Strengthening Flu Defenses: How Pharmacies are Leading the Charge in Canada
Lessons can be learned from Canadian models of influenza vaccine management, including proactive patient conversations and optimal workflows.
The Canadian Pharmacists Journal recently published a review titled “A future-forward immunization model of care for high-risk patients in pharmacies: A Canadian consensus." It establishes practice guidelines for pharmacists working in community pharmacy settings while encouraging them to take proactive steps to ensure high-risk patients receive a flu vaccination.
Influenza is one of the most common respiratory diseases in the world, leading to thousands of hospitalizations and deaths in Canada each year. Its peak incidence is between November and April in the northern hemisphere, as shown by an increase in infections from influenza strains A and/or B. Like the US, many patients in Canada doubt the flu vaccine’s efficacy, even though the National Advisory Committee on Immunization (NACI) recommends vaccination for all Canadians aged 6 months and older, particularly those at a higher risk.
Older man receiving a flu shot | Image credit: anon | stock.adobe.com
There is a misconception that the flu vaccine can cause influenza itself, and some argue that natural immunity gained through exposure to the virus is more significant. However, while natural exposure can trigger a strong immune response, it may also lead to more severe symptoms compared with those who receive the vaccine. Vaccines offer a more controlled exposure and lessen the chances of severe influenza-related complications, hospitalizations, and deaths.
Personalized education targeting high-risk individuals about the advantages of the flu vaccine can help dismiss these misconceptions, enhance understanding, and increase vaccine rates. The expansion in availability of flu vaccinations in community pharmacies across Canada has increased access to vaccinations, especially for those at higher risk. During the 2022-2023 flu season, the number of Canadians vaccinated at pharmacies was more than triple those who received their vaccination in physicians’ offices.
NACI has identified individuals for whom the flu vaccine is especially recommended, including young children aged 6 to 59 months (about 5 years), individuals with chronic health issues, pregnant patients, individuals living in nursing homes or other long-term care facilities, adults aged 65 and older, Indigenous communities, health care professionals, and childcare workers. Despite broad knowledge of these risk factors, some individuals might not realize they are in the high-risk category.
The objective of the guidelines are to create a practical, pharmacy-based approach that encourages community pharmacists to accurately screen, assess, and inform high-risk individuals about vaccination benefits and the dangers of influenza. To accomplish this objective, a multidisciplinary team of clinicians across Canada formed consensus-driven protocols to screen high-risk individuals for influenza vaccination in a community pharmacy setting.
The team identified 4 primary areas of interest: proactivity, patient screening, assistance with obtaining vaccinations, and pharmacy workflow. Consensus voting concluded that pharmacies should utilize data from their dispensing software to proactively identify and contact high-risk patients and recommend immunization against influenza. Pharmacists can also proactively screen patients in person, including at a prescription refill, when creating a new patient profile, or during other touchpoints.
For patients who are not eligible to receive a vaccine at the pharmacy, the consensus found that pharmacists should help them identify somewhere else to receive the vaccine (e.g. alternate medical clinics, public health units, etc.). Furthermore, pharmacists should educate patients and provide information about the importance of pursuing this vaccine elsewhere, to increase the likelihood that the patient will receive the vaccine.
Finally, team members discussed optimal pharmacy workflows at length. Online booking systems for appointments are optimal, and individual pharmacies should determine the ideal time interval between vaccine appointments. A postvaccination observation area should be designated, and households seeking multiple immunizations should book together in consecutive timeslots to ensure convenience.
