Transforming Vaccination Globally & Regionally Collection 2020

FIP is excited to have hosted the initiative entitled “Transforming Vaccination Globally and Regionally.” This initiative involved a three-part series of 8 online events each, and is the first FIP transformational outcome-based online programme of its kind, culminating in the signing of the historical commitment by FIP and member organisations to transform vaccinations globally and regionally.

FIP’s vision is a world where everyone benefits from access to safe, effective, quality, and affordable medicines and health technologies. Our mission is to support global health by enabling the advancement of pharmaceutical practice, sciences and education.

With the preventative health agenda, and in the setting of COVID-19, there is a need to transform the way we think about vaccination delivery.

Vaccination is second only to clean water in its ability to transform health. With different countries and regions having varying legal, political, and governance structures, there is an opportunity to transform vaccination globally and regionally by promoting pharmacists as an avenue to facilitate patient access and global health.

To achieve improved outcomes for people though vaccination, there is a need for commitment, solidarity, and action. Now is the time to transform vaccination globally and regionally.

The Transforming Vaccination Globally and Regionally program is a three-part digital Programme about transforming the global & regional vaccination agenda for pharmacy, delivered as live events that are accessible now and in to the future through the http://transformingvaccination.fip.org/ website. The programme and its outcomes are underpinned by the FIP Development Goals and are the first such application of the newly launched Goals.

FIP is pleased to present this digital Transforming Vaccination Collection which captures the key outcomes of the programme and support the implementation and progression of the Commitment which pharmacy professionals from around the world pledged to support.

The Transforming Vaccination Programme Team 

The Editorial

Hear from the FIP Chief Executive Officer Dr. Catherine Duggan on why this Collection is important.  

 

Catherine Duggan

CEO of FIP – catherine@fip.org

 

Editorial Script

Welcome to the Transforming Vaccination Globally and Regionally Programme Collection.

My name is Catherine Duggan, and I am the Chief Executive Officer of FIP.

The FIP “Transforming Vaccination Globally and Regionally” programme delivered in 2020 was the first FIP digital transformation programme involving a three-part series of 24 digital events, culminating in a Global Summit and the FIP Commitment to Action on Improving Vaccination Coverage Through Pharmacies.

The progamme was held over 3 series of 8 events each. Series 1 of the program focussed on identifying the needs of pharmacists and pharmaceutical scientists, so that they are empowered to participate in vaccination programs and address the needs of their communities with respect to vaccine access, health literacy, and preventative health. Series 2 described the actions that must be undertaken in order to meet the needs identified in series 1, from regulatory change; updates to education & qualifications of pharmacists and pharmaceutical scientists; and removing barriers that have been identified that impact on equitable access to vaccination. Series 3 focussed on the local needs of our member organisations, examining how these actions have been implemented, or will be implemented moving forward.

You can revisit all episodes which are available for free on transfromingvaccination.fip.org.

We’re pleased to present to you this Digital Collection which outlines the key outcomes of the programme, and in which we revisit and reflect on the programme’s main highlights and provide resources that support the uptake of the Commitment globally and regionally. Importantly, this Collection also includes an action plan for implementing the Commitment through the FIP Development Goals.

We hope this Collection helps you, our members, progress the vaccination transformation journey in your nations and regions.

Happy reading and we look forward to your engagement!

The FIP Perspective on Vaccination in Pharmacy

The role of pharmacists in immunisation and vaccination varies across the world. In some countries, pharmacists are primarily involved in ensuring the safe supply and dispensing of vaccines, as well as advocating for immunisation, while in other countries they are empowered to play a more active role, as they are legally authorised to organise vaccination activities and campaigns. 

It is estimated that 10 million lives per year could be saved by increasing access to medicines and vaccinations.1 Community pharmacists are therefore in a strong position to provide a major contribution to public health due to their accessibility, distribution and available medicines expertise. During the pandemic in 2020, this accessibility and contribution was amplified as they remained open and accessible to all communities globally. For years, pharmacists have been highly trusted healthcare professionals and can therefore significantly improve communication channels and provide public reassurance on product quality, roles emphasised even more in 2020. Pharmacists can also more easily identify patients at higher risk and specific target groups for vaccination, providing the necessary advice and actively participating in reminder and recall systems to ensure that vaccination schedules are met and regional/global goals achieved.2 

The high accessibility and distribution of community pharmacies make them a first point of contact for patients, providing an excellent opportunity to expand and increase access to immunisation services. This is particularly important in rural, isolated and medically underserved areas, where access to vaccination points can be challenging. Also, in the event of emergencies or outbreaks of communicable diseases, pharmacists should be considered as invaluable contributors, together with other healthcare professionals, in the delivery, access and administration of vaccines. 

