, risk of bias assessments, and meta-analyses using random-effect models, were performed. Results Four RCTs and 15 non-RCTs, encompassing influenza, pneumococcal, herpes zoster, and tetanus-diphtheria and pertussis vaccine types, and administered in diverse settings including community pharmacies, were included. Pooled effect sizes revealed that, as compared to usual care, pharmacists, regardless of their intervention, improved the overall immunisation uptake by up to 51% [RR 1.51 (1.28, 1.77)] while immunisation frequency doubled when pharmacists acted specifically as advocators [RR 2.09 (1.42, 3.07)]. Conclusion While the evidence for pharmacist immunisers was mixed, their contribution to immunisation programmes boosted public vaccination rate. Pharmacists demonstrated leadership and acquired indispensable advocator roles in the community and hospital settings. Future research could explore the depth of engagement and hence the extent of influence on immunisation uptake.
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Affiliation(s)
- Mohamad Hafiz Abd Rahim
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
| | - Siti Hajar Mahamad Dom
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
| | - Mohd Shah Rezan Hamzah
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
| | - Siti Hawa Azman
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
| | - Zahirah Zaharuddin
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
| | - Mathumalar Loganathan Fahrni
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor Branch, Bandar Puncak Alam, Malaysia
- Center for Drug Policy and Health Economics Research (CDPHER), Universiti Teknologi MARA (UiTM), Puncak Alam, Malaysia
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16
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Kim C, Guo A, Yassanye D, Link-Gelles R, Yates K, Duggar C, Moore L, El Kalach R, Jones-Jack N, Walker C, Gibbs Scharf L, Pillai SK, Patel A. The US Federal Retail Pharmacy Program: Optimizing COVID-19 Vaccine Delivery Through a Strategic Public-Private Partnership. Public Health Rep 2023; 138:870-877. [PMID: 37503697 PMCID: PMC10576480 DOI: 10.1177/00333549231186606] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
To help achieve the initial goal of providing universal COVID-19 vaccine access to approximately 258 million adults in 62 US jurisdictions, the federal government launched the Federal Retail Pharmacy Program (FRPP) on February 11, 2021. We describe FRPP's collaboration among the federal government, US jurisdictions, federal entity partners, and 21 national chain and independent pharmacy networks to provide large-scale access to COVID-19 vaccines, particularly in communities disproportionately affected by COVID-19 (eg, people aged ≥65 years, people from racial and ethnic minority groups). FRPP initially provided 10 000 vaccination sites for people to access COVID-19 vaccines, which was increased to >35 000 vaccination sites by May 2021 and sustained through January 31, 2022. From February 11, 2021, through January 31, 2022, FRPP vaccination sites received 293 million doses and administered 219 million doses, representing 45% of all COVID-19 immunizations provided nationwide (38% of all first doses, 72% of all booster doses). This unprecedented public-private partnership allowed the federal government to rapidly adapt and scale up an equitable vaccination program to reach adults, later expanding access to vaccine-eligible children, during the COVID-19 pandemic. As the largest federal COVID-19 vaccination program, FRPP exemplifies how public-private partnerships can expand access to immunizations during a public health emergency. Pharmacies can help meet critical national public health goals by serving as convenient access points for sustained health services. Lessons learned from this effort-including the importance of strong coordination and communication, efficient reporting systems and data quality, and increasing access to and demand for vaccine, among others-may help improve future immunization programs and support health system resiliency, emphasizing community-level access and health equity during public health emergencies.
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Affiliation(s)
- Christine Kim
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angela Guo
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Strategic Innovative Solutions, LLC, Clearwater, FL, USA
| | - Diana Yassanye
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruth Link-Gelles
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kirsten Yates
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chris Duggar
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lori Moore
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roua El Kalach
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nkenge Jones-Jack
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chastity Walker
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynn Gibbs Scharf
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Satish K. Pillai
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anita Patel
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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17
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Chiappin M, Leguelinel-Blache G, Roux-Marson C, Kinowski JM, Dubois F. Impact of a clinical pharmacist's intervention on pneumococcal vaccination in a population of at- risk hospitalized patients: The IP-VAC study. Infect Dis Now 2023; 53:104765. [PMID: 37499757 DOI: 10.1016/j.idnow.2023.104765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of clinical pharmacist intervention on compliance with pneumococcal vaccination (PV) recommendations in hospitalized patients. METHODS This was a prospective, single-center, before-and-after study conducted in 2019-2020. Patients had to be over 18 years of age, at risk of pneumococcal infection, and with no PV. No changes were made in the observational phase. During the interventional phase, the clinical pharmacist discussed a prescription for preventive PV and a mention in the discharge letter. A pharmaceutical consultation sensitized the patient to the interest of PV. The clinical pharmacist ensured that a complete vaccination protocol would be carried out by the retail pharmacist within 3 months of hospitalization. RESULTS One hundred and sixty-seven (167) patients were included. In the observational phase, 2.3% of patients received a complete vaccination protocol after discharge from primary care. The rate increased to 63.8% after the clinical pharmacist's intervention (p < 0.001). Vaccines were prescribed by hospital physicians in 97.5% of cases, while 40% of discharge letters included the indication for PV. CONCLUSION The clinical pharmacist's intervention led to delivery of a complete PV protocol after discharge for over half the patients. This study demonstrated the feasibility of a pharmaceutical intervention to promote PV in hospital activities.
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Affiliation(s)
- M Chiappin
- Département de pharmacie, CHU Nîmes, Université de Montpellier, Nîmes, France.
| | - G Leguelinel-Blache
- Département de pharmacie, CHU Nîmes, Université de Montpellier, Nîmes, France; Institut Desbrest d'Épidémiologie et de Santé Publique, Univ Montpellier, INSERM, Montpellier, France; Département de Droit et Économie de la santé, Université de Montpellier, Montpellier, France
| | - C Roux-Marson
- Département de pharmacie, CHU Nîmes, Université de Montpellier, Nîmes, France; Institut Desbrest d'Épidémiologie et de Santé Publique, Univ Montpellier, INSERM, Montpellier, France
| | - J-M Kinowski
- Département de pharmacie, CHU Nîmes, Université de Montpellier, Nîmes, France; Institut Desbrest d'Épidémiologie et de Santé Publique, Univ Montpellier, INSERM, Montpellier, France
| | - F Dubois
- Département de pharmacie, CHU Nîmes, Université de Montpellier, Nîmes, France; Institut Desbrest d'Épidémiologie et de Santé Publique, Univ Montpellier, INSERM, Montpellier, France
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18
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Chadi A, Thirion DJG, David PM. Vaccine promotion strategies in community pharmacy addressing vulnerable populations: a scoping review. BMC Public Health 2023; 23:1855. [PMID: 37741997 PMCID: PMC10518112 DOI: 10.1186/s12889-023-16601-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/23/2023] [Indexed: 09/25/2023] Open
Abstract
CONTEXT Social determinants of health are drivers of vaccine inequity and lead to higher risks of complications from infectious diseases in under vaccinated communities. In many countries, pharmacists have gained the rights to prescribe and administer vaccines, which contributes to improving vaccination rates. However, little is known on how they define and target vulnerable communities. OBJECTIVE The purpose of this study is to describe how vulnerable communities are targeted in community pharmacies. METHODS We performed a systematic search of the Embase and MEDLINE database in August 2021 inspired by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA ScR). Articles in English, French or Spanish addressing any vaccine in a community pharmacy context and that target a population defined as vulnerable were screened for inclusion. RESULTS A total of 1039 articles were identified through the initial search, and 63 articles met the inclusion criteria. Most of the literature originated from North America (n = 54, 86%) and addressed influenza (n = 29, 46%), pneumococcal (n = 14, 22%), herpes zoster (n = 14, 22%) or human papilloma virus vaccination (n = 14, 22%). Lifecycle vulnerabilities (n = 48, 76%) such as age and pregnancy were most often used to target vulnerable patients followed by clinical factors (n = 18, 29%), socio-economical determinants (n = 16, 25%) and geographical vulnerabilities (n = 7, 11%). The most frequently listed strategy was providing a strong recommendation for vaccination, promotional posters in pharmacy, distributing leaflet/bag stuffers and providing staff training. A total of 24 barriers and 25 facilitators were identified. The main barriers associated to each vulnerable category were associated to effective promotional strategies to overcome them. CONCLUSION Pharmacists prioritize lifecycle and clinical vulnerability at the expense of narrowing down the definition of vulnerability. Some vulnerable groups are also under targeted in pharmacies. A wide variety of promotional strategies are available to pharmacies to overcome the specific barriers experienced by various groups.
