Vaccine Administration in Pharmacies, Nontraditional Clinics Could Help Increase Access
Deck: In order to meet national targets, the United States should expand vaccination administration in complementary sites like pharmacies.
Increasing vaccine administration at complementary sites—including pharmacies, mobile clinics, and pop-up clinics—may help expand access in the United States, according to data published in the Journal of the American Pharmacists Association.1
Vaccine Administration in Pharmacies, Nontraditional Clinics Could Help Increase Access / yuriygolub - stock.adobe.com
While vaccines remain effective for preventing infectious disease, the United States still fails to meet certain national targets, with disparities that persist in different racial and ethnic populations. In this study, the researchers wanted to explore the possibility of expanding vaccine delivery by nonphysician healthcare providers (NPHPs) in settings outside of traditional clinics.
The researchers conducted interviews with healthcare providers (HCPs) and vaccination policy experts. They aimed to better understanding perspectives and experiences with complementary settings and vaccine administration by NPHPs. They also sought to determine how policies and patient preferences affect initiatives to increase vaccine administration and to determine any barriers or facilitators to vaccine administration.
Overall, 38 participants completed interviews between April and August 2021. Each interview was conducted by 2 moderators to help reduce bias and variance in interview style; the interviews themselves centered around a pre-tested, structured interview guide.
Out of all participants, 47.4% were NPHPs, 21.1% were physicians, 18.4% were advocates, and 13.1% were policy makers. More than half (60.5%) worked in health care delivery, 31.6% worked in academic research, 28.9% worked in education, and 18.4% worked in program implementation, policy making, and advocacy. Places of employment included hospital/clinic (34.2%), academic institution (26.3%), nonprofit or governmental organization (13.2%), local government agency (7.9%), pharmacy (5.3%), and national government agency (2.6%).
The results indicated that views around vaccine delivery shifted significantly since the COVID-19 pandemic—during the pandemic, there was an increased use of complementary sites for vaccine delivery. The participants noted that these delivery systems increased visibility and use by the public. Notably, participants discussed the success of “drive-through” vaccination locations, which largely did not exist before the pandemic.
Patient preference, paired with site convenience, played a key role in willingness to receive a vaccine at a complementary site. Some patients continue to express preference to receive a vaccine in a clinical setting, while others were willing to be vaccinated at a complementary site due to the convenience. Participants noted that the more flexible hours and reduced costs associated with complementary sites were major advantages. They also said that perceived cleanliness and professionalism was important to make patients feel confident in receiving vaccines at complementary sites.
When asked, most participants indicated that they believed patients would be comfortable receiving vaccines from NPHPs. Again, many participants cited the COVID-19 pandemic with increasing patient confidence in NPHP vaccine administration. However, some participants noted that certain patient populations, including those with chronic or complex health conditions, should only receive vaccines from physicians rather than NPHPs. Currently, there is no standardized training program for vaccine administration for clinical and complementary providers; this may represent an area for future improvement.
Participants identified several factors that can be barriers to vaccine access for vulnerable populations, including language barriers, digital literacy, limited technology access, out-of-pocket costs, and transportation barriers. For NPHPs administering vaccines to these populations, the participants underscored the importance of understanding cultural and subcultural issues affecting these patients.
In order to increase confidence and trust in NPHP vaccine administration, participants noted that physicians play a key role. Patient willingness to receive vaccines at complementary sites can be strongly influenced by their physician’s opinion. Participants also believed there is an opportunity for scope of practice laws to empower more health care providers to administer vaccines.
“In particular, participants advised that state and local public health and patient advocacy organizations should work with state and local level governments to overcome logistical and bureaucratic hurdles to ensure NPHPs are able to practice to the top of their license,” wrote the researchers.
READ MORE: Immunization Resource Center
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