The opening hours of pharmacies mean easy and convenient access to vaccination services both for working and non-working individuals. It is worth noting that a large-scale US study of 7,800 pharmacies found that 30.5% of vaccines were administered outside of the usual opening hours of physician’s offices. The study concluded that a large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable.3 The accessibility is never more evident than during the pandemic. 

On the technical side, community pharmacists and pharmacies may provide the infrastructure and medicines expertise required by the vaccines supply chain and storage of cold-chain products, and the safety and quality assurance that society demands of vaccines. 

Pharmacists are highly trusted healthcare professionals who can offer evidence-based information and advice, which helps build individual and societal trust in vaccines as essential medicines. According to current FIP data, pharmacists play a role as vaccination advocates and patient educators in at least 34 countries, representing approximately half of the world’s population, and they have an active role as immunisers. 

Aside from the international diversity of scenarios, with regard to the legal authority of pharmacists and pharmacies to administer vaccines, there are also important differences across countries (or even across subnational jurisdictions in federal states) in terms of the range of vaccines that pharmacies may administer. In a few countries, for example, Argentina, Canada, Costa Rica, Portugal, the UK and the USA, pharmacists are authorised to administer a broad range of vaccines, while in several others the range is more limited. Vaccination against seasonal influenza is the one most commonly administered by pharmacies and is present in all countries where pharmacy-based vaccination is allowed and which have shared data on the range of vaccines with FIP. The rapid increase in the number of jurisdictions that have regulated pharmacy-based vaccination in recent years or expanded the range of age groups and/or vaccines that pharmacists can administer seems to indicate that governments and policy-makers in general understand that increasing vaccination coverage is a public health imperative and that pharmacists should be part of the solution. The wealth of evidence available that demonstrates the impact of pharmacy-based vaccination on immunisation coverage and the economic impact it has for individuals, families, communities and health systems is growing year after year, and this has been crucial to support well-informed policy decisions that recognise and support these expanded roles for pharmacists. 

 

References 

  1. International Pharmaceutical Federation (FIP). FIP global vaccination advocacy toolkit. The Hague: International Pharmaceutical Federation; 2019.  
  1. World Health Organization. Equitable access to essential medicines: a framework for collective action [Internet]. WHO policy perspectives on medicines, Geneva, Switzerland; 2004.  
  1. International Pharmaceutical Federation (FIP). An overview of current pharmacy impact on immunisation – A global report 2016. The Hague: International Pharmaceutical Federation; 2016.  
  1. Goad J, Taitel M, Fensterheim L, Cannon A. Vaccinations administered during off-clinic hours at a national community pharmacy: implications for increasing patient access and convenience. Ann Fam Med [Internet]. 2013 Sep;11(5):429-36.  

A Global Commitment: Implementation through the Development Goals

Pharmacists’ Contribution to Vaccination

Pharmacists have an essential public health role by acting as educators and advisers, facilitating and participating in national and global routine immunisation strategies and practices and/or delivering pharmacy-based vaccinations. Pharmacists assist in overcoming any barriers or misconceptions patients and the public have to vaccination through education, providing evidence-based information and advice to overcome misbeliefs and misconceptions regarding vaccinations. All these roles have already been successfully implemented in various countries around the world and there is a wealth of evidence of the impact of pharmacists’ vaccination-related roles, as outlined in the FIP document Expanding Immunisation Coverage Through Pharmacists.1 

The accessibility and distribution of community pharmacies usually makes them a first point of contact for patients and the public in general, providing the opportunity to promote and increase vaccination services. Due to their easy accessibility, pharmacists can more easily identify and target patients who are at higher risk of vaccine-preventable diseases and their complications. As advocates for vaccination, they build trust with the community to establish the crucial nature of vaccines and their benefits. With their knowledge of the vaccine supply chain and storage of cold products, pharmacists ensure safety and quality of vaccines.2 They are essential contributors for expanding vaccination coverage and overcoming the challenges necessary to improving vaccination compliance. 

The following video excerpt from the programme’s first episode highlights the critical role of pharmacy in the global vaccination agenda.  

FIP Commitment to Action on Improving Vaccination Coverage through Pharmacies and the pharmacy team

One of the primary outcomes of the Transforming Vaccination Regionally and Globally programme was a pledge made by pharmacists, pharmacy technicians, pharmaceutical scientists and pharmacy educators to transform vaccination globally, regionally and locally through the FIP Commitment to Action on Improving Vaccination Coverage through Pharmacies. 

The commitment, launched in December 2020 during the first FIP Virtual Global Summit on transforming vaccination in pharmacy describes 17 actions which include the following objectives:  
• To address vaccines hesitancy; 
•  To strive towards equity of access to vaccinations, with particular focus on expanding vaccination pathways for adults; 
•  To advocate legislative frameworks that provide the regulatory assurance of pharmacist-delivered vaccination services and appropriate funding models; and 
•  To ensure health system readiness for mass immunisation against current and future pandemics. 

