Expert: Community Pharmacists Are a ‘Part of the Solution in the Vaccination Endeavor Globally’

Pharmacist-led services are not only important during COVID-19 immunization efforts in the United States, but are additionally critical in vaccination endeavors globally, according to Catherine Duggan, FRPhamS, CEO of the International Pharmaceutical Federation (FIP) during a webinar hosted by United States Pharmacopeia, World Health Organization (WHO), and the Sabin Vaccine Institute.

“Pharmacists are part of the solution in this vaccination endeavor that we have globally,” Duggan said during the webinar. “The world has changed since previous vaccination campaigns were in place. We have to pick what worked then.”

Duggan explained that specifically, it’s critical for health care professionals to understand that there is a lot behind vaccine hesitancy for many people, from their concerns regarding the speed of vaccine development to fears around potential adverse effects (AEs) to vaccines, such as the concerns regarding the AstraZeneca COVID-19 vaccine.

“What we know as pharmacists, pharmaceutical scientists, and pharmacy educators at FIP is that all health professionals need to play their role in being a wise and trusted source of advice,” Duggan said. “To create some safe space where we understand that people may have concerns and to think about the concerns from their part, rather than just only from the facts, will go a long way.”

At FIP, Duggan noted that the organization received a lot of feedback regarding how the administration methods for the currently available COVID-19 vaccines might not be suitable for certain countries for cultural reasons. They also received feedback on how the vaccine contents or their potential AEs remain enough of a concern that some would prefer to remain unvaccinated.

“The world has been taken aback by the entire global nature of this pandemic,” Duggan said during the webinar. “No one government has gotten it completely right so far. So, our populations are reeling a little bit. It’s important that we all step up and provide calm information in an accessible way that really addresses the causes of concern, not just platitudes of ‘They are safe so get on with it’ because if someone does think they’re safe, they will have the vaccine.”

This level of interpersonal communication on vaccine information to assuage people’s fears requires vaccine advocates be within communities and be representative of those communities. This positioning allows advocates to speak with patients and their families in order to fully address their concerns and help them understand the data around the vaccines, which have made very clear in both the real-world setting and in clinical trials that they are safe.

This is where community pharmacists play a pivotal role globally, according to Duggan.

“Across the world, without exception, community pharmacies have remained open to provide essential services and access to medicines. They’ve found themselves being a source of contact and a port of call for their local communities,” Duggan said.

Duggan noted that community pharmacists have additionally been an authority in communities who can provide assurance and support around the facts, even at times when perhaps their country’s government might be shakier in terms of that level of assurance and clarity for its citizens.

“I think having somebody in a position of authority speaking well about the vaccine is important, and we’ve seen some of our governments have shaky moments around that,” Duggan said. “Having somebody in your community who looks like you, who feels like you, who has the same background as you, who can address your concerns, is as important. We need this pyramid approach where everybody can access information at different times and sources. I think that’s our takeaway, and we’ve seen that across the globe.”

Pharmacists have held this position of authority in communities globally around immunizations for many years, which prompted the WHO to officially recognize their role as global immunizers in 2011. This recognition has allowed pharmacists to take an active role as immunizers in 27 countries and territories globally. In 34 countries, representing about half of the world’s population, pharmacists have taken on the role of vaccination advocates as well, even in countries where they do not have the authority to vaccinate.

“For example, in Ireland, influenza vaccinations have increased by 48% since pharmacists started vaccinating in 2011,” Duggan said during the session. “In Costa Rica, from July 2017 to 2018, pharmacists performed over 48,000 immunizations. We see in many countries that they have very successful vaccination programs for children, but then we don’t see the same spread, or the same expectation of vaccine uptake in older adults.”

Duggan noted that this lack of vaccine uptake among older adults historically may be a contributing factor to the current vaccine hesitancy regarding COVID-19 vaccinations in this population. This may be due to older adults being less accustomed to needing to be vaccinated, prompting latent concerns due to this lack of prior knowledge.

“I wonder whether that’s part of the story with COVID-19, that the most at risk are the least used to getting vaccinations and vaccines in higher income countries. We’ve seen that in this pandemic, but also with seasonal flu, pneumococcal disease, and other diseases. It’s essential to improve immunization coverage across the whole population,” Duggan said.

Specifically, where pharmacy-based vaccinations have been introduced around the globe, vaccination rates have been found to significantly increase across all vaccination providers, not just in pharmacies.

“There’s a myth that if you introduce one profession into the mix, that others may be under-vaccinating, but actually we see the vaccination rate increase across providers,” Duggan said during the webinar. “We think this is possibly because community pharmacists in particular, and hospital pharmacists as they talk to patients going home, they can recommend going to the local pharmacy, and it’s another port of access.”

In light of these positive data regarding the uptake in vaccination rates when pharmacists are authorized immunizers, 16 more countries have put forth legislation to authorize pharmacists as immunizers in order to support the success of their COVID-19 immunization campaigns.

Additionally, IFP has worked to provide case studies and advocacy toolkits from countries where the authorization of pharmacists as immunizers have been successful, in order to showcase to other countries the extent to which pharmacy can impact their COVID-19 vaccination efforts.

“My take-home message is: Pharmacy can be a part of the solution. It won’t take away the solution from another profession,” Duggan said during the webinar. “There’s enough people out there needing vaccinations for us all to take part.”

REFERENCE

Verjee Z, Duggan C, Swaminathan S, Gellin B, Piervincenzi R, Etienne C. Quality, Speed & Equity: Delivering COVID-19 Vaccines to the World. Virtual webinar; March 15, 2021. Accessed March 26, 2021.