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Affiliation(s)
- Alexandre Chadi
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
| | - Daniel J G Thirion
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
- McGill University Health Centre, Montreal, QC, Canada
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19
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Zimmermann C, Jusufoska M, Tolic J, Abreu de Azevedo M, Tarr PE, Deml MJ. Pharmacists' approaches to vaccination consultations in Switzerland: a qualitative study comparing the roles of complementary and alternative medicine (CAM) and biomedicine. BMJ Open 2023; 13:e074883. [PMID: 37696631 PMCID: PMC10496653 DOI: 10.1136/bmjopen-2023-074883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Many community pharmacies in Switzerland provide complementary and alternative medicine (CAM) approaches in addition to providing biomedical services, and a few pharmacies specialise in CAM. A common perception is that CAM providers are sceptical towards, or opposed to, vaccination. OBJECTIVES Key objectives of this study are to examine the potential roles of biomedically oriented and CAM-specialised pharmacists regarding vaccine counselling and to better understand the association between vaccine hesitancy and CAM. DESIGN We conducted semistructured, qualitative interviews. Transcripts were coded and analysed using thematic analysis. Interview questions were related to: type of pharmaceutical care practised, views on CAM and biomedicine, perspectives on vaccination, descriptions of vaccination consultations in community pharmacies and views on vaccination rates. SETTING Qualitative interviews in three language regions of Switzerland (German, French and Italian). PARTICIPANTS We interviewed 18 pharmacists (N=11 biomedically oriented, N=7 CAM specialised). RESULTS Pharmacist participants expressed generally positive attitudes towards vaccination. Biomedically oriented pharmacists mainly advised customers to follow official vaccination recommendations but rarely counselled vaccine-hesitant customers. CAM-specialised pharmacists were not as enthusiastic advocates of the Swiss vaccination recommendations as the biomedically oriented pharmacists we interviewed. Rather, they considered that each customer should receive individualised, nuanced vaccination advice so that customers can reach their own decisions. CAM-specialised pharmacists described how mothers in particular preferred getting a second opinion when they felt insufficiently advised by biomedically oriented paediatricians. CONCLUSIONS Vaccination counselling in community pharmacies represents an additional option to customers who have unmet vaccination consultation needs and who seek reassurance from healthcare professionals (HCPs) other than physicians. By providing individualised vaccination counselling to vaccine-hesitant customers, CAM-specialised pharmacists are likely meeting specific needs of vaccine-hesitant customers. As such, research and implementation efforts should more systematically involve pharmacists as important actors in vaccination provision. CAM-specialised pharmacists particularly should not be neglected as they are important HCPs who counsel vaccine-hesitant customers.
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Affiliation(s)
- Clara Zimmermann
- University Department of Medicine, Kantonsspital Baselland, Bruderholz, Switzerland
- University of Basel, Basel, Switzerland
| | - Meliha Jusufoska
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Josipa Tolic
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Marta Abreu de Azevedo
- University of Basel, Basel, Switzerland
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | | | - Michael J Deml
- Institute of Sociological Research, Department of Sociology, University of Geneva, Geneva, Switzerland
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20
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Watanabe AH, Veettil SK, Le LM, Bald E, Tak C, Chaiyakunapruk N. Clinical and economic implications of increasing access to herpes zoster vaccination rate in community pharmacies. J Am Pharm Assoc (2003) 2023; 63:1530-1538. [PMID: 37207710 DOI: 10.1016/j.japh.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/30/2023] [Accepted: 05/09/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND A community pharmacist plays an important role in providing vaccination to the general public in the United States. No economic models have been used to assess the impact of these services on public health and economic benefits. OBJECTIVE This study aimed to estimate the clinical and economic implications of community pharmacy-based herpes zoster (HZ) vaccination services with a hypothetical scenario of nonpharmacy-based vaccination in the State of Utah. METHODS A hybrid model of decision tree and Markov models was used to estimate lifetime cost and health outcomes. This open-cohort model was populated based on Utah population statistics and included a population of 50 years and older who were eligible for HZ vaccination between the years 2010 and 2020. Data were derived from the U.S. Bureau of Labor Statistics, the Utah Immunization Coverage Report, the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, the CDC National Health Interview Survey, and existing literature. The analysis was performed from a societal perspective. A lifetime time horizon was used. The primary outcomes were the number of vaccination cases increased and the number of shingles and postherpetic neuralgia (PHN) cases averted. Total costs and quality-adjusted life-years (QALYs) were also estimated. RESULTS Based on a cohort of 853,550 people eligible for HZ vaccination in Utah, an additional 11,576 individuals were vaccinated in the community pharmacy-based scenario compared with the nonpharmacy-based vaccination, resulting in 706 averted cases of shingles and 143 averted cases of PHN. Community pharmacy-based HZ vaccination was less costly (-$131,894) and gained more QALYs (52.2) compared with the nonpharmacy-based vaccination. A series of sensitivity analyses showed that the findings were robust. CONCLUSIONS Community pharmacy-based HZ vaccination was less costly and gained more QALYs and was associated with improved other clinical outcomes in the State of Utah. This study might be used as a model for future evaluations of other community pharmacy-based vaccination programs in the United States.
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Lavenue A, Simoneau I, Mahajan N, Srirangan K. Development and Implementation of Workshops to Optimize the Delivery of Vaccination Services in Community Pharmacies: Thinking beyond COVID-19. PHARMACY 2023; 11:129. [PMID: 37624084 PMCID: PMC10458354 DOI: 10.3390/pharmacy11040129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/01/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Vaccines are widely recognized as the most economically efficient strategy to combat infectious diseases. Community pharmacists, being highly accessible healthcare professionals, have the potential to significantly contribute to the promotion and facilitation of vaccination uptake. In Canada, the jurisdiction of healthcare falls under provincial legislation, leading to variations in the extent of pharmacist practice throughout the country. While some pharmacists in Canada already functioned as immunizers, Québec pharmacists gained the authority to prescribe and administer vaccines in March 2020 amidst the COVID-19 pandemic. Our workshop aimed to equip pharmacists in Québec with the necessary guidance to optimize vaccinations, emphasizing the importance of maintaining and expanding immunization services beyond influenza and COVID-19 vaccines in the future. During the workshop, pharmacists had the opportunity to exchange valuable insights and best practices regarding workflow optimization, identifying areas for improvement in competency, effectively reaching vulnerable population groups, and integrating allied team members into their practice. Participants were also asked to develop a plan of action to help implement practice change beyond the workshop. Interactive workshops centered around discussions like these serve as catalysts for advancing the pharmacy profession, uniting professionals with a collective aim of enhancing patient care.
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Affiliation(s)
- Arnaud Lavenue
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
| | - Isabelle Simoneau
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
| | - Nikita Mahajan
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
- School of Pharmacy, University of Waterloo, 10A Victoria Street S., Kitchener, ON N2G 1C5, Canada
| | - Kajan Srirangan
- Toc Toc Communications, 104-7030 Rue Marconi, Montréal, QC H2S 3K1, Canada; (I.S.); (N.M.); (K.S.)
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22
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Singleton BA, Al-Dahir S, Gillard C, Earls M, Bommarito J, Duhe M, Phi K. Perceived Role, Identity and Experiences of Pharmacists and the Potential Impact on COVID-19 Vaccine Uptake per Louisiana Region: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6459. [PMID: 37569001 PMCID: PMC10418418 DOI: 10.3390/ijerph20156459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
Some of the lowest COVID-19 community vaccination rates in America are found in Louisiana. This study investigated: (1) barriers that Louisiana pharmacists encountered during the pandemic; and (2) the effect of pharmacists' role and identity confidence on willingness to enforce vaccine mandates, and COVID-19 vaccine uptake. Fifty-four community pharmacists from nine regions of Louisiana participated in the study. Pharmacists completed questionnaires about: personal demographics, patient population, vaccination encouragement, COVID-19 concerns, and vaccination administration rates. The importance of feeling like a trusted voice in the community, as well as professional perception and self-assurance, were measured using Likert scale questions. During focus groups, participants discussed experiences with the COVID-19 vaccination rollout and vaccination-related obstacles. As the pandemic progressed, pharmacists reported being overworked, understaffed, and overburdened with new responsibilities. In regions with lower vaccination rates, pharmacists were less likely to feel at ease enforcing vaccine mandates. Independent pharmacists were less comfortable enforcing vaccine mandates than chain pharmacists but had more positive perceptions of their role and identity. This study contributes to further understanding of pharmacy workflow obstacles and pharmacists' perceptions of their professional roles and identities in the community.