“Pharmacy is a highly skilled and trusted health workforce that can deliver an effective and impactful health intervention. All the actions in this commitment are urgently needed to ensure equitable access to vaccines and vaccination services to all people around the world, across all ages and leaving no one behind, to reduce the burden of vaccine-preventable diseases, and to enable pharmacists to play an even greater part in the fight against emerging diseases,” said FIP CEO Dr Catherine Duggan. 

Discussions during the transforming vaccination programme provided a number of insights and priorities. The focus for FIP include : compiling country cases so that experiences can be shared; assuring quality of education and training; supporting logistics; working with other health professions to address barriers to pharmacy vaccination; providing guidelines and other support; and continuing advocacy efforts to raise awareness of the value of vaccination coverage through pharmacies. 

 

Watch the launch of the Commitment here

 

View the FIP Commitment to Action on Improving Vaccination Coverage through Pharmacies here.

 

 

 

 

Transforming Vaccination through the FIP Development Goals

The Transforming Vaccination Regionally and Globally programme was the first digital transformation series used the recently launched FIP Development Goals to unify vaccination in pharmacy across the entire profession. The second series of the programme ‘Setting transformative goals’ Discussed mechanisms and drivers to progress the most relevant FIP Development Goals (FIP DGs) in the context of transforming vaccination in pharmacy. 

The following table summarises the outcomes of series 2: key mechanisms across the FIP Development Goals that can support the transformation of vaccination in pharmacy and can serve as an action plan that could be adopted and adapted by regions and countries worldwide.  

1 – Academic Capacity

Engagement with pharmaceutical higher education development policies and ready access to leaders in all sectors of pharmacy practice and pharmaceutical science, in order to support supply-side workforce development in the areas vaccination training & service delivery.
Capacity for in-practice training and development linked with education providers; pathways for professional advancement from foundation training through to advanced practice and/or specialisation in the areas vaccination training & service delivery.
Institutional academic capacity to deliver quality pharmaceutical sciences education and training for pharmacists and pharmaceutical scientists who contribute to patient care, new discoveries and development, clinical utilisation, marketing regulations, and the economic assessment of vaccines and vaccine services.

 

2 – Early Career Training

Foundation training infrastructures in place for the early post-registration (post-licensing) years of the pharmaceutical workforce as a basis for consolidating initial vaccination education and training, and progressing the novice workforce qualified prior to this commitment towards qualification in vaccination service delivery.
Training strategy and infrastructures providing structured journeys for early career pharmacy practitioners and pharmacy support workers linked towards professional recognition and certification in vaccination service delivery.
Education and training of graduate/post-graduate students and early career pharmaceutical scientists to advance their skills in basic, translational, clinical, and regulatory sciences associated with vaccine development and vaccination service delivery.

3 – Quality Assurance

Transparent, contemporary and innovative processes for the quality assurance of needs-based education and training system, service delivery, and maintaining competence in vaccination delivery by pharmacists.
Training strategies and infrastructures providing early career pharmacists and pharmacy support workers professional recognition & and certification for vaccination service qualification.
Quality and integrity in research, development, manufacturing, and regulations of vaccinations and vaccination services to assure access to safe and effective medical products globally.

4 – Advanced and Specialist Development

Education and training infrastructures in place for the recognised advancement of the pharmaceutical workforce as a basis for enhancing competency of existing pharmacist workforce, in the area of vaccination delivery.
Education and training infrastructures in place for the recognized advancement of the pharmaceutical workforce in the area of vaccination service delivery as a basis for enhancing patient care and health system deliverables.
Sector-specific competency and development frameworks and infrastructures for advanced and specialised pharmacist-delivered vaccination services.

Event 2.1 is linked to Development Goal 4: Advanced and Specialist Practice.

You can watch the event recording here or download event slides.

5 – Competency Development

Clear and accessible developmental frameworks describing competencies and scope of practice for pharmacist vaccinators.
Support the development and training through short courses, certifications (recognition, credentialing) and other continuing professional development opportunities relevant to maintaining vaccination competency.
Develop evidence-based competency frameworks for pharmaceutical scientists to effectively meet the needs in academia, industry, and regulatory bodies in the development of vaccines and vaccination services.

6 – Leadership Development

Strategies and programmes in place that develop professional leadership skills (including clinical and executive leadership) relevant to the delivery and promotion of vaccinations.
Strategies and programmes for professional leadership which incorporates team- and collaborative performance, vaccine service development in line with local needs, and clinical leadership in the area of vaccination that demonstrates responsibility, accountability, decision-making ownership and professional autonomy.
Strategies and programmes for scientific leadership are in place to sustain excellence in vaccine sciences research, development, manufacturing, and regulations.

