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Availability And Storage Of Vaccines In Community Pharmacies
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Pharmacists as Vaccine Facilitators
The
early involvement of pharmacists with immunizations was limited to the
distribution of vaccine products and hosting of immunization providers
in their pharmacy. Community pharmacists facilitated immunizations given
by other health care providers, such as physicians and nurses, by
providing their pharmacies as venues to provide vaccines. Hosting other
providers was usually limited to 2–3 days during the fall and for a
short number of hours during each event. Revenue generated from such
events was also retained by the providers of immunization, and the
pharmacy benefited through goodwill and collateral sales (Grabenstein,
1998). However, with all states currently allowing pharmacists to
immunize, modern community pharmacists now use their pharmacies to host
their own immunization services year-round. This movement away from
being distributors or facilitators to being full providers of
immunizations may explain the scarce literature on the role of
pharmacists as vaccine facilitators and distributors.
As vaccine
distributors, pharmacies facilitate other providers in administering
vaccinations by ordering and distributing vaccine products to physicians
and medical clinics. In a random sample of community pharmacies from 17
states, about one in five pharmacies engaged in vaccine distribution by
reselling or distributing vaccines to local physicians and/or clinics
(Hung, et al., 2007).
The pharmacist’s role as a facilitator improves
immunization rates by increasing other health care providers’
accessibility to vaccine products and the locations where these
providers can offer immunization services. In this role, pharmacists
also aid other providers in improving their immunization offerings and
rates of immunizations. It is important to note that while community
pharmacists no longer serve in the originally defined role of
facilitators (hosting other providers of immunizations), serving as
facilitators was important in the progression of community pharmacists
to immunizers by presenting the public with the concept of vaccination
delivery in the pharmacy setting. For countries looking to implement
pharmacy-based immunization delivery services, it is suggestedthat
pharmacists serve as vaccine facilitators to trial immunization services
in the pharmacy and expose the public and health system to vaccine
delivery occurring in the community pharmacy.
Pharmacists as Immunizers
According
to the APhA Annual Pharmacy-Based Influenza and Adult Immunization
Survey 2013, pharmacists provide vaccinations in 86% of community
pharmacy settings. Patients are also increasingly being referred to the
pharmacy for immunizations by the pharmacists (AphA, 2013) with
pharmacists authorized to administer vaccines in all 50 states, the most
effective and efficient pharmacist role for providing vaccination
services is to serve as an immunizer. As active immunizers, pharmacists
assess patients for indications and contraindications and administer
vaccines directly to the patients that they serve. Immunizing
pharmacists follow the recommendations and immunization schedules
provided by the Advisory Committee on Immunization Practices and the
Centers for disease Control and prevention (CDC, 2015), in a review of
interventions to increase influenza and pneumococcal vaccination rates
among community-dwelling adults, results showed that pharmacist
interventions were ineffective when pharmacists only gave reminders to
physicians and did not themselves administer the vaccinations (Lau, et
al., 2012). This role as an immunizer offers pharmacists the ability to
deliver complete and successful immunization services by combining the
roles of vaccine educator and immunizer.
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