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Affiliation(s)
- Brittany A. Singleton
- Division of Clinical and Administrative Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA
| | - Sara Al-Dahir
- Division of Clinical and Administrative Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA
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23
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Rubinstein EB, Rayel H, Crawford EC, Larson M. Using a rapid ethnographic assessment to explore vaccine hesitancy on a public university campus in the Upper Midwest. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37399535 DOI: 10.1080/07448481.2023.2225628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 04/27/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023]
Abstract
Objective: This exploratory study examined campus attitudes toward vaccines to guide subsequent development of context-relevant interventions for increasing vaccine acceptance and uptake. Participants: We gathered ethnographic data on a convenience sample of campus community members (students, faculty, staff) at a public university over six weeks in spring 2022. Methods: Student researchers conducted a rapid ethnographic assessment across campus locations. Weekly team debriefs enabled ongoing, iterative refinement of instruments and supplemented observational fieldnotes. Data analysis was inductive and oriented toward practical recommendations for intervention development. Results: Four themes, and attendant recommendations, emerged: 1) social identities and social roles influence health-related beliefs, including vaccination; 2) vaccine knowledge influences vaccination behaviors; 3) language surrounding vaccines (sometimes) matters; 4) vaccines aren't considered part of general health and wellness and can't be forced. Conclusions: Findings highlight the need to address individual, social, and institutional contexts when designing campus-based behavioral interventions for vaccine uptake.
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Affiliation(s)
- Ellen B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA
| | - Hannah Rayel
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
| | - Elizabeth C Crawford
- Department of Communication, North Dakota State University, Fargo, North Dakota, USA
| | - Mary Larson
- Department of Public Health, North Dakota State University, Fargo, North Dakota, USA
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Skoy E, Rubinstein EB, Nagel L, Preugschas AH, Larson M. Preparedness for a pandemic: Independent community pharmacists' experiences delivering COVID-19 vaccines. J Am Pharm Assoc (2003) 2023; 63:1049-1056. [PMID: 37001584 PMCID: PMC10060799 DOI: 10.1016/j.japh.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/20/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To identify the experiences and preparedness for independent community pharmacies to deliver COVID-19 vaccines. DESIGN A mixed-methods study collected quantitative and qualitative data. SETTING AND PARTICIPANTS Every independent community pharmacy providing COVID-19 vaccines in North Dakota. OUTCOME MEASURES During state-required site visits, quantitative data determined by a Centers for Disease Control and Prevention (CDC)-developed reviewer guide were collected on each pharmacy's preparedness on vaccine provision and quality assurance to provide COVID-19 vaccines. Qualitative data to describe the lived experiences of pharmacists were collected through site visit documentation and semistructured interviews with participating pharmacists. RESULTS Fifty-two pharmacies received site visits. All visited pharmacies met full compliance with CDC's reviewer guide for billing and documentation of vaccine, vaccine procedures, recipient communication, and handling of ancillary supplies. Pharmacies varied in their compliance of vaccine storage and handling requirements. Forty-three interviews yielded 4 main themes about pharmacies' role in vaccination during the pandemic: (1) professional role, (2) accessibility, (3) patient relations, and (4) community role. CONCLUSION Site visits demonstrated that independent community pharmacies were prepared to provide COVID-19 vaccines in response to public need, despite varying degrees of experience with and provision of routine immunizations. Interviews revealed that pharmacists recognized their important contribution to COVID-19 vaccine provision efforts.
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Hernandez M, Franks AM, Payakachat N. Changes in Arkansans' attitudes toward pharmacist involvement and regulation of medical cannabis following its availability in Arkansas. J Am Pharm Assoc (2003) 2023; 63:1131-1137.e4. [PMID: 37207711 DOI: 10.1016/j.japh.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Pharmacists are likely to encounter questions from patients regarding medical cannabis (MC). This serves as an opportunity for pharmacists to provide reliable medical information about MC dosing, drug interactions, and impact on preexisting health conditions. OBJECTIVES This study examined changes in perceptions of the Arkansan community toward MC regulation and pharmacist involvement in MC dispensing after MC products became available in Arkansas. METHODS A longitudinal, self-administered online survey was conducted in February 2018 (baseline) and September 2019 (follow-up). Baseline participants were recruited through Facebook posts, emails, and printed flyers. Participants from the baseline survey (N = 1526) were invited to participate in the follow-up survey. Paired t tests were used to determine changes in responses, and multivariable regression analysis was used to identify factors associated with follow-up perceptions. RESULTS Participants (n = 607, response rate 39.8%) started the follow-up survey, resulting in 555 usable surveys. The largest group of participants was 40-64 year old (40.9%). The majority were female (67.9%), white (90.6%), and reported past 30-day cannabis use (83.1%). Compared to baseline, participants preferred less regulatory control of MC. They were also less likely to agree that pharmacists helped improve MC-related patient safety. Participants favoring less MC regulation were more likely to report 30-day cannabis use and perceived cannabis to have low health risk. Past 30-day cannabis use was also significantly associated with disagreement that pharmacists improve patient safety and are well-trained to provide MC counseling. CONCLUSION After MC product availability, Arkansans' attitudes changed toward less MC regulation and less agreement with the pharmacist's role in improving MC safety. These findings call for pharmacists to better promote their role in public health safety and demonstrate their knowledge concerning MC. Pharmacists should advocate for an expanded, active consultant role in dispensaries to improve safety of MC use.
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Kpozehouen EB, Heywood AE, Menzies R, Seale H, Brotherton J, Raina Macintyre C. Informing the design of a whole of life immunisation register for Australia. Vaccine 2023; 41:3011-3018. [PMID: 37037706 DOI: 10.1016/j.vaccine.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 02/26/2023] [Accepted: 03/17/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION In 2016, Australia launched a whole life immunisation register, the Australian Immunisation Register (AIR), building on a universal childhood register established in 1997. Immunisation Information Systems are well established in Europe, the US and elsewhere. However, a national system covering immunisation across the lifespan, with complete capture of the population and satisfactory data quality, is rare. METHODS A national workshop was convened in 2016 with key stakeholders from the government, new and existing vaccine users, and vaccine providers to review the ideal features of the AIR to ensure optimal effectiveness. This workshop focused on the functionality needed to identify population groups newly included in the register and support the achievement of high immunisation coverage in these groups eligible for National Immunisation Program vaccines. RESULTS Key recommendations included the need for bidirectional data flow between the AIR and providers; systematic approaches to the capture and recording of accurate and complete data to ascertain important denominators for subpopulations, includingAboriginal and Torres Strait Islander status, medical risk factors, occupation, ethnicity, country of birth, and vaccines given during pregnancy; linkage with other government datasets including notifiable diseases; the capture of adverse events following immunisation; ease of access by patients, providers; and by researchers. CONCLUSIONS Some recommendations from the workshop have informed the development and future utility of the AIR. Some recommendations from the workshop have been integrated into the current iteration of the AIR, which is more important than ever given the roll-out of COVID-19 vaccines. The accuracy and validity of data have subsequently improved through data entry controls, data integrity checks and reporting requirements. Access to AIR data for research remains protracted and costly, limitingresearch potential.
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Affiliation(s)
| | - Anita E Heywood
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Robert Menzies
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Julia Brotherton
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Formerly Australian Centre for the Prevention of Cervical Cancer, East Melbourne, Australia
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Mourad N, Mourad L, Hammoudi Halat D, Farah Z, Hendaus M, El Sayed Trad I, El Akel M, Safwan J, Rahal M, Younes S. Factors Affecting Influenza Vaccination Uptake and Attitudes among Lebanese University Students: The Impact of Vaccination Promotional Programs and COVID-19 Pandemic. Vaccines (Basel) 2023; 11:vaccines11050949. [PMID: 37243053 DOI: 10.3390/vaccines11050949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination is the most effective preventative strategy against influenza, yet university students' influenza vaccination uptake remains low. This study aimed firstly to determine the percentage of university students who were vaccinated for the 2015-2016 influenza season and to identify reasons for non-vaccination, and secondly to examine the impact of external factors (on-campus/online influenza awareness campaigns and COVID-19 pandemic) on their influenza vaccination uptake and attitudes for the 2017-2018 and 2021-2022 influenza seasons. A descriptive study was conducted over three phases for three influenza seasons at a Lebanese university in the Bekaa Region. Based on data collected in 2015-2016, promotional activities were developed and implemented for the other influenza seasons. This study was conducted using an anonymous, self-administered questionnaire by students. The majority of the respondents in the three studies did not receive the influenza vaccine (89.2% in the 2015-2016 study, 87.3% in the 2017-2018 study, and 84.7% in the 2021-2022 study). Among the unvaccinated respondents, the main reason for non-vaccination was that they thought that they did not need it. The primary reason for vaccination among those who were vaccinated was that they believed they were at risk of catching influenza in a 2017-2018 study and due to the COVID-19 pandemic in the 2021-2022 study. As for attitudes towards influenza vaccination post-COVID-19, significant differences were shown among the vaccinated and unvaccinated respondents. The vaccination rates among university students remained low despite of the awareness campaigns and COVID-19 pandemic.