7 – Advancing Integrated Services

A patient-centred and integrated health services foundation for workforce development, relevant to social determinants of health and needs-based approaches to workforce development for the implementation of pharmacist-delivered vaccination services.
A people-centred and integrated health care provision that is based on an interprofessional and cross-setting seamless continuum including pharmacist-delivered vaccination services.
Scientific strategies to evaluate pharmacist-delivered vaccination services and programmes, including translational and reverse-translational research.

Event 2.2 is linked to Development Goal 7: Advancing Integrated Services

You can watch the event recording here or download event slides.

8 – Working with Others

Clearly identifiable elements of collaborative working and interprofessional education and training in vaccination service delivery, development of programmes, and policy development.
Clearly identifiable elements of inter- and intra-professional collaboration and multi-disciplinary healthcare, delivered through cohesive and interdependent teams working across interfaces and transitions of care to ensure maximal vaccine coverage of the public, through the utilisation of all capable workforces.
Transdisciplinary collaboration to advance education, research, development, manufacturing and regulations that collectively improve access to vaccination services.

9 – Continuing Professional Development Strategies

Existing workforce will be empowered to undertake professional development that results in the capacity of the pharmacist workforce to deliver vaccination services in all settings
In-practice and needs-based continuing professional development (CPD) and continuing education (CE) linked to career development pathways and practice frameworks, aligned with maintaining competence and recency of knowledge in the area of vaccination service delivery
Facilitate collaboration between academia, industry, and government to identify professional development priorities for pharmaceutical scientists and pharmacists in maintaining relevant knowledge in vaccine development and delivery

10 – Equity and Equality

Clear strategies for addressing equity and diversity inequalities in pharmaceutical workforce development, continued education and training, and career progression opportunities in the areas of vaccination service delivery.
Clear strategies for equity and diversity in vaccination service delivery, service access and service impact so that all people have access vaccination services, and all suitably qualified pharmacists are enabled to contribute to vaccine delivery.
Equity in global capacity of pharmaceutical sciences training, research infrastructure, development and manufacturing capabilities, and evidence-based regulatory oversight in the development and implementation of pharmacist-delivered vaccination services.

Event 2.6 is linked to Development Goal 10 Equity and Equality

You can watch the event recording here or download event slides.

11 – Impact and Outcomes

Evidence of the impact of the pharmaceutical workforce within health systems and health improvement in the delivery of vaccination services by pharmacists.
Evidence of the impact of pharmacist-delivered vaccination services in terms of health outcomes and quality of life, improved efficiency of health systems and sustainability.
Strategies and programmes in place to enable timely access to safe, effective, and affordable vaccines and methods of delivering vaccination services.

12 – Pharmacy Intelligence

An international strategy and corresponding actions to collate and share workforce data and workforce planning activities that promotes the development and implementation of pharmacist-delivered vaccination services.
A comprehensive international strategy to collate, share and utilise intelligence on service provision, development, delivery and needs to inform evidence-based services development, policymaking and funding decisions that support pharmacist-delivered vaccination services.
Data-driven decision strategies to accelerate research, development, manufacturing, and market approval of vaccines, in order to maximise clinical benefits for individual patients.

13 – Policy Development

Clear and manageable strategies to develop the pharmaceutical workforce to implement pharmacist-delivered vaccination services and address regulatory and attitudinal barriers to pharmacist-delivered vaccination services.
Clear pharmacy-led strategies to develop and implement evidence-based practice-related policies for vaccination service implementation, integration and remuneration, aligned with broader national health policies and priorities.
Defined strategies to implement needs-based pharmaceutical policies that drive national research priorities, intellectual property protection, licensing, and pricing decisions that facilitate and promote the utilisation of pharmacist-delivered vaccination services.

Event 2.6 is linked to Development Goal 13 Policy Development

You can watch the event recording here or Download event slides

14 – Medicine Expertise

Strategies and systems in place to prepare and train a workforce that can deliver expertise in vaccines and pharmacist-delivered vaccination services.
Strategies and systems in place to provide expert information and advice to patients, formal and informal caregivers, health care professionals and relevant agencies and stakeholders on vaccines and pharmacist-delivered vaccination services.
Promote use of vaccines by mobilising pharmacist expertise in the utilisation of vaccines in delivering quality health care interventions at a person and society level.

15 – People-Centred Care

Strategies in place to develop pharmaceutical education and the workforce to support the delivery of people-centred care in practice, with particular focus on debunking misinformation and disinformation about vaccination
Collaborative interprofessional strategies and people-centred professional services to support the prevention, screening, clinical management and therapeutic optimisation of vaccine-preventable diseases, and addressing fears that people have about vaccinations
Promote the provision of science-based information about vaccinations and collaborate with stakeholders to make available the latest relevant scientific information about vaccinations and vaccine-preventable diseases

16 – Communicable Diseases

Education and training infrastructures in place to develop a workforce prepared to deliver quality services around communicable and vector-borne diseases through the development of pharmacist-delivered vaccination services
Strategies and people-centred professional services for the prevention, surveillance, management and therapeutic optimisation of communicable and vector-borne diseases through the utilisation of pharmacist-delivered vaccination services
Capacity to monitor and respond to communicable disease with innovative approaches for prevention and treatment, including the development of new vaccines, vaccination methods, and the utilisation of the pharmacist workforce to rapidly deploy new vaccines into areas of emerging need.

