Independent Pharmacy-Led Pneumococcal Immunization Campaign Improves Vaccine Uptake

An independent pharmacy-led pneumococcal immunization campaign led to an immediate and sustained increase in vaccine uptake, according to a poster presented virtually at the American Society of Health-System Pharmacists (ASHP) 2020 Midyear Clinical Meeting & Exhibition.

Tiana Tilli, PharmD, RPh, ACPR, director of pharmacy innovation and professional affairs at Whole Health Pharmacy Partners, discussed the results of the program, known as the “Did You Pneu” campaign, across independent community pharmacies in Canada, in a virtual presentation on December 6, 2020.

“Although the scope of practice of Ontario pharmacists has expanded to include pneumococcal vaccines, little research exists of pharmacy-led immunization programs,” Tilli said in the presentation.

The Public Health Agency of Canada’s National Advisory Committee on Immunizations recommends adults 65 years and older receive pneumococcal conjugate vaccine followed by the pneumococcal polysaccharide vaccine. Canada’s vaccination coverage goal is to reach 80% immunization coverage; however, uptake of at least 1 dose is only 58% in this targeted population, according to Tilli.

Pharmacists practicing in Ontario, Canada, received the authority to administer pneumococcal vaccines in December 2016. Two years later, the “Did You Pneu” campaign was developed with the intention to address barriers to vaccination uptake, including lack of awareness of pneumococcal disease and lack of strong recommendations by health care providers.

“The ‘Did You Pneu’ adult immunization campaign aimed to address these barriers by providing community pharmacy teams with the necessary education and tools to increase pneumococcal vaccine uptake,” Tilli said in her presentation of the results.

The first month-long campaign was introduced in November 2018.

The program included:

• Pharmacist education materials (adult immunization webinar, immunization manual)
• In-pharmacy marketing materials (posters, countertop displays, staff buttons, prescription bag attachments, pamphlets)
• Pharmacy operational supports (prescriber recommendation templates)

Following the launch of the first campaign, pharmacists collected feedback via telephone interviews to inform updates to the program to be rolled out in the second month-long campaign in November 2019.

These updates included:

1. Re-focusing the webinar to be on pneumococcal disease specifically
2. Developing social media marketing materials
3. Enhancing operational supports to include a section for patient self-screening for pneumococcal immunization in the banner’s influenza vaccine consent form and developing pneumococcal vaccine counseling guides.

According to Tilli, the investigators then performed a retrospective observational analysis that looked at pneumococcal vaccine purchase data from a convenience sample of 10 pharmacies from January 2017, before campaign implementation, to December 2019, after 2 campaigns had been held.

Overall, pneumococcal vaccine purchases increased by 23% during the first campaign and another 213% during the second campaign. Sustained vaccine uptake was observed in subsequent months as well, with a 47% increase in the mean number of pneumococcal vaccines purchased per month by the pharmacy banner. Tilli suggested that campaigns should be repeated over several years to further increase uptake.

“This suggests that pharmacists have a role in promoting pneumococcal immunization and can contribute toward reaching Canada’s pneumococcal vaccination coverage goal,” Tilli concluded.

She noted that barriers of the campaign included vaccine cost and out-of-pocket costs for some patients, as well as campaign materials not reaching the entire pharmacy team.

Given the success of the program, Tilli indicated that the next steps include developing adult immunization campaigns for additional vaccine preventable disease, such as herpes zoster and meningitis.

Reference

1. Tilli T, Faggioni M, Wong R. “Did You Pneu?”: Impact of an Adult Immunization Campaign across Independent Community Pharmacies. Poster presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 6, 2020. Virtual. Accessed December 6, 2020. https://www.eventscribe.net/2020/midyearposters/posteragenda.asp?m=nobucket&pfp=Schedule