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Affiliation(s)
- Nisreen Mourad
- School of Pharmacy, Lebanese International University, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
| | - Lidia Mourad
- School of Pharmacy, Lebanese International University, Lebanon
| | - Dalal Hammoudi Halat
- Academic Quality Department, QU Health, Qatar University, Doha 2713, Qatar
- School of Pharmacy, Lebanese International University, Lebanon
| | - Zeina Farah
- Epidemiological Surveillance Program, Ministry of Public Health, Beirut, Lebanon
| | - Mohamed Hendaus
- School of Pharmacy, Lebanese International University, Lebanon
| | - Israa El Sayed Trad
- Global Health Institute Department, American University of Beirut, Beirut 11-0236, Lebanon
- School of Pharmacy, Lebanese International University, Lebanon
| | - Marwan El Akel
- School of Pharmacy, Lebanese International University, Lebanon
- School of Education, Lebanese International University, Beirut 14404, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
- International Pharmaceutical Federation, 2517 JP The Hague, The Netherlands
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Lebanon
| | - Samar Younes
- School of Pharmacy, Lebanese International University, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut 1103, Lebanon
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Alrasheedy AA, Aldawsari AH, Alqasir MI, Alsawyan OA, Alalwan OA, Alwaker SA, Almutairi MS, Godman B. Knowledge of Community Pharmacists in Saudi Arabia Regarding Human Monkeypox, Its Management, Prevention, and Vaccination: Findings and Implications. Vaccines (Basel) 2023; 11:vaccines11040878. [PMID: 37112790 PMCID: PMC10143221 DOI: 10.3390/vaccines11040878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Many cases of monkeypox have recently been reported in countries where this disease is not endemic, raising a global health concern. Consequently, healthcare professionals (HCPs), including pharmacists, need to be aware of the disease, its prevention, including the role of vaccines, and its management to reduce transmission. A cross-sectional, questionnaire-based study was conducted among conveniently sampled community pharmacists in the Qassim region of Saudi Arabia. A total of 189 community pharmacists participated in the study, giving a response rate of 72.97%. From these, 86.77% were male, 51.32% were ≤30 years old, 36.51% were aged between 31-40 years, and 43.39% had 1-5 years of experience as community pharmacists. Their overall knowledge was 17.72 ± 5.56 out of a maximum of 28. The overall rate of correct answers for the knowledge statements was 63.29%, with 52.4% answering ≥50-<75% of the knowledge questions correctly and 31.2% answering ≥75% of the questions correctly. The knowledge subdomain related to diagnosis and clinical characteristics recorded the highest score, with the subdomain relating to causative pathogens and epidemiology recording a lower score. Overall, community pharmacists had moderate knowledge of monkeypox and its clinical management, prevention, and the role of vaccines, which is a concern for the future. Consequently, tailored, flexible, and timely educational interventions are needed to ensure that HCPs, including community pharmacists, are fully equipped with the latest evidence-based knowledge regarding this viral disease to reduce transmission and improve care.
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Affiliation(s)
- Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Abdulrahman H Aldawsari
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Munyib I Alqasir
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Omar A Alsawyan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Osama A Alalwan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Saleh A Alwaker
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Masaad S Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Sakr F, Dabbous M, Rahal M, Salameh P, Akel M. Challenges and opportunities to provide immunization services: Analysis of data from a cross-sectional study on a sample of pharmacists in a developing country. Health Sci Rep 2023; 6:e1206. [PMID: 37064320 PMCID: PMC10098443 DOI: 10.1002/hsr2.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/13/2023] [Accepted: 03/25/2023] [Indexed: 04/18/2023] Open
Abstract
Background and Aims Vaccine-preventable illnesses continue to be a global health concern as immunization coverage remains below its targets. National plans emphasize on the essential role of multidisciplinary efforts and approaches to vaccination programs. Pharmacists are globally getting involved in immunization services as important members of the healthcare team. This study aimed to determine barriers, and assess challenges and possible opportunities to provide immunization in the Lebanese pharmacy practice. Methods This was a cross-sectional study that included pharmacists from all over Lebanon, as part of a national research to assess the role of pharmacists as immunizers. All registered pharmacists in Lebanon practicing in community, hospital, or other clinical settings were considered eligible for participation. A web-based self-administered validated questionnaire, which is initially developed by the American Pharmacists Association, was adapted with permission. Results A total of 315 pharmacists responded to the survey. Only 23.1% declared completing an immunization training program. Over half of pharmacists (58.4%) administer vaccines to patients. A significant association between lack of support from physicians to pharmacists (adjusted odds ratio [ORa] = 2.099, 95% confidence interval [CI] = 1.290-3.414, p = 0.003) and vaccine administration was found, while cost associated with professional development and additional training (ORa = 0.533, 95% CI = 0.287-0.989, p = 0.046) was inversely associated to it. Logistic, financial, and legislative requirements as essential necessities were determined to successfully expand pharmacist-led immunization services. Conclusions The major barriers and challenges to vaccine administration by pharmacists comprised a lack of physicians' support and expenses associated with professional development and additional training. Pharmacists administer more vaccination despite lack of support from physicians; whereas they administer less vaccination due to cost associated with professional development and further training. The scope of pharmacy practice in Lebanon is not well recognized by other healthcare providers and stakeholders to include immunization services.
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Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International UniversityBeirutLebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris‐Est CréteilCréteilFrance
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris‐Est CréteilCréteilFrance
- INSPECT‐LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie‐Liban)BeirutLebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International UniversityBeirutLebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International UniversityBeirutLebanon
| | - Pascale Salameh
- INSPECT‐LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie‐Liban)BeirutLebanon
- School of Medicine, Lebanese American UniversityByblosLebanon
- School of Pharmacy, Lebanese UniversityBeirutLebanon
- Department of Primary Care and Population HealthUniversity of Nicosia Medical SchoolNicosiaCyprus
| | - Marwan Akel
- School of Pharmacy, Lebanese International UniversityBeirutLebanon
- INSPECT‐LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie‐Liban)BeirutLebanon
- School of Education, Lebanese International UniversityBeirutLebanon
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Thomas D, Abdalla A, Hussein S, Joury J, Elshamy A, Khalifa S, Saleh Z. Pharmacists’ readiness and willingness to vaccinate the public in United Arab Emirates community pharmacies: A cross-sectional study. F1000Res 2023; 12:292. [DOI: 10.12688/f1000research.131153.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Background: Pharmacist-administered vaccination is currently implemented in many countries worldwide. It has contributed to increased vaccine access and vaccine uptake. This observational cross-sectional study assessed community pharmacists’ willingness, and readiness to administer vaccines to the public in the United Arab Emirates (UAE) and relate it to national and international policies on vaccination. Methods: This research was an online survey of 24-questions that was made available to community pharmacists via social media and WhatsApp. The survey was open for six weeks (from April to June 2022). Descriptive and inferential analysis was performed. Results: The questionnaire was completed by 374 of 575 (65%) respondents. More than half (64.2%) of the respondents agreed or strongly agreed that pharmacists should be able to vaccinate and 68.4% responded that they were willing to administer vaccines if local regulations allowed them to vaccinate. Most (81.8%) expressed willingness to complete training required to be able to administer vaccines in their pharmacies. Logistic regression showed that pharmacists defined as having high readiness were significantly more willing to undergo all essential training to start a vaccination service in their pharmacies than were pharmacists with poor readiness (OR 2.647; 95% CI: 1.518–4.615; p=0.001). High readiness was also significantly associated with agreement on safety of pharmacy-based vaccination (p=0.027). Conclusions: The majority of community pharmacists surveyed showed readiness to commence pharmacy-based vaccination services. Those with high readiness characteristics are amenable to receiving essential training and consider that vaccination in the community pharmacy setting would be safe.