Event 2.4 is linked to Development Goal 16 Communicable Diseases

You can watch the event recording here.

17 – Antimicrobial Stewardship

Strategies and systems in place to develop a pharmacist-delivered vaccination services as a supportive process to delivering antimicrobial stewardship through the prevention or eradiation of vaccine-preventable infections
Infrastructures and frameworks in place that support the development and utilisation of pharmacist-delivered vaccination services as a pillar of antimicrobial stewardship.
Promote research and development of new vaccination methods, new candidates for vaccines, methods for rapid identification of emerging infections, and methods for evaluating the impact of vaccination on antibiotic stewardship programmes

Event 2.5 is linked to Development Goal 17 Antimicrobial Stewardship.

You can watch the event recording here or Download event slides

18 – Access to Medicines and Services

Strategies in place to widen access to vaccinations through pharmacist-delivered vaccination services, utilising a responsive, capable, available and well-distributed pharmaceutical workforce.
Systems in place to optimise access to vaccines and pharmacist vaccination services through appropriate supply chains, quality standards, self-care & prevention services, and affordability and fair pricing policies.
Access to innovative science and information, new/innovative therapies, new delivery/manufacturing processes that enhance and complement pharmacist delivered vaccination services.

Event 2.6 is linked to Development Goal 18 Access to Medicines and Services

You can watch the event recording here or download event slides.

19 – Patient Safety

Workforce and education strategies linked to patient safety mechanism and reducing medication-related harm in practice and delivery of pharmacist-lead vaccination services
Patient safety mechanisms linked to reducing vaccination and vaccination service-related harm, quality assurance processes in vaccination service delivery, and legislation & regulations applicable to vaccination services
Safety in the development and use of vaccines and vaccine services is promoted through the advancement of vaccine safety science.

Event 2.7 is linked to Development Goal 19 Patient Safety

You can watch the event recording here or download event slides.

20 – Digital Health

Enablers of digital transformation within health infrastructure will be leveraged to assist the pharmacy workforce to implement effective processes for accessing and contributing to shared digital health records, assisting with the efficient utilisation of pharmacist-delivered vaccination services
Systems and structures in place to develop and deliver effective vaccination services through the utilisation of quality digital health services, digital literacy, utilisation of technology, utilisation of digital enablers, and configuration of responsive digital services to widen access and equity to pharmacist delivered vaccination services.
Application of and access to digital technology in healthcare delivery and development, that delivers a collaborative model of health care utilising the expertise of all health professionals in the effective delivery of vaccination services

21 – Sustainability in Pharmacy

Strategies and systems in place that utilise the workforce to enhance sustainable pharmacist-delivered vaccination services.
Policies, regulations and strategies to ensure the sustainability of the environment and minimise the impact of vaccination services. Appropriate mechanisms to ensure the sustainability of pharmacist-delivered vaccination services, through appropriate remuneration models.
Scientific strategies and policies in place to maintain consistent supply of vaccinations throughout lifecycle while limiting negative consequences for the environment

Transforming Vaccination Globally and Regionally: In Review 

The “Transforming Vaccination Globally and Regionally” programme consisted of a three-part series of 8 online events, culminating in the signing of a historical commitment to transform vaccinations globally and regionally through workforce enablement by FIP and member organisations. This commitment sought to address anti-science and misinformation and address hesitancy. The commitments also extended to incorporate vaccination qualifications into pharmacist workforce education, from undergraduate to continuing development, in order to ensure all pharmacists in all settings are capable of delivering vaccinations as a standard part of pharmacist practice.   

Series 1 events focused on identifying the needs of the pharmacist and pharmaceutical scientist workforce to deliver on vaccination transformation.   

Series 2 events discussed the actions required to deliver on the needs identified in series 1, aligned to the FIP Development Goals.   

Series 3 focused on FIP member organizations across 6 regions, and how they have addressed or will address these actions to deliver on the commitment to transform vaccines globally and regionally.

Series 1 summary: Identifying transformation needs    

Series 1 involved 8 events that looked at the identification of needs to transform vaccination globally and regionally for science, practice, workforce, and education. This involved identifying the needs of the pharmacist and pharmaceutical scientist workforce to deliver on vaccination transformation globally and regionally.   

