Search Results (47)

Background: Pneumococcal vaccination rates in the United States (US) remain suboptimal, especially for adults aged 19 to 64 with high-risk medical conditions. Community-pharmacy-based immunization services increase vaccine access, particularly in rural areas. This study describes the provision of pneumococcal immunization services, assesses the processes used to identify and confirm patient eligibility, and determines barriers to immunization services in rural community pharmacies. Methods: A cross-sectional survey was emailed to members of the Rural Research Alliance of Community Pharmacies, located in the southeastern US. The survey assessed which pneumococcal vaccines were offered, age groups, prescription requirements, and how patient eligibility was determined. In addition, participants were asked to rate a series of patient-related and organizational barriers to pneumococcal vaccination. Results: Ninety-four pharmacies completed the survey, with most (96.8%) offering pneumococcal vaccines, most commonly PCV20 (95.6%). Most pharmacies vaccinated patients upon request (98.9%) or when patients presented with a prescription (82.4%), but few proactively contacted patients to schedule the vaccination (17.6%). Pharmacists most often administered pneumococcal vaccines to patients aged 65 and older and used patient age and immunization information systems to identify eligible patients. The most common patient-related barrier was the patient’s belief that they do not need the vaccine. The most common organizational barriers were inadequate reimbursements for vaccine administration and vaccine products. Conclusions: Pneumococcal vaccinations are commonly offered in rural community pharmacies, which play an important role in immunization access. With recent guideline changes to the age-based recommendation, there is an opportunity to optimize strategies to increase vaccine uptake. Full article

Background/Objectives: Seasonal influenza vaccination is crucial for reducing morbidity, mortality, and healthcare burdens. The 2023/2024 Ligurian vaccination campaign (Italy) utilized an inclusive model involving local health authorities, general practitioners, pediatricians, and pharmacies to enhance accessibility. Our study aimed at focusing on factors influencing vaccine uptake, public attitudes and access to preventive healthcare services. Methods: A cross-sectional survey was conducted among adults (≥18 years) in Ligurian pharmacies visitors during the vaccination campaign. A self-administered structured questionnaire gathered data on demographics, vaccination history, healthcare access, and awareness. Results: The study included 30,499 participants, and the median age with P25–P75 (years) was 62.0 [47.0–74.0]; 54.6% were female. Considering determinants of accepting influenza vaccination, age was identified as a strong independent predictor. Each one-year increase in age was associated with a 3.8% increase in the odds of influenza vaccination (OR 1.03, 95% CI 1.03–1.04, p < 0.001). Compared to individuals who never visited their general practitioners, those who visited “sometimes”, “often”, or “very often” had significantly higher odds of influenza vaccination (OR 1.54, 1.97, and 1.98, respectively; p < 0.001 for all categories). The strongest predictor of influenza vaccination in the 2023/2024 season was having received the influenza vaccine in the previous season (2022/2023) (OR 71.73, 95% CI 65.38–78.78, p < 0.001). Consistent with increasing age predicting higher influenza vaccination uptake, older age was associated with lower odds of refusing the vaccine due to the belief that “getting or transmitting influenza does not matter” or due to “other or unspecified reasons”. In contrast, receipt of the COVID-19 vaccination significantly increased the odds of holding these opinions. Among individuals who cited reasons such as fear of side effects, concerns about vaccine safety, fear of injections, general opposition to vaccines, or doubts about vaccine effectiveness, having received the COVID-19 vaccine was associated with lower odds of citing these as barriers to influenza vaccination. Conclusions: Fear of side effects and perceived unnecessary vaccination are key barriers. Targeted education and the involvement of general practitioners could enhance vaccine acceptance, particularly among hesitant groups. Full article