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Wang Q, Yang L, Li L, Liu C, Jin H, Lin L. Willingness to Vaccinate Against Herpes Zoster and Its Associated Factors Across WHO Regions: Global Systematic Review and Meta-Analysis. JMIR Public Health Surveill 2023; 9:e43893. [PMID: 36892937 PMCID: PMC10037179 DOI: 10.2196/43893] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/25/2022] [Accepted: 01/19/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND A life-course immunization approach would enhance the quality of life across all age groups and improve societal well-being. The herpes zoster (HZ) vaccine is highly recommended for older adults to prevent HZ infection and related complications. The proportions of willingness to receive the HZ vaccine varies across countries, and various kinds of factors, including sociodemographics and individual perceptions, influence the willingness to vaccinate. OBJECTIVE We aim to estimate the HZ vaccination willingness rate and identify factors associated with vaccine uptake willingness across all World Health Organization (WHO) regions. METHODS A global systematic search was performed on PubMed, Web of Science, and the Cochrane Library for all papers related to the HZ vaccine published until June 20, 2022. Study characteristics were extracted for each included study. Using double arcsine transformation, vaccination willingness rates with 95% CIs were pooled and reported. The willingness rate and associated factors were analyzed by geographical context. Associated factors were also summarized based on Health Belief Model (HBM) constructs. RESULTS Of the 26,942 identified records, 13 (0.05%) papers were included, covering 14,066 individuals from 8 countries in 4 WHO regions (Eastern Mediterranean Region, European Region, Region of the Americas, and Western Pacific Region). The pooled vaccination willingness rate was 55.74% (95% CI 40.85%-70.13%). Of adults aged ≥50 years, 56.06% were willing to receive the HZ vaccine. After receiving health care workers' (HCWs) recommendations, 75.19% of individuals were willing to get the HZ vaccine; without HCWs' recommendations, the willingness rate was only 49.39%. The willingness rate was more than 70% in the Eastern Mediterranean Region and approximately 55% in the Western Pacific Region. The willingness rate was the highest in the United Arab Emirates and the lowest in China and the United Kingdom. The perception of HZ severity and susceptibility was positively associated with vaccination willingness. The perceived barriers to vaccination willingness (main reasons for unwillingness) included low trust in the effectiveness of the HZ vaccine, concerns about safety, financial concerns, and being unaware of the HZ vaccine's availability. Older individuals, those having lower education, or those having lower income levels were less likely to willing to be vaccinated. CONCLUSIONS Only 1 in 2 individuals showed a willingness to be vaccinated against HZ. The willingness rate was the highest in the Eastern Mediterranean Region. Our findings show the critical role HCWs play in promoting HZ vaccination. Monitoring HZ vaccination willingness is necessary to inform public health decision-making. These findings provide critical insights for designing future life-course immunization programs.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Lan Li
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
| | - Chang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Sayyed SA, Sharkas AR, Ali Sherazi B, Dabidian A, Schwender H, Laeer S. Development and Assessment of Innovative High-Fidelity Simulation Vaccination Course Integrating Emergency Cases for Pharmacy Undergraduates-A Randomized Controlled Study. Vaccines (Basel) 2023; 11:vaccines11020324. [PMID: 36851202 PMCID: PMC9967866 DOI: 10.3390/vaccines11020324] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Recently, pharmacists in Germany were allowed to administer influenza and COVID-19 vaccines for people aged 12 years and older in order to increase vaccination coverage rates. In order to adapt the pharmacy curriculum for clinical practice, an innovative, vaccination training course using a high-fidelity simulator (HFS) was developed, implementing clinical scenarios to manage adverse events. In a randomized controlled trial using a pre and post design with pharmacy undergraduates, the intervention group interacted with an HFS, while the control group was trained with low-fidelity injection pads. Before and after the respective training, each participant went through an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire and knowledge quiz. Both training methods showed a significant increase in skills, but there was also a significant greater increase in the intervention group when compared to the control group, particularly with respect to the vaccination process. Furthermore, every individual in the intervention group improved from the pre- to post-training OSCEs. Therefore, HFS has been proven to be an appropriate tool to train pharmacy students for the purposes of vaccine administration and to prepare for future challenges. Particularly, recognizing and managing adverse reactions can be addressed in a very effective way.
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Affiliation(s)
- Shahzad Ahmad Sayyed
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
- Correspondence:
| | - Ahmed Reda Sharkas
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Bushra Ali Sherazi
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Armin Dabidian
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Holger Schwender
- Mathematical Institute, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Stephanie Laeer
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
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Klosko RC, Lynch SE, Cabral DL, Nagaraju K, Johnston YA, Steinberg JD, McCall KL. Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022. Vaccines (Basel) 2023; 11:vaccines11020276. [PMID: 36851154 PMCID: PMC9962937 DOI: 10.3390/vaccines11020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86-4.54) in a medical provider's office, 0.85 (95% CI, 0.26-2.43) in a pharmacy and 1.01 (95% CI, 0.15-3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71-1.47) in a medical provider's office, 1.06 (95% CI, 0.72-1.54) in a pharmacy, and 1.12 (95% CI, 0.61-1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency.
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Affiliation(s)
- Rachel C. Klosko
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Sarah E. Lynch
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Danielle L. Cabral
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Kanneboyina Nagaraju
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Yvonne A. Johnston
- Master of Public Health Program, Decker College of Nursing and Health Sciences, Binghamton University, Johnson City, NY 13790, USA
| | - Joshua D. Steinberg
- United Health Services Family Medicine Residency and Upstate Medical University College of Medicine Clinical Campus, Johnson City, NY 13790, USA
| | - Kenneth L. McCall
- School of Pharmacy & Pharmaceutical Sciences, Binghamton University, Johnson City, NY 13790, USA
- Correspondence: ; Tel.: +607-777-5853
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Gatwood J, Brookhart A, Kinney O, Hagemann T, Chiu CY, Ramachandran S, Gravlee E, Hohmeier K. Impact of patient and provider nudges on addressing herpes zoster vaccine series completion. Vaccine 2023; 41:778-786. [PMID: 36526504 DOI: 10.1016/j.vaccine.2022.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine the combined impact of provider-facing and text message-based, patient nudges on herpes zoster vaccine series completion. METHODS Following a period during which Kroger Health implemented provider facing nudges, select US patients that initiated herpes zoster vaccination were randomized to receive timed text messages when the second dose was due and available as part of a quality improvement exercise. Main comparisons were between patients intervened by provider nudge only and those intervened by both provider and patient nudges. Data were assessed by GEE-basedlogistic and linear regression, controlling for available patient- and store-level characteristics, and geospatial analyses. RESULTS During the baseline period, 100,627 adults received at least one HZ vaccine dose and 83.9% completed the series within 6 months over 88.6 days (SD: 26.53) on average. In the intervention period, 120,339 adults were vaccinated at least once and series completion was 88.3% (both provider nudges and text messaging) and 85.3% (not texted) during this observation window (both p < 0.0001). Time between doses was shorter for those who received text messages compared to both the baseline period and those in the intervention period that were not texted (both p < 0.001). Controlling for multiple characteristics, the odds of completion improved in the intervention period compared to baseline (OR: 1.07; 95% CI: 1.033-1.111), but a noticeably higher completion odds was observed amongst patients who received a text message in the intervention period (OR: 1.35; 95% CI: 1.286-1.414). Adjusting for patient and pharmacy factors, those who were texted received their second herpes zoster vaccine dose 8.6 days sooner (95% CI: -9.08 - -8.17, p < 0.0001) compared to those intervened by the provider nudge only. CONCLUSION The combined use of clinical and patient-focused nudges is a simple mechanism by which pharmacies and other health care access points can address the multi-dose vaccine needs of diverse patient populations.
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Affiliation(s)
- Justin Gatwood
- University of Tennessee Health Science Center, College of Pharmacy, 301 S. Perimeter Park Drive, Nashville, TN 37211, USA.
| | | | - Olivia Kinney
- Kroger Health, 555 Race Street, Cincinnati, OH 45202, USA
| | - Tracy Hagemann
- University of Tennessee Health Science Center, College of Pharmacy, 301 S. Perimeter Park Drive, Nashville, TN 37211, USA
| | - Chi-Yang Chiu
- University of Tennessee Health Science Center, College of Medicine, Doctor's Office Building, Memphis, TN 38163, USA
| | - Sujith Ramachandran
- University of Mississippi, School of Pharmacy, P.O. Box 1848, Oxford, MS 38677, USA
| | - Emily Gravlee
- University of Mississippi, School of Pharmacy, P.O. Box 1848, Oxford, MS 38677, USA
| | - Kenneth Hohmeier
- University of Tennessee Health Science Center, College of Pharmacy, 301 S. Perimeter Park Drive, Nashville, TN 37211, USA
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Koskan AM, LoCoco IE, Daniel CL, Teeter BS. Rural Americans' COVID-19 Vaccine Perceptions and Willingness to Vaccinate against COVID-19 with Their Community Pharmacists: An Exploratory Study. Vaccines (Basel) 2023; 11:vaccines11010171. [PMID: 36680016 PMCID: PMC9864964 DOI: 10.3390/vaccines11010171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
In early 2022 in the U.S., rural adults were the least likely to vaccinate against COVID-19 due to vaccine hesitancy and reduced healthcare access. This study explored the factors influencing rural adults' COVID-19 vaccine perceptions and their acceptance of pharmacist-administered vaccination. We utilized phone-based semi-structured interviews with 30 adults living in rural regions of one southwestern state and analyzed the data using a team-based thematic analysis approach. Vaccine-willing participants described knowing other people affected by the virus and their desired protection from the virus. They reported trusting scientific institutions and the government to provide safe vaccines. Vaccine-hesitant populations, however, feared that the COVID-19 vaccine development process had been rushed, compromising the safety of these newer vaccines. Although they differed in the news sources they preferred for receiving COVID-19 vaccine information, both vaccine-willing and vaccine-hesitant participants described trusting local authorities, such as healthcare providers and county government officials, to provide accurate COVID-19 vaccine information. Regarding the acceptability of pharmacist-administered COVID-19 vaccinations, all but one participant described their acceptance of this healthcare delivery approach. Future outreach should leverage rural adults' trust in local sources, including community pharmacists, deemed more convenient access points to healthcare, when addressing vaccine hesitancy.