The first event was significantly held on World Pharmacist Day 2020 (#WPD2020) which gave the opening event a profile and impact. The series looked at strategy and policy for global change, empowering pharmacists and addressing barriers, vaccine development and innovation as well as addressing barriers to uptake, adherence, misinformation and anti-Science in the so-called infodemic. The issue of supporting workforce transformation and evolving the pharmacist qualification was explored with various representatives from member organisations globally sharing their insights and experiences to help challenge and progress pharmacist vaccination globally and regionally.    

Speakers presented at round tables, at panel discussions and in webinars to share their insights into the priority areas to transform vaccination globally and regionally.   

The clear and pressing needs of science, practice and workforce and education were identified which led into series 2. 

Episode 1.1 is entitled Introducing the FIP ‘Transforming Vaccination Globally & Regionally’ series Programme… needs, action and outcomes 

Guest panellists addressed the changes needed in workforce, professional practice, and pharmaceutical science to achieve global and regional transformation in vaccination delivery; strategies to overcome vaccine hesitancy and anti-science misinformation about vaccines; the context of the pandemic in current vaccine delivery and transforming vaccine delivery; and how vaccination transformation aligns with the FIP Workforce Development Goals. 

This episode set the stage for the entire programme, outlining the discussions in Episodes 2 to 8 of series 1, as well the themes for Series 2: Actions Required to Achieve Vaccination Transformation; and Series 3: Vaccination Transformation in 6 FIP Regions 

 

 

 

Episode 1.2 is entitled Transforming practice: A focus on strategy & policy for global change. 

Guest panellists addressed the strategy required to deliver changes in policy, both at a workforce level and at a regulatory level, to deliver on the promise of pharmacist participation in vaccination services. 

 

Episode 1.3 is entitled Enabling practice: Empowering pharmacists & removing barriers. 

Guest panellists with expertise in workforce up skilling discussed the barriers to pharmacists delivering transformation of vaccination; access to facilities needed in practice to deliver vaccination; regulatory barriers to vaccination by pharmacists; and addressing stakeholder resistance to change. This episode outlines the process of getting Pharmacists from the NOW of current practice to the VISION of pharmacist practice that will deliver on the commitment to transforming vaccinations.   

The discussion considered the practice needs of pharmacists in all settings; insights from an operational level in delivering vaccination services where they have not been offered before; understanding what good pharmacist vaccination practice looks like; and considerations of space utilization, storage, and logistics to support pharmacist vaccinations.   

 

Episode 1.4 is entitled Addressing barriers to uptake: Adherence, Misinformation, & Anti-Science. 

Guest panellists with expertise in pharmaceutical sciences discussed the science of vaccination; new developments in vaccination delivery; the state of COVID vaccine research; medicine adherence with a focus on vaccine hesitancy; and the impact of misinformation and anti-science on the uptake of life-saving vaccination programmes. 

This episode features interviews with scientists and vaccination experts Colin Pouton, Professor of Pharmaceutical Biology, Monash Institute of Pharmaceutical Sciences (Australia) and Nikolai Petrovsky, Founder and CEO, Vaxine (Australia). Interviews were conducted by Chair of FIP Board of Pharmaceutical Science Ross McKinnon and hosted by FIP CEO Catherine Duggan. 

Episode 1.5 is entitled From smallpox to COVID-19: Vaccine development & innovation 

Guest panellists with expertise in pharmaceutical sciences discussed the history and the future of vaccination; how vaccines are developed; the difficulties in developing vaccines for emerging diseases; and the impact this has on the ability to deliver new vaccines to populations in a timely manner. Panellists discussed current research and where this is heading in the near future; recent developments in vaccine production & logistics; and how COVID has impacted on vaccine delivery and uptake worldwide. 

The event featured a special segment with Ronald T. Piervincenzi, CEO, United States Pharmacopeia (USP), USA. In addition, FIP CEO Catherine Duggan led a discussion with Ross McKinnon and Giovanni Pauletti – (FIP Scientific Secretary, St. Louis College of Pharmacy, USA) to identify key take-aways & needs to transform vaccination through pharmaceutical sciences and what FIP can do to progress this journey. 

 

Episode 1.6 is entitled Transforming our workforce: Evolving the pharmacist’s qualification. 

Guest panellists with expertise in education and workforce development discussed the integration of vaccination content into undergraduate courses so that every graduate pharmacist is able to vaccinate from day 1 of practice.   

Discussions focused on course development and accreditation; considerations for regulation around provision of vaccinations by graduating pharmacists; and the infrastructure needed within the existing workforce to deliver experiential contact for graduating pharmacists.  

 

Episode 1.7 is entitled Enabling our workforce: Supporting ongoing competence. 

Guest panellists with expertise in education and workforce development discussed the delivery of vaccination qualifications to pharmacist to ensure that pharmacists in all settings are able to provide vaccinations.  