Background: The success of vaccination programs depends on a complex interplay of logistical, social, and structural factors. The objective of this study was to analyze the different approaches to vaccine administration implemented by several Italian regions since the onset of the SARS-CoV-2 pandemic. Methods: After careful qualitative review of information gathered from scientific articles, official reports (grey literature), contact with regional health authorities, and local health departments, five vaccination strategies across several Italian regions focusing on alternative vaccine providers and/or settings were identified. The innovative practices implemented by different actors covered specific topics and were then examined and described in detail. Results: In Veneto, where prevention departments were the main actor, herpes zoster vaccination coverage for the 65-year-old cohort increased from 44.4% to 54.9%; in Tuscany, family pediatricians administered 64% of all childhood vaccines; in Liguria, pharmacies delivered 70.1% of COVID-19 vaccines, while vaccinating in schools in Taranto led to higher human papilloma virus vaccination rates compared to regional and national averages. Finally, in all the regions, hospitals focused on vaccinating healthcare workers and vulnerable populations. Conclusions: The positive outcomes of these five experiences may, in a context of limited resources, encourage other national and international entities to adopt innovative practices, which offer new perspectives beyond the traditional delivery methods (i.e., local health authority vaccination centers for childhood and adolescent immunizations, and family doctors for adults and the elderly). These strategies suggest the efficacy of specific local approaches favored by regional autonomy in optimizing vaccine distribution and coverage. Full article

Background/Objectives: Healthcare professionals’ (HCPs’) accurate knowledge of and positive attitudes toward immunization greatly influence society’s acceptance of it. Early and appropriate immunization education for HCP students is vital. This study aimed to understand current immunization education and vaccine hesitancy among medical, nursing, and pharmacy students in Japan. Methods: An anonymous self-administered online questionnaire was administered to final-year medical, nursing, and pharmacy students in Japan between 6 and 31 March 2023. Survey items assessed current immunization education, preparedness for clinical practice, immunization knowledge, and the degree of vaccine hesitancy. Results: Overall, 525 students (127 (24.2%) medical, 252 (48.0%) nursing, and 146 (27.8%) pharmacy) responded, of whom 39.8% raised concerns regarding new vaccine risks (24.4%,15.9%, and 23.3%, respectively; p = 0.22) and adverse effects (14.2%, 12.7%, and 17.1%, respectively; p = 0.57), including trust in government information (61.4%, 50/4%, and 56.8%, respectively; p = 0.337) or recommended vaccines (57.5%, 4.7%, and 43.8%, respectively; p = 0.113). Preparedness for future clinical practice varied significantly among schools, with medical students (54%) feeling more prepared compared to nursing (34.3%) and pharmacy students (39.1%) (p < 0.001). The average correct immunization knowledge rate was 59.9%, with significant differences between schools (medical 62.7%, nursing 57.6%, and pharmacy 59.6%; p < 0.001). There was no significant correlation between knowledge level and self-assessed preparedness (r = 0.066, p = 0.132). The HCP students wished to receive more immunization education and sought improvements in comprehensive knowledge, communication skills, and practice-based content. Conclusions: For Japan’s HCP students, the enhancement of immunization education focusing on hesitancy and risk–benefit communication is necessary. Full article

Pharmacists are well-positioned to help increase pediatric immunization rates. This study assessed the types of pediatric vaccines offered in community pharmacies, compared participant/pharmacy characteristics and participants’ perceptions of barriers and pharmacists’ role in providing pediatric immunizations between pharmacy-based providers and non-providers, and assessed factors associated with pharmacy-based pediatric immunization provision. A cross-sectional survey was sent to Alabama community pharmacies from February to April 2023, of which 240 responded (20.5% response rate). Measures included whether they offered childhood vaccines in 2022 and the types of vaccines administered, participants’ perceptions of pharmacists’ role in pediatric immunization, and perceived barriers to providing pharmacy-based pediatric immunizations. Roughly half of pharmacies (50.8%) provided pediatric immunization services with influenza vaccines (91.0%) the most commonly provided vaccines and poliovirus-inactivated vaccines (4.9%) the least. Pharmacies providing pediatric immunization services significantly differed from non-providers. That is, the majority of providers practiced within a grocery or retail store; they were younger and practiced in a pharmacy with higher average daily prescription volume and a higher average pharmacy practice full-time equivalent; and they perceived lower implementation logistics barriers and a lower role of pharmacists regarding pediatric immunization. Multivariable logistic regression analysis indicated that implementation logistics is significantly associated with pharmacies offering pediatric immunization services after controlling for pharmacy/participant characteristics (p = 0.01). Therefore, ameliorating implementation logistics barriers should be considered when devising strategies to promote pediatric immunization services in community pharmacies. Full article