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Affiliation(s)
- Alexis M. Koskan
- College of Health Solutions, Arizona State University, 425 N 5th Street, Phoenix, AZ 85004, USA
- Correspondence:
| | - Iris E. LoCoco
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 550 E Van Buren Street, Phoenix, AZ 85006, USA
| | - Casey L. Daniel
- Department of Family Medicine, Whiddon College of Medicine, University of South Alabama, 5795 USA North Drive, Mobile, AL 36608, USA
| | - Benjamin S. Teeter
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W Markham St., Little Rock, AR 72205, USA
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Characteristics of U.S. older adult medicare beneficiaries receiving the influenza vaccination at retail pharmacies. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100220. [PMID: 36691454 PMCID: PMC9860398 DOI: 10.1016/j.rcsop.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/04/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
Background Pharmacy-provided influenza vaccination services have become more prevalent among the older adult population. However, little is known about the characteristics of older adults associated with receiving the influenza vaccination at retail pharmacies and how these associated characteristics have changed. Objective To examine characteristics of older adults associated with use of retail pharmacy-provided influenza vaccination services and how the characteristics changed between 2009 and 2015. Methods The study used a retrospective, cross-sectional design with data from the 2009 and 2015 Medicare Current Beneficiary Survey. Older adults aged 65 and older who completed a community questionnaire and received the influenza vaccination during the previous winter were identified. Andersen's Behavioral Model of Health Services Use was the conceptual framework for inclusion of the population characteristics. A multivariable log-binomial regression was performed to estimate the association between the population characteristics and use of pharmacy-provided vaccination service, and the relative change in associations between 2009 and 2015. Survey weights were applied in all analyses. Results The results showed older adults who were non-Hispanic black (compared to non-Hispanic white), who did not have secondary private insurance (compared to those who had), who did not have physician office visit (compared to those who had) and who lived in non-metro area (compared to those who lived in metro area) had become more likely to use pharmacy-provided influenza vaccination services in 2015 than in 2009. Conclusions Pharmacy-provided influenza vaccination services appear to reduce access barriers for racially and socioeconomically disadvantaged older adults. Findings could help inform not only the retail pharmacies that provide vaccination services to better outreach to potential target populations but also policy makers about the disadvantaged populations that would benefit from the vaccination services provided by retail pharmacies.
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Lip A, Pateman M, Fullerton MM, Chen HM, Bailey L, Houle S, Davidson S, Constantinescu C. Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review. Vaccine 2023; 41:23-35. [PMID: 36437208 PMCID: PMC9688224 DOI: 10.1016/j.vaccine.2022.09.093] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.
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Affiliation(s)
- A Lip
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - M Pateman
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - M M Fullerton
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - H M Chen
- 19 to Zero Inc., Rocky Mountain House, Alberta, Canada
| | - L Bailey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - S Houle
- School of Pharmacy, Faculty of Science, University of Waterloo, Waterloo, Ontario, Canada
| | - S Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - C Constantinescu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Pediatric Infectious Diseases, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Berenbrok LA, Gessler C, Kirisci L, Herrera-Restrepo O, Coley KC. Impact of pharmacist motivational interviewing on hepatitis B vaccination in adults with diabetes. J Am Pharm Assoc (2003) 2023; 63:66-73.e1. [PMID: 36115757 DOI: 10.1016/j.japh.2022.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/12/2022] [Accepted: 08/14/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND In 2011, the Advisory Committee on Immunization Practices recommended hepatitis B (HepB) vaccination for previously unvaccinated adults (aged 19-59 years) with diabetes. Despite these recommendations, vaccination coverage for HepB vaccination for persons with diabetes remains low. OBJECTIVES The primary objective was to determine the impact of a community pharmacist-led motivational interviewing (MI) intervention on HepB vaccination initiation among adults with diabetes who were previously unvaccinated against HepB. The secondary objective was to describe HepB vaccination series completion among adults with diabetes who initiated the first dose of a HepB vaccine. METHODS A prospective, nonrandomized, controlled cluster trial was conducted across 58 regional grocery store chain pharmacies: a total of 29 pharmacies in the MI group and 29 pharmacies in the control group. Pharmacy location-level baseline data were collected during a 12-month pre-program period. The MI program was delivered over 10 months. Alerts were generated during prescription processing throughout the study period for eligible patients at each MI pharmacy location. The MI consisted of a face-to-face conversation between the pharmacist and the patient at the time of prescription pick-up. The difference in the primary outcome of HepB vaccination series initiation between patients receiving MI and control patients was assessed using a difference-in-differences analysis. For series completion, patients who initiated the HepB vaccination series were followed up for over 12 months after their first HepB vaccine dose. RESULTS There was a statistically significant 3.711% increase in HepB vaccination when comparing eligible individuals who received the MI intervention (n = 1569) to eligible individuals in the control group (n = 3640). Of the patients in the MI group who initiated HepB vaccination, 40 of 65 patients (61.5%) completed the vaccination series. CONCLUSION A pharmacist-led MI intervention increased HepB vaccination rates among adult patients with diabetes. Community pharmacists can effectively provide vaccinations that require multiple doses to complete the vaccination series.
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Isenor JE, Cossette B, Murphy AL, Breton M, Mathews M, Moritz LR, Buote R, McCarthy L, Woodill L, Morrison B, Guénette L, Marshall EG. Community pharmacists' expanding roles in supporting patients before and during COVID-19: An exploratory qualitative study. Int J Clin Pharm 2023; 45:64-78. [PMID: 36289174 PMCID: PMC9607833 DOI: 10.1007/s11096-022-01430-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Timely access and attachment to a primary healthcare provider is associated with better population health outcomes. In Canada, community pharmacists are highly accessible and patients struggling to access a family physician or nurse practitioner (i.e., "unattached") may seek care from a community pharmacist. Community pharmacists took on additional roles during the COVID-19 pandemic; however, little is known about how community pharmacists managed the needs of attached and unattached patients before and during the COVID-19 pandemic. AIM To describe Nova Scotian community pharmacists' roles in caring for unattached patients before and during the COVID-19 pandemic and identifying barriers and facilitators to optimizing patient access. METHOD Semi-structured interviews with community pharmacists (n = 11) across the province of Nova Scotia (Canada) were conducted. RESULTS Five key themes were noted: (1) rising pressure on pharmacists to meet unique health needs of attached and unattached patients; (2) what pharmacists have to offer (e.g., accessibility, trustworthiness); (3) positioning pharmacists in the system (e.g., how pharmacists can address gaps in primary healthcare); (4) pharmacist wellbeing; and, (5) recommendations for practice post-pandemic (e.g., maintain some policy changes made during the COVID-19 pandemic). CONCLUSION Before and during the pandemic, community pharmacists played a significant and increasing role providing care to patients, especially unattached patients. With growing numbers of unattached patients, it is vital that community pharmacists are supported to provide services to care for the health needs of patients.
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Affiliation(s)
- Jennifer E. Isenor
- grid.55602.340000 0004 1936 8200College of Pharmacy and Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Benoit Cossette
- grid.86715.3d0000 0000 9064 6198Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Andrea L. Murphy
- grid.55602.340000 0004 1936 8200College of Pharmacy and Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Mylaine Breton
- grid.86715.3d0000 0000 9064 6198Department of Community Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Maria Mathews
- grid.39381.300000 0004 1936 8884Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Lauren R. Moritz
- grid.55602.340000 0004 1936 8200Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Richard Buote
- grid.55602.340000 0004 1936 8200Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Lisa McCarthy
- grid.417293.a0000 0004 0459 7334Institute for Better Health, Trillium Health Partners, Mississauga, ON Canada ,grid.17063.330000 0001 2157 2938Leslie Dan Faculty of Pharmacy and Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Lisa Woodill
- Pharmacy Association of Nova Scotia, Dartmouth, NS Canada
| | - Bobbi Morrison
- grid.264060.60000 0004 1936 7363St. Francis Xavier University, Antigonish, NS Canada
| | - Line Guénette
- grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy and CHU de Québec Research Centre, Université Laval, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy, Université Laval, Québec, QC Canada
| | - Emily Gard Marshall
- Primary Care Research Unit, Department of Family Medicine, Dalhousie University, Halifax, Canada.
