The range of benefits from pharmacist vaccination is huge, and so is the potential, writes Karalyn Huxhagen

FIP recently released ‘An overview of current pharmacy impact on immunisation: A global report 2016’. This report looks at many countries and their progress with pharmacist involvement in immunisation programs.
Many countries have legislated for pharmacists to be able to vaccinate many years ago. The resultant immunisation rates and decrease in infectious disease status in those countries is providing data that can be utilised to prove the worth of pharmacist involvement in immunisation programs.
To understand this area of health you need to understand the definition of two words: vaccination and immunisation. They are often used interchangeably and in the incorrect context.
The FIP report defines ‘Immunisation is the process whereby an individual becomes immune against an infectious disease either by natural contact with an infectious agent or by vaccination (administration of a vaccine to stimulate immunisation).” Vaccination is the process of administering a vaccine which the report defines as ‘vaccines are biological preparations containing one or more active and relatively harmless antigens.’
The report goes on to state ‘The WHO estimates that vaccination saves between 2-3 million lives each year across all age groups; it is one of the safest, more efficient and cost-effective measures for preventing, controlling and eradicating life-threatening infectious diseases.’
The WHO lists 26 infectious diseases that can easily be prevented by a vaccine.
When immunisation in pharmacy was first mooted I pushed very hard to be part of this initiative. Immunisation is a vital part of preventative health strategy and access to pharmacies and pharmacists is a given in nearly every location in Australia making pharmacy an ideal location to provide immunisation services.
Undertaking the training and upskilling to be competent to perform these services was not difficult or outside my comfort zone. I was planning to be a nurse before I became a pharmacist..
I had undertaken advanced first aid including sticking needles in oranges and bananas well before I undertook first year anatomy at UQ where I was allowed to dissect skin and tissue. I have dissected and immunised frogs, toads, mice and rabbits so it was a logical step to move on to jabbing a human.
As part of the immunisation project in Queensland we conducted influenza clinics in the pharmacy I managed.
The people we enrolled and immunised were appreciative that they could complete this valuable health prevention initiative in a clean environment under the direction of a trusted health professional. While they waited for their prescriptions we immunised everybody that was willing and who fitted the criteria of the project.
When completing the survey we had a result of 27% of participants who told us that they would never had made the effort to be immunised unless their workplace provided the service and the vaccine.
The participants found the service in the pharmacy to be conducted with efficiency and professionalism and they all indicated that they were willing to have their yearly influenza vaccine at the pharmacy. Many have returned and asked whether we can perform their travel vaccinations and vaccinations needed for employment e.g. Hepatitis B.
This may seem a small figure but 27% in our pharmacy multiplied by all of the pharmacies across Australia increases the rate of immunisation in Australia immensely.
With extending the scope of the vaccinations available from pharmacists there is a need to ensure areas such as patient recall and follow up are stringently adhered to. Missing vaccines or allowing time gaps to elongate reduces the effectiveness of the immunisation program.
Pharmacy has excellent recall systems to remind patients to have their repeat prescriptions dispensed so implementing a vaccination recall program is an easy fit within pharmacy practice.
To increase immunisation rates there are a multitude of tasks that involve pharmacists:
  • Informing consumers about the need for vaccination;
  • Discussing the risks and benefits of immunisation;
  • Identifying high risk consumers and  specific target groups;
  • Providing evidence based information to consumers who may have reservations about vaccinating;
  • Advocating for and promoting vaccination services;
  • Involvement in the supply chain of vaccines to consumers; and
  • Providing immunisation services (Nurse administered, Pharmacist administered).
In times of pandemic or health crisis pharmacists provide vital roles for emergency immunisation:
  • Storage of larger quantities of vaccines for targeted vaccination programs;
  • Logistic coordination for supply, storage and administration of vaccines;
  • Administration of vaccines to at risk consumers; and
  • Identification and location of at risk consumers.
Pandemic and crisis planning involves community and hospital pharmacies and pharmacists. They are vital to the coordination of vaccination services. Crisis planning activation occurs during and after catastrophic flooding, cyclones and bushfires.
The ability to use pharmacists and pharmacies that are located in areas that are cut off from vehicular access is invaluable to ensure that at risk patients are immunised for hepatitis A and B and influenza.
As the risk of infectious outbreaks are identified airlifts of vaccines to these areas requires a coordinated logistic exercise that culminates in using health professionals who have the skills to provide compliant storage conditions and vaccination services.
Providing immunisation services in rural and remote Australia and in communities without regular GP or nursing services is a vital part of the community pharmacists role.
I recently worked in Alpha which has a visiting GP and the local nurse who is the ‘go to girl’ for everything. The nurse had needed to go away for several weeks which left the community pharmacist as the only ‘in town’ health professional at times.
The pharmacist being able to provide vaccinations when the consumers come to town from long distances away is opportunistic and desirable for the people who live in the more rural and remote communities.
Similarly when influenza starts to spread in these small communities with aged care facilities and small community hospitals it is important that vaccinations are given quickly to reduce the incidence of disease outbreak.
The varied role of pharmacists and pharmacies in providing immunisation and vaccination services is a very important component of the preventative health programs.
WHO and FIP have recognised the need to analyse the data from other countries to allow similar services to be established in those countries that are not part of these programs.
Australia is finally moving forward with each State Health Department altering their respective state legislation to allow the expansion of the scope of practice of pharmacists.
Pharmacy students will learn immunisation practices as part of their university curriculum and this expanded role will become a normal part of pharmacy practice.
Karalyn Huxhagen is a community pharmacist and was 2010 Pharmaceutical Society of Australia Pharmacist of the Year. She has been named winner of the 2015 PSA Award for Quality Use of Medicines in Pain Management and is group facilitator of the Mackay Pain Support Group.
source : https://ajp.com.au/education/clinical-pharmacy/clinical-tips-pharmacist-vaccination-matters/