Back to Pharmacists as immunizers

pharmacist giving flu shotOPEN’s Pharmacists-as-immunizers research is yielding important findings that can help meet the province’s priority to strengthen the effectiveness of its immunization system, one of the health-promotion objectives in the Ministry of Health and Long-term Care’s Patients First: Action Plan for Health Care report (PDF).

The two key goals of this OPEN research project are to estimate the change in Ontario’s influenza vaccination coverage since pharmacists were granted the authority to immunize in 2012 and to characterize the patients vaccinated by community pharmacists versus those in physician offices.

“We found a net gain of almost half a million vaccinations over the 2013–14 flu season,” said Dr. Nancy Waite, co-lead of the project. “This figure takes into account the net number of doses provided by public health practitioners and the number of doses billed by pharmacists and physicians.”

More than 750,000 vaccinations were administered by pharmacists over 2013–14, the second flu season during which pharmacists could vaccinate. Half of Ontario’s community pharmacies are now providing this service, so considerable capacity is available to further increase pharmacist influenza immunizations.

“Looking deeper we found that when compared with patients immunized in physicians’ offices, those receiving flu shots from pharmacists were more likely to be between 20 and 64 years old, live in areas of higher income, be non-immigrant and have fewer health conditions,” Dr. Waite said. “In most public health units — except in the Greater Toronto Area and a few other regions in the province — patients were more likely to be immunized by community pharmacists.”

Project researchers also found that in subsequent influenza seasons, patients were most likely to return to the provider they had been immunized by the previous year, whether pharmacist or physician.

In-person surveys of individuals in community pharmacies show that improving public awareness of pharmacists as immunizers and increasing service accessibility are still needed. This is particularly true for younger adults who are less aware of this service but are more inclined, once they are aware of it, to opt for pharmacy-based immunizations.

The team’s province-wide survey of community pharmacists identified various facilitators of service delivery such as interest in improving patient health, as well as barriers such as disrupted workflow and staffing issues. The survey also revealed a willingness to expand services beyond the influenza vaccine, illustrating the potential for harmonized immunization by pharmacists and other health professionals to improve immunization rates and overcome the pervasive challenge of vaccination hesitancy.

pharmacist immunization wins and needles two pager“These findings can inform future provincial influenza immunization campaigns and suggest that further expansion of pharmacist immunization services to include other vaccines may be feasible and desirable,” Dr. Waite said.

Wins & Needles

We all want healthier communities, and there’s no better example of cost-effective public health initiatives than vaccinations. More than 50 percent of Ontario pharmacies have been part of the free influenza vaccine administration program since 2012, creating a net increase of almost 500,000 vaccinated Ontario residents.

But in 2014 OPEN undertook a survey of members of the public who had not been vaccinated by Ontario pharmacists. More than half of respondents said they didn’t need or want the influenza vaccine. More than a quarter didn’t know pharmacists could deliver influenza vaccinations.

Our research suggests that the convenience of getting an influenza vaccine at the pharmacy, plus the trust clients have in the advice of their local pharmacists, could lead to even higher influenza vaccine coverage in the province. Vaccination-trained and certified pharmacists in Ontario are willing to take a broader role in vaccination.