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Di Castri AM, Halperin DM, Ye L, MacKinnon-Cameron D, Kervin M, Isenor JE, Halperin SA. Healthcare provider awareness, attitudes, beliefs, and behaviors regarding the role of pharmacists as immunizers. Hum Vaccin Immunother 2022; 18:2147356. [PMID: 36472081 PMCID: PMC9762776 DOI: 10.1080/21645515.2022.2147356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We explored perceptions of healthcare providers in Nova Scotia and New Brunswick about pharmacists as immunizers. Pharmacists' scopes of practice are increasingly broadening to include immunization, and providers and policymakers may find meaning in the lessons we learned. Invitations to participate in our online survey were circulated by professional associations, health authorities, and in social media posts. A total of 204 healthcare providers completed our survey, of whom 59.3% were pharmacists, 17.6% were nurses, and 23.0% were physicians. Nurses (30.6%) and physicians (34.0%) experienced fewer logistical barriers to immunizing compared to pharmacists, 71.1% of whom identified practice logistics as a determinant in offering vaccines to patients (p < .001). Pharmacists were most supportive of the expansion of their own scope of practice to include the provision of vaccines to adults (95.9%) and children as young as five years (92.6%) compared to nurses (72.2% and 69.4%) and physicians (61.7% and 40.4%) (p < .001). Diversity of opinion was evident even among pharmacists about whether they should be permitted to vaccinate children younger than five years. Nurse and physician respondents had lower odds of thinking pharmacists have enough training to vaccinate (p < .001), that vaccines should be given in a pharmacy (p < .001), and of supporting the expansion of pharmacists' scope of practice (p < .001) than pharmacists did in the multivariable analyses. Pharmacists are well-positioned and willing to vaccinate and generally have support from their nurse and physician peers, but logistical challenges and interprofessional complexities persist as barriers to optimizing immunization by pharmacists.
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Affiliation(s)
- Antonia M. Di Castri
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna M. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada,CONTACT Donna M. Halperin Canadian Center for Vaccinology, Dalhousie University, IWK Health, and Nova Scotia Health, Halifax, NS, Canada; Rankin School of Nursing, St. Francis Xavier University, PO Box 5000, Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Melissa Kervin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada
| | - Jennifer E. Isenor
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health, Halifax, NS, Canada,Department of Pediatrics, Dalhousie University, Halifax, NS, Canada,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
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Khan D, Hughes CA, Schindel TJ, Simpson SH. A survey of Alberta pharmacists' actions and opinions in regard to administering vaccines and medications by injection. J Am Pharm Assoc (2003) 2022; 63:599-607.e13. [PMID: 36586749 DOI: 10.1016/j.japh.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pharmacists in Alberta have been authorized to administer vaccines and other medications by injection for more than 10 years; however, little is known about the provision of this service and their opinions regarding this service. Understanding pharmacists' experiences regarding injection services would inform development of strategies to improve provision of injection services. OBJECTIVES To describe the actions related to administering an injection, including identification of commonly administered medications, and to identify perceived barriers and facilitators pharmacists face when providing injection services. METHODS An online survey was developed and loaded into REDCap, and e-mail invitations were sent to 5714 pharmacists registered with the Alberta College of Pharmacy in October 2020. Responses were analyzed using descriptive statistics. Pharmacists who administered at least one injection in the previous year were considered active providers, and their opinions regarding injection services were compared with nonactive providers. RESULTS A total of 397 pharmacists responded to our survey, mean age was 42 years, 66% were female, 82% were community pharmacists, and 90% were active providers. The most common injection, administered by 98% of active providers, was influenza vaccine, followed by vitamin B12 (95%), herpes zoster vaccine (88%), hepatitis vaccines (86%), and pneumococcal vaccines (82%). Nonactive providers were more likely than active providers to report that comfort with administering injections (P < 0.001) and managing adverse reactions (P = 0.013) were moderate or major barriers to providing injections. More than 60% of pharmacists indicated that access and automated reporting to the provincial immunization registry would be essential to increasing the frequency of providing injection services. CONCLUSION We identified that Alberta pharmacists administer a wide variety of vaccines and other medications by injection. Respondents identified several barriers and facilitators to providing these services. Addressing these barriers may help improve provision of injection services by pharmacists.
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Eiden AL, Barratt J, Nyaku MK. Drivers of and barriers to routine adult vaccination: A systematic literature review. Hum Vaccin Immunother 2022; 18:2127290. [PMID: 36197070 PMCID: PMC9746483 DOI: 10.1080/21645515.2022.2127290] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/02/2022] [Accepted: 09/17/2022] [Indexed: 12/15/2022] Open
Abstract
We performed a systematic literature review in PubMed and Embase (2016-2021) to investigate the drivers of and barriers to routine vaccination in adults aged 50 and older globally. A thematic assessment identified three categories across 61 publications: sociodemographic, health-related, and attitudinal. The most common sociodemographic determinants (factors identified in studies; n = 47) associated with vaccination uptake were economic status, age, education, and household composition, which had mixed effects on vaccine uptake. For health-related determinants (n = 27), individuals with comorbidities and health care consumption were the most common factors, both increased vaccine uptake. The most common attitudinal factors (n = 42) were self-efficacy, provider or other's recommendations, and vaccine-preventable disease awareness; across studies, all attitude factors had a positive effect, unlike the sociodemographic and health status categories. Findings suggest that patient and provider awareness and education campaigns are effective ways to increase uptake of routine vaccinations in older adults.
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Affiliation(s)
- Amanda L. Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| | - Jane Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
| | - Mawuli K. Nyaku
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
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Merks P, Kowalczuk A, Wong A, Chung K, Religioni U, Świetlik D, Rotmans-Plagens K, Cameron J, Sola KF, Kazmierczak J, Blicharska E, Vaillancourt R, Neumann-Podczaska A. Patient satisfaction with pharmacist-administered COVID-19 vaccines in Poland: a survey study in the vaccination centres context. BMC Health Serv Res 2022; 22:1339. [DOI: 10.1186/s12913-022-08720-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Since 2021, pharmacists in Poland have been authorised to administer vaccinations against COVID-19, which is of particular significance in the efforts towards preventing the spread of the pandemic. The primary objective of this study was to evaluate the patients’ satisfaction with delivering vaccinations through national vaccination centres.
Methods
This study was conducted in 2021. The research tool was an anonymous questionnaire distributed to patients after vaccination. The questionnaire was developed specifically for the purpose of the study. Ultimately, 628 patients participated in this study.
Results
Nearly 97% of the respondents agreed that the administration of vaccinations by pharmacists had been convenient, and pharmacists possessed the relevant skills to provide this service. Almost 90% of the respondents expressed their readiness to be vaccinated by pharmacists again. Nearly all the respondents indicated that pharmacists should also provide other vaccinations.
Conclusions
Patients in Poland have a positive attitude toward vaccinations administered by pharmacists in national vaccination centres.
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Dauz A, O’Neil CK, Stewart-Lynch A. Assessing the Impact of the Consultant Pharmacist on Pneumococcal Vaccine Administration in a Long-term Care Facility. Sr Care Pharm 2022; 37:565-570. [DOI: 10.4140/tcp.n.2022.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective To describe the impact of consultant pharmacist recommendations on the frequency of pneumococcal vaccines administered to older people admitted to a long-term care facility (LTCF). Design: Retrospective observational study. Setting: LTCF with skilled
and intermediate level care. Participants: Adult patients newly admitted to a LTCF in Southwestern Pennsylvania between December 1, 2016, and November 30, 2017, and between January 1, 2018, and December 31, 2019, were included. Interventions The intervention in the
study was a consultant pharmacist-driven immunization screening service that was implemented as part of the admission medication review process in January 2018. To assess the impact of the service, the pneumococcal immunization rates of patients who were candidates for pneumococcal vaccination
were compared between two patient cohorts who were defined by exposure to the immunization needs assessment and subsequent recommendations by a consultant pharmacist. Results A total of 468 patient admissions were included, with 68 in Cohort 1 and 400 in Cohort 2. Pneumococcal
immunization rate, calculated as number of pneumococcal vaccinations administered over the number of admissions eligible for pneumococcal vaccination, had a statistically significant increase (1.9%-20.2%; P < 0.05). Conclusion The recommendations from a consultant
pharmacist as a result of an immunization needs assessment upon admission to a LTCF significantly contributed to an increased rate of pneumococcal immunizations. Further investigation is warranted to evaluate future strategies to reduce vaccination refusals.
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Affiliation(s)
- Aileen Dauz
- Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania
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Patient-Guided Talking Points to Address COVID-19 and General Vaccine Hesitancy. PHARMACY 2022; 10:pharmacy10050137. [PMID: 36287458 PMCID: PMC9611272 DOI: 10.3390/pharmacy10050137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/25/2022] Open
Abstract
Vaccination remains one of the most effective ways to limit spread of disease. Waning public confidence in COVID-19 vaccines has resulted in reduced vaccination rates. In fact, despite vaccine availability, many individuals choose to delay COVID-19 vaccination resulting in suboptimal herd immunity and increased viral mutations. A number of qualitative and quantitative studies have been conducted to identify, understand, and address modifiable barriers and factors contributing to COVID-19 vaccine hesitancy among individuals with access to vaccine. Vaccine confidence may be improved through targeted patient–provider discussion. More patients are turning to pharmacists to receive their vaccinations across the lifespan. The primary goal of this commentary is to share evidence-based, patient talking points, tailored by practicing pharmacists, to better communicate and address factors contributing to vaccine hesitancy and reduced vaccine confidence.