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. Full article

Background: The COVID-19 pandemic intensely involved pharmacists in France, with new responsibilities on a large scale, introducing to dispensary practice the performance of vaccination and nasopharyngeal swabs. This study aimed to assess the prevalence of burnout, anxiety, and depression in pharmacists after the COVID-19 health crisis and to identify factors associated with psychological distress. Methods: A cross-sectional observational study involved 1700 pharmacies in an entire French region. Sociodemographic, geographical, and medical information (burnout tested with the MBI and anxiety/depression measured on the HAD scale) were collected via an online anonymous self-administered questionnaire. The characteristics of the pharmacy and the practice of antigen testing and vaccination were requested. Quantitative and qualitative variables associated with psychological distress were investigated with a factor analysis. Results: In total, 360 responses were collected (20.5%). Of the responses, 41.9% showed definite anxiety symptoms and 18.3% showed proven depressive symptoms. Three clusters were described according to the intensity of burnout experience, depersonalization, and loss of personal accomplishment. The analysis identified that one cluster was at high risk of burnout (high burnout and depersonalization scores). Of these stressed, exhausted pharmacists, 69.3% showed definite anxiety, 37.9% showed proven depression, and in smaller pharmacies. The carrying out of antigenic testing and anti-COVID vaccination, as well as the geographical location of the pharmacy, were not discriminating factors in these three groups. Conclusion: Mental health care and suicide prevention should be provided to at-risk pharmacists. It seems essential to publicize the range of resources available to support pharmacists. Full article

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. Full article

Given the complexities surrounding vaccine acceptance of COVID-19 and other vaccines, it is important to determine the underlying health beliefs of patients in order to bridge gaps and promote vaccine confidence. With pharmacies as key hubs for vaccinations and vaccine conversations, examining patient perspectives through the lens of community pharmacy may provide a targeted insight into their patient populations. The primary objectives of this study were to measure COVID-19 vaccine intention and compare vaccine acceptance at pharmacies and clinics between California and Ohio. The secondary objectives included subgroup comparisons of vaccine intention and vaccine acceptance based on demographic characteristics. A previously validated survey instrument (5C survey tool) was administered at pharmacy sites in California and Ohio to examine respondents’ vaccine acceptance (confidence, complacency, constrains, calculation, and collective responsibility). Additional items were added to capture flu and COVID-19 vaccine intention. Reliability and confirmatory factor analysis were completed for the 13-item 5C. Comparisons were made between sites and within different demographic groups. Good reliability (Cronbach’s alpha = 0.768) was found, with nearly all items loading on their hypothesized domains. Respondents from Ohio had significantly higher complacency and constraints domain scores. Highest acceptance was revealed in females, individuals with a Master’s degree or higher, and individuals with the intention to receive a flu vaccine. The adapted 5C is a reasonable tool to measure vaccine intention in English-speaking populations in the US. Certain demographic groups may have lower vaccine acceptance; pharmacists could consider implementing a tool, such as the 5C tool, to identify low acceptance. Given that the 5C tool gathers information on different domains of vaccine acceptance, healthcare professionals could utilize these results to improve trust and vaccine confidence in their patient populations; focused conversations concerning any of the respective domains could best address individual concerns and barriers about vaccinations, notably the COVID-19 and flu vaccines. Full article

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. Full article

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. Full article

Background: Four COVID-19 vaccines are approved for use in Australia: Pfizer-BioNTech BNT162b2 (Comirnaty), AstraZeneca ChAdOx1 (Vaxzevria), Moderna mRNA-1273 (Spikevax), and Novavax NVX-CoV2373 (Nuvaxovid). We sought to examine the type and management of immediate adverse events following immunisation (I-AEFI) after COVID-19 vaccination. Methods: Retrospective review of I-AEFI recorded between July 2021 and June 2022 in 314 community pharmacies in Australia. Results: I-AEFI were recorded in 0.05% (n = 526/977,559) of all COVID-19 vaccinations (highest: AstraZeneca (n = 173/161,857; 0.11%); lowest: Pfizer (n = 50/258,606; 0.02%)). The most common reactions were: (1) syncope, after the first dose of AstraZeneca (n = 105/67,907; 0.15%), Moderna (n = 156/108,339; 0.14%), and Pfizer (n = 22/16,287; 0.14%); and (2) Nausea/vomiting after the first dose of Pfizer (n = 9/16,287; 0.06%), Moderna (n = 55/108,339; 0.05%), and AstraZeneca (n = 31/67,907; 0.05%) vaccines. A total of 23 anaphylactic reactions were recorded (n = 23/977,559; 0.002%), and 59 additional I-AEFI were identified using MedDRA^® terminology. Pharmacists primarily managed syncope by laying the patient down (n = 227/342; 66.4%); nausea/vomiting was managed primarily by laying the patient down (n = 62/126; 49.2%), giving water (n = 38/126; 30.2%), or monitoring in the pharmacy (n = 29/126; 23.0%); anaphylactic reaction was treated with adrenaline (n = 18/23; 78.3%) and n = 13/23 (56.5%) anaphylactic reactions were treated with the combination of: administered adrenaline, called ambulance, and laid patient down. Conclusion: The most commonly recorded I-AEFI was syncope after COVID-19 vaccination in pharmacy; I-AEFI are similar to those previously reported. Pharmacists identified and managed serious and non-serious I-AEFI appropriately and comprehensively. Full article

