Qualitative Investigation of Community Pharmacy Immunization Enhancement Program Implementation

Abstract

Background: Despite widely available nonseasonal immunization services in community pharmacies, actual pharmacist-administered vaccines are not yet optimal. A flexible choice multicomponent intervention, the “We Immunize” program, was implemented in Alabama and California community pharmacies, with the goal to enhance pneumococcal and zoster immunization delivery. Limited research has been done to qualitatively understand factors influencing immunization service expansion. Objective: Explore pharmacist perceptions of the We Immunize program in terms of its acceptability, impact, and real-world feasibility, and pharmacist-perceived facilitators and barriers influencing success in immunization delivery enhancement. Methods: This practice-focused qualitative research used semistructured telephone interviews with 14 pharmacists at the completion of the 6-month intervention. Results: Major program implementation facilitators were technician inclusion, workflow changes, training and feedback, goal setting, and enhanced personal selling and marketing activities. Multiple pharmacies increased the number of delivered pneumococcal and zoster immunizations, and increased revenue. Many pharmacists felt professional image, knowledge, skills, roles, and personal satisfaction were enhanced, as were technician knowledge, skills, and roles. Program flexibility, along with multiple perceived benefits, increases the potential for success. Conclusions: The We Immunize program appears to have been viewed positively by participating pharmacists and was seen as having a beneficial impact on immunization delivery in the community pharmacies in which it was implemented.

A Qualitative Study of Views and Experiences of Women and Health Care Professionals about Free Maternal Vaccinations Administered at Community Pharmacies

“…Participants' concerns about the gap between general practice and midwife care, and the relatively few maternal vaccinations given in general practice may have helped this support. Other vaccine providers may gradually accept pharmacists vaccinating as others have suggested [50]. Interviewing more nurses than doctors may have influenced our findings; in Canada, nurses accepted pharmacist vaccinators more than doctors [51].…”

“…Increasing vaccinator staff should also help, using intern pharmacists (pre-registration), and pharmacy technicians would help raise awareness, help the pharmacy be more proactive about maternal vaccinations, and allow vaccinations throughout all opening hours. Educating pharmacy technicians about vaccinations helped them raise vaccinations with consumers in a US study [ 50 ], and pharmacy technicians as immunisers occurs in some jurisdictions [ 49 , 57 , 58 ]. Text reminders from the pharmacy might also aid uptake, as found with maternal vaccinations from other health care providers [ 59 ], but would need sensitivity, and should not replace verbal conversations.…”

“…Qualitative research exploring pharmacy-delivered vaccinations has typically been limited to consumers' [21,[63][64][65] and/or pharmacists' views [47,50,66,67], while a strength of this study was the inclusion of other health care provider groups, pharmacists and consumers.…”