Discussions included the types of professional development available for pharmacists; practical administration skills; strategies for addressing vaccine hesitancy; logistics needed to support vaccine services; and regulatory barriers to pharmacist vaccination.  

Episode 1.8 is entitled Reviewing the FIP Transforming Vaccination Programme: Enabling and supporting our profession. 

This roundtable discussion re-examined the issues from this series so far. Panellists discussed their key insights from each episode, and the path forward to achieve transformation of vaccination globally and regionally.  

 

Series 2 summary: Setting transformative goals

The second series in the programme consisted of 8 events that focused on the FIP Development Goals from the perspective of vaccination to identify actions to transform vaccination globally and regionally.   

This series looked at the FIP Development Goals, as 17 of these goals are linked to vaccination. The FIP DGs that were discussed include: FIP DG 10 equity and equality; FIP DG18 Access to Medicines & Services focusing on access to vaccination by all to improve health globally; FIP DG 13 Policy Development; FIP DG 19 Patient Safety; FIP DG 4 Advanced & Specialist Development, FIP DG 7 Advancing Integrated Services, FIP DG 16 Communicable Diseases; and FIP DG 17 Antimicrobial Stewardship.  

Series 2 of the Transforming Vaccination Globally and Regionally Programme was about Action. We took the needs that were identified in series 1 and discussed the Actions that we need to take to address the FIP Development Goals. 

Attendees discussed the mechanisms and drivers that will progress the FIP Development Goals in the context of transforming vaccination in pharmacy; addressing training requirements, policy development, evolution of existing health systems, equity & access to health resources, patient safety, and medicines stewardship principle  

Episode 2.1 is titled Vaccination from Specialist Practice to Every Day Practice, and is aligned with FIP Development Goal 4: Advanced & Specialist Development. 

Attendees discussed the processes required to take vaccination by pharmacists from a specialized field that few pharmacists deliver in some jurisdictions, to a standard part of pharmacists’ care in all settings and locations. 

Attendees also discussed the pioneering work that has been made in countries around the world where vaccinations are provided by pharmacists, how this was achieved, and what steps need to be taken to normalise pharmacists as vaccinators. 

 

Episode 2.2 is titled Empowering Pharmacists to Deliver Vaccination at the Health-System Level, and is aligned with FIP Development Goal 7: Advancing Integrated Services. 

Attendees discussed change management principles in the context of integrating advanced practice services into every day practice, ensuring that vaccination by pharmacists in all settings and jurisdictions is consistent with best evidence and practice guidelines. 

Where a pharmacist is present in all settings, vaccinations can be provided. Ensuring collaborative work and shared documentation with all healthcare professionals to ensure it is an integrated service 

 

Episode 2.3 is titled Removing Policy Barriers to Pharmacist Vaccinations, and is aligned with FIP Development Goal 13: Policy Development 

Attendees discussed the process of policy development, identification of barriers, and engagement with stakeholders to ensure that pharmacist vaccination is accessible to all people in all settings where pharmacists work. 

 

Episode 2.4 is titled Pharmacist Vaccinators and Communicable Disease Management, and is aligned with FIP Development Goal 16: Communicable Diseases 

During this event, Catherine Duggan interviewed Dr Michael Klepser about communicable diseases from the perspective of vaccination by a pharmacist, including the role of vaccination in the prevention and suppression of communicable and vector-borne disease, and the promise of addressing these diseases that pharmacist vaccinators will deliver. 

 

Episode 2.5 is titled Pharmacist Vaccinators and Antimicrobial Stewardship and is aligned with FIP Development Goal 17: Antimicrobial Stewardship 

Attendees discussed the role of vaccination in antimicrobial stewardship, preserving antimicrobial effectiveness, preventing antimicrobial resistance, and the promise of addressing these issues that pharmacists vaccinators will deliver. 

 

Episode 2.6 is titled The Role of Pharmacist Vaccinators in Improving Access to and Equity in Healthcare Outcomes and is aligned with FIP Development Goal 18: Access to Medicines and Services and FIP Development Goal 10: Equity and Equality 

Attendees discussed the role of pharmacists in ensuring that vaccinations are widely and easily accessible by all people in all areas of the world, and the expertise of pharmacists in delivering the logistics and services needed to increase vaccination rates. 

The session was moderated by Catherine Duggan ( CEO – FIP, UK). Speakers included Jane Barratt – (Secretary General – International Federation on Ageing, Canada) and Alexandra (Ali) Ruth – (Doctoral Student – Johns Hopkins Bloomberg School of Public Health, USA). 

 

Episode 2.7 is titled Pharmacist Vaccinators and Patient Safety and is aligned with FIP Development Goal 19: Patient Safety 

Attendees discussed the role of pharmacists in delivering safe vaccinations; participation in vaccination monitoring and adverse event reporting, and the role of improving vaccination rates as a method of reducing overall harm caused by preventable disease. 