To address diminishing pediatric vaccination rates resulting from the COVID-19 pandemic, the Public Readiness and Emergency Preparedness (PREP) Act allows pharmacists, technicians, and pharmacy interns to administer any vaccine that the Advisory Committee on Immunization Practices (ACIP) guidelines recommend for all patients aged 3 years and older. A survey was conducted to evaluate the role of pharmacy personnel in the community setting providing immunizations for the pediatric patients. Sixty-seven pharmacies were contacted in a state where pharmacists are allowed to administer vaccinations to any patient over the age of six months. Of the 58 respondent pharmacies offering vaccinations for pediatric patients, the most commonly reported vaccines included influenza (97%), tetanus, diphtheria, and pertussis (88%), hepatitis (71%), human papillomavirus (69%), meningococcal vaccines (66%), polio (45%), and Haemophilus influenzae type b vaccine (40%). Nearly all respondent pharmacies (56/58) reported having at least one of the ACIP-recommended routine childhood vaccinations available for patients under the age of 18. Community pharmacies are well-positioned to administer routine vaccinations to pediatric patients and address declining pediatric vaccination rates. Full article

Health risk assessments (HRAs) are tools used to collect information on patients’ current health conditions, personal and family medical history, and lifestyle factors that can impact their overall health. The objectives of this pilot project were to implement an HRA as part of the appointment-based model workflow and to assess the resulting pharmacy-patient-care service opportunities. Sixteen HRA questions from a single health plan were incorporated into the appointment-based model workflow at an independent community pharmacy. Questions were administered either telephonically or in person over two patient encounters. Pharmacy staff were trained on how to administer the HRA, what to do if patients needed immediate assistance, how to provide referrals, and how to document of responses. Forty-nine patients were contacted and 38 (77.6%) completed the HRA. The median time for HRA completion was 19 min and the identified opportunities were vaccination (49), smoking cessation (15), diabetes prevention program (14), asthma control assessments (8), and substance use disorder screening and referral (3). This pilot project demonstrates that community pharmacies can implement HRAs and utilize the results to identify new pharmacy-patient-care service opportunities that can contribute to improved patient care and practice sustainability. Full article

Healthcare professionals must play an exemplary role in the field of vaccinology. It is convenient that they are trained during their time at university. The objective of this study was to determine the acceptability of the vaccines against COVID-19 in health sciences students in Spanish universities. A cross-sectional study was performed regarding the acceptance of the vaccines against COVID-19 in students in the Health Sciences Degrees in Spanish universities was performed on a sample of students of nursing, medicine, and pharmacy during the spring of 2021, via an online questionnaire with 36 questions designed ad hoc, self-administered, anonymized, and standardized. There were 1222 students participating, of Spanish nationality (97.4%), women (80.5%) and with an average age of 22.0 ± 4.8 years old. Of those, 12.3% had had the disease, 44.0% had to quarantine, 70.8% had undergone diagnostic tests, out of which 14.1% were positive. In total, 97.5% of those surveyed indicated their desire of being vaccinated, if possible, with Comirnaty^® (74.9%). At the time of the study, 49.6% were already vaccinated. The reasons for vaccination differed according to the degree and the doubts about vaccine safety was the largest reason for reluctance. Some 37.7% suspected that there are unknown adverse effects and 85.6% of those vaccinated experienced some mild effects after injection. Vaccine acceptance and confidence in the recommendations given by health authorities is high in health sciences students. Full article