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El Hajj MS, Al‐Ziftawi N, Stewart D, Al‐Khater DMAY. Community pharmacists' participation in adult vaccination: A cross-sectional survey based on the theoretical domains framework. Br J Clin Pharmacol 2022; 89:773-786. [PMID: 36098619 PMCID: PMC9538350 DOI: 10.1111/bcp.15529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES This study aims to assess Qatar community pharmacists' practices in advocating and promoting adult vaccination and to characterize and quantify potential determinants of participation in adult vaccination as vaccine administrators, based on the theoretical domains framework (TDF). METHODS A cross-sectional survey of a randomly selected sample of community pharmacists in Qatar was conducted using a self-administered validated questionnaire. Items in the questionnaire on potential determinants of participation in adult vaccination were based on TDF. TDF items were subjected to principal components analysis. RESULTS In total, 271 respondents completed the questionnaire (67.7%). Most respondents (83.5%) did not have any previous training in vaccination administration and were not involved in any vaccine-related advocacy activities (78.9%). Principal components analysis of TDF items gave eight components: pharmacists' perceived knowledge and skills (median score of 22, interquartile range [IQR] 17-26, possible range: 7-35); perceived confidence (16; IQR 12-20, possible range: 5-25); perceived external support (9; IQR 7-11, possible range: 3-15); professional role identity (38; IQR 33-42, possible range: 11-55); emotions (10; IQR 9-12, possible range: 3-15); perceived consequences (22; IQR 18-24, possible range: 6-30); perceived usefulness (16; IQR 14-18, possible range: 4-20); and behaviour control (6; IQR 4-8, possible range: 2-10). CONCLUSION Pharmacists' perceived knowledge, skills, confidence and behavioural control are potentially important factors to address to facilitate participation in vaccination administration in Qatar. Along with providing vaccination training to community pharmacists, there is a need to change the current pharmacy practice structure to improve managerial and government support for and to equip pharmacies with resources for this role.
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Affiliation(s)
| | | | - Derek Stewart
- College of Pharmacy, QU HealthQatar UniversityDohaQatar
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Aguolu OG, Malik AA, Ahmed N, Omer SB. Overcoming Vaccine Hesitancy for Future COVID-19 and HIV Vaccines: Lessons from Measles and HPV Vaccines. Curr HIV/AIDS Rep 2022; 19:328-343. [PMID: 36114951 PMCID: PMC9483354 DOI: 10.1007/s11904-022-00622-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The discovery of vaccines significantly reduced morbidity and mortality of infectious diseases and led to the elimination and eradication of some. Development of safe and effective vaccines is a critical step to the control of infectious diseases; however, there is the need to address vaccine hesitancy because of its potential impact on vaccine uptake. METHODS We conducted a narrative review of studies on interventions to address measles and human papillomavirus vaccine hesitancy. We discussed how lessons learned from these studies could be applied towards COVID-19 and future human immunodeficiency virus vaccines. RESULTS We found that there are several successful approaches to improving vaccine acceptance. Interventions should be context specific and build on the challenges highlighted in various settings. CONCLUSION Strategies could be used alone or in combination with others. The most successful interventions directly targeted the population for vaccination. Use of financial incentives could be a potential tool to improve vaccine uptake.
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Affiliation(s)
- Obianuju G. Aguolu
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Amyn A. Malik
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
| | - Noureen Ahmed
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
| | - Saad B. Omer
- Yale Institute for Global Health, Yale University, New Haven, CT USA
- Section of Infectious Diseases, Department of Medicine, Yale School of Medicine, Yale University, New Haven, CT USA
- Yale School of Public Health, Yale University, New Haven, CT USA
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Rathbone AP, Baqir W, Campbell D. Barriers and enablers to pharmacists' involvement in a novel immunisation programme. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 7:100173. [PMID: 36082145 PMCID: PMC9445373 DOI: 10.1016/j.rcsop.2022.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022] Open
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Houle SKD, Timony P, Waite NM, Gauthier A. Identifying vaccination deserts: The availability and distribution of pharmacists with authorization to administer injections in Ontario. Can Pharm J (Ott) 2022; 155:258-266. [PMID: 36081916 PMCID: PMC9445507 DOI: 10.1177/17151635221115183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
Introduction: Pharmacist-administered immunizations have been associated with improved vaccination rates; however, little is known about whether areas with little to no access to this service (“vaccination deserts”) exist. The objective of this work is to determine the geographic availability of pharmacists with authorization to administer injections in the province of Ontario. Methods: Ontario College of Pharmacists registry data were used to identify patient care–providing pharmacists in community pharmacies and their ability to administer injections. Their number of hours worked was converted into full-time equivalents (FTEs), assuming 40 hours per week represents 1 FTE. Practice site(s) were mapped by postal code and presented by Public Health Unit (PHU) area. Communities within PHUs were further categorized as urban or rural and northern or southern, with ratios of FTEs per 1000 population calculated for both injection-trained and non-injection-trained pharmacists. Results: In total, 74.6% of Ontario’s practising community pharmacists are authorized to provide injections. Northern PHUs had slightly better access to pharmacist injectors (0.61 FTEs/1000 overall vs 0.56/1000 in the south), while rural communities had lower availability (0.41 FTEs/1000) than urban communities (0.58 FTEs/1000). PHUs with greater population size and density had greater availability of pharmacist immunizers, while PHUs with greater land area were more likely to not have any immunizing pharmacists present ( p < 0.001 for all). Discussion: As pharmacists increasingly become preferred vaccination providers, awareness of disparities related to access to pharmacy-based immunizations and collaboration with public health and primary care providers to address them (e.g., through mobile vaccination clinics) will be required to ensure equitable access. Can Pharm J (Ott) 2022;155:xx-xx.
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Boyce TG, Christianson B, Hanson KE, Dunn D, Polter E, VanWormer JJ, Williams CL, Belongia EA, McLean HQ. Factors associated with human papillomavirus and meningococcal vaccination among adolescents living in rural and urban areas. Vaccine X 2022; 11:100180. [PMID: 35755142 PMCID: PMC9218554 DOI: 10.1016/j.jvacx.2022.100180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/01/2022] Open
Abstract
Background Studies have shown that adolescent vaccination rates with human papillomavirus (HPV) and quadrivalent meningococcal conjugate (MenACWY) vaccines are lower in rural areas of the U.S. than in urban areas. We sought to determine factors associated with vaccine acceptance in these two settings. Methods We conducted a cross-sectional survey of 536 parents or guardians of teens age 13 through 15 years in select rural and urban counties of Minnesota and Wisconsin. We collected information on demographic variables, receipt of adolescent vaccines, and attitudes toward HPV vaccine in particular. Multivariable logistic regression models were used to assess associations between covariates and outcomes of interest (HPV vaccine receipt and MenACWY receipt). Results Of the 536 respondents, 267 (50%) resided in a rural county. Most respondents were female (78%) and non-Hispanic White (88%). About half (52%) of teens of the surveyed parents received the three vaccines recommended specifically for adolescents: 90% received tetanus-diphtheria-acellular pertussis (Tdap), 84% received MenACWY, and 60% received one or more doses of HPV vaccine. Rural and urban parents surveyed differed on several covariates relating to teen's health services, parent's demographics, and household characteristics. Parent's perception of the importance that their healthcare providers placed on vaccination with HPV and MenACWY were independently associated with receipt of each of those vaccines (odds ratio [OR] 6.37, 95% confidence interval [CI] 2.90-13.96 and OR 2.15, 95% CI 1.07-4.31, respectively). Parents of vaccinated teens were less likely to report concerns about potential harm from the HPV vaccine or having heard stories about health problems caused by the HPV vaccine. Conclusion Teen receipt of HPV vaccine and MenACWY appears to be influenced by parents' perception of vaccine importance, provider recommendations, and concerns regarding potential harm from the HPV vaccine. Continued education of providers and parents of the importance of adolescent vaccinations is warranted.
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Key Words
- Adolescent
- CDC, Centers for Disease Control and Prevention
- CHIAS, Carolina HPV Immunization Attitudes and Beliefs Scale
- HPV, human papillomavirus
- Human papillomavirus
- IIS, immunization information system
- IRB, Institutional Review Board
- MCRI, Marshfield Clinic Research Institute
- MDH, Minnesota Department of Health
- MIIC, Minnesota Immunization Information Connection
- MenACWY, quadrivalent meningococcal conjugate vaccine
- Rural population
- Tdap, tetanus-diphtheria-acellular pertussis vaccine
- UIC, Urban Influence Codes
- Vaccinations
- WIR, Wisconsin Immunization Registry
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Affiliation(s)
- Thomas G Boyce
- Marshfield Clinic Research Institute, Marshfield, WI, USA
| | | | - Kayla E Hanson
- Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Denise Dunn
- Minnesota Department of Health, St. Paul, MN, USA
| | | | | | - Charnetta L Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, WI, USA
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