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Di Castri AM, Halperin DM, Ye L, MacKinnon-Cameron D, Kervin M, Isenor JE, Halperin SA. Public awareness, attitudes, beliefs, and behaviors regarding the role of pharmacists as immunizers. Hum Vaccin Immunother 2021; 17:3052-3065. [PMID: 33988486 PMCID: PMC8381788 DOI: 10.1080/21645515.2021.1913963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022] Open
Abstract
Vaccine coverage is below desired levels in Canada, despite National Advisory Committee on Immunization recommendations. One solution to improve coverage is to offer vaccines in pharmacies. We explore the awareness, attitudes, beliefs, and behaviors of the general public in four communities in Nova Scotia (NS) and New Brunswick (NB) about the changing role of pharmacists as immunizers. Adult members of the public were invited to complete an online survey through advertisements in print and online, and through e-mail lists at local universities. Immunization status among participants (n = 985) varied across vaccines with slightly more than one-half of the participants (51.8%) reporting receipt of a seasonal influenza vaccine last year, 38.0% reporting receipt of the meningococcal C or ACWY vaccine, and 77.7% reporting receipt of the pertussis vaccine. Despite variable self-reported receipt of vaccines, the pervasive belief that participants were not at risk of getting vaccine-preventable diseases, and a lack of awareness about which vaccines are recommended for adults, participants in this study held vaccine-positive beliefs. Participants, especially those who had previously been vaccinated in a pharmacy (39.0%), were supportive of the inclusion of pharmacists as immunizers although nearly one-half of the participants would feel more comfortable getting vaccinated by a pharmacist if another practitioner recommended it to them. While cost threatens to be a barrier to pharmacists as immunizers, this study suggests that they are well-positioned to improve vaccine coverage and to communicate recommendations and other vaccine-related information to the public.
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Affiliation(s)
- A. M. Di Castri
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, NS, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - D. 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, Antigonish, NS, Canada
| | - L. Ye
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, NS, Canada
| | - D. MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, NS, Canada
| | - M. Kervin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, NS, Canada
| | - J. E. Isenor
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, NS, Canada
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - S. A. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health 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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Isenor JE, Edwards NT, Alia TA, Slayter KL, MacDougall DM, McNeil SA, Bowles SK. Impact of pharmacists as immunizers on vaccination rates: A systematic review and meta-analysis. Vaccine 2016; 34:5708-5723. [PMID: 27765379 DOI: 10.1016/j.vaccine.2016.08.085] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/24/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Underutilization of vaccination programs remains a significant public health concern. Pharmacists serve as educators, facilitators, and in some jurisdictions, as administrators of vaccines. Though pharmacists have been involved with immunizations in various ways for many years, there has yet to be a systematic review assessing the impact of pharmacists as immunizers in these three roles. OBJECTIVE To complete a systematic review of the literature on the impact of pharmacists as educators, facilitators, and administrators of vaccines on immunization rates. METHODS We identified 2825 articles searching the following databases from inception until October 2015: PubMed, EMBASE, Cochrane Libraries, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, Google Scholar. Grey literature was identified through use of the Canadian Agency for Drugs and Technology in Health "Grey Matters" search tool. Content from relevant journals and references of included studies were also searched. Inclusion criteria were clinical or epidemiologic studies in which pharmacists were involved in the immunization process. Studies were excluded if no comparator was reported. Two reviewers independently completed data extraction and bias assessments using standardized forms. RESULTS Thirty-six studies were included in the review, 22 assessed the role of pharmacists as educators and/or facilitators and 14 assessed their role as administrators of vaccines. All studies reviewed found an increase in vaccine coverage when pharmacists were involved in the immunization process, regardless of role (educator, facilitator, administrator) or vaccine administered (e.g., influenza, pneumococcal), when compared to vaccine provision by traditional providers without pharmacist involvement. Limitations of the results include the large number of non-randomized trials and the heterogeneity between study designs. CONCLUSIONS Pharmacist involvement in immunization, whether as educators, facilitators, or administrators of vaccines, resulted in increased uptake of immunizations. PROSPERO Registration: CRD42013005067.
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Affiliation(s)
- J E Isenor
- College of Pharmacy, 5968 College St, PO Box 15000, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada; Canadian Center for Vaccinology, 5850/5980 University Ave, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; Faculty of Medicine, 1459 Oxford St, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada.
| | - N T Edwards
- College of Pharmacy, 5968 College St, PO Box 15000, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada
| | - T A Alia
- College of Pharmacy, 5968 College St, PO Box 15000, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada
| | - K L Slayter
- Canadian Center for Vaccinology, 5850/5980 University Ave, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; Faculty of Medicine, 1459 Oxford St, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada
| | - D M MacDougall
- Canadian Center for Vaccinology, 5850/5980 University Ave, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; School of Nursing, 1 West Street, St. Francis Xavier University, Antigonish, Nova Scotia, B2G 2W5, Canada
| | - S A McNeil
- Canadian Center for Vaccinology, 5850/5980 University Ave, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; Faculty of Medicine, 1459 Oxford St, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada; Department of Medicine, 1276 South Park St, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, B3H 2Y9, Canada
| | - S K Bowles
- College of Pharmacy, 5968 College St, PO Box 15000, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada; Canadian Center for Vaccinology, 5850/5980 University Ave, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada; Faculty of Medicine, 1459 Oxford St, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada; Department of Pharmacy, 1796 Summer St, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, B3H 3A6, Canada; Centre for Health Care for the Elderly, 5955 Veterans Memorial Lane, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, B3H 2E1, Canada
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