 

Episode 2.8 is titled Setting Transformative Goals for Vaccination Globally 

It is a summary event that brings together the topics and issues discussed throughout Series 2, how they meet the needs raised in Series 1, and how this sets the stage for Series 3, where we examined the context Transforming Vaccinations Globally and Regionally within 6 global regions. 

 

All of the Series 2 events are still available to view at the transforming vaccination website, and we hope you are inspired to visit the site and watch these videos as a first step to transforming vaccination in your practice, and – with FIP – transforming vaccination globally and regionally 

Concrete mechanisms were identified to transform vaccination globally and regionally. The tools and structures to enable nations and regions to achieve global transformation of vaccination were shared in these events which leads into Series 3.   

Series 3 summary: Committing to transformation

Series 3 looks at regional engagement to enable a roadmap to be developed for each region and indicators and country level metrics to develop and monitor progress through data collection in the transformation of vaccination globally and regionally. Needs assessments will be able to be done to develop action plans for each region and institution as well as toolkits for needs assessments to aid the transformation of vaccination globally and regionally. With a compilation of best practice from countries to aid other countries in their progress towards pharmacist vaccination.   

Discussions focussed on the progress made in each of the 6 world regions with regards to pharmacist vaccination, the quality and universal access to vaccinations, barriers and challenges facing countries and the regional needs for future transformation. In each regional event, countries were able to share resources and interventions adapted to expand the pharmacist role in vaccination. 

Series 3 shared lessons learned from different countries in the region that achieved a transformation and can help to drive change in the enforcement of the greater role of pharmacists in the most important key areas of health care, vaccination.  

Episode 3.1 looked at Regional Needs and Drivers for Transforming Vaccination in Europe 

This event showcased country examples such as Belgium, France, Malta, Turkey among many others – in addition to understanding the perspectives of regional organisations including Pharmaceutical Group of the European Union (PGEU) , European Healthcare Distribution Association (GIRP). 

Esteemed guest, the technical officer from WHO Regional Office for Europe Dr Niyazi Cakmak attended, and expressed support to the agenda on vaccination in pharmacy. Dr. Niyazi noted that “[The provision of vaccination services] should not be considered in terms of public or private sector perspective. The major driving issue is public service. In that sense, pharmacies provide a public health service. That is how the community pharmacy concept is built on.” 

Episode 3.2 looked at Regional needs and drivers for transforming vaccination: South East Asia. 

This event showcased examples from India, Sri Lanka, Thailand and Nepal. Esteemed guest, the Regional Advisor from the WHO Regional Office for SEA, Manisha Shridhar attended and presented on the Role of Pharmacy Professionals in Vaccination for the COVID19 context and expressed strong support for the role of pharmacy and offered strategic recommendations to support the agenda on vaccination in pharmacy.  

Episode 3.3 looked at Regional needs and drivers for transforming vaccination: Eastern Mediterranean. 

This event showcased examples from Jordan, Lebanon, Egypt, Pakistan and Yemen.  

Esteemed guest, the Technical Officer from the WHO Regional Office for EMR, Adi Nuseirat expressed strong support towards enabling other agenda on vaccination in pharmacy and mentioned that Pharmacists role as HCP expands to include building public awareness, counselling and administration of vaccines.  

Episode 3.4 looked at Regional needs and drivers for transforming vaccination: Western Pacific. 

This event showcased examples from Philippines, Australia and Hong Kong. 

Episode 3.5 looked at Regional needs and drivers for transforming vaccination: Africa. 

This event showcased examples from Cameroon, Ghana, Algeria and Kenya.   

Episode 3.6 looked at Regional needs and drivers for transforming vaccination: Americas. 

This event showcased examples from Panama, Uruguay, Argentina, Ecuador, and Paraguay. 

Episode 3.7 – a roundtable event – is entitled From regional to global: Common priorities for action to transform vaccination 

This roundtable event dissected priorities, needs and barriers across the world’s six regions. Moderators from the six regional discussed common priorities for action to transform vaccination.  

Episode 3.8 is the finale event of the programme and was the FIP Global Virtual Summit: Committing to action to transform vaccination in pharmacy. 

The global virtual Summit is a high-level event that recapped the primary outcomes of the 24-event digital series. It also provided the forum for the launch of the FIP Commitment to Action on Vaccination in Pharmacy. Global leaders from health and pharmacy join this landmark event. 

Transforming Vaccination Globally & Regionally: In Action 

Actions Identified throughout the regions presenting their experiences during Series 3 

Europe

 

Regional needs and priorities identified to transform vaccination 

  • Using lessons learned from countries that achieved a transformation of their pharmacy services can help to drive forward change also in other regions  
  • Fostering (undergraduate) education on vacation across the entire European region   
  • Supporting the entire European region in the adoption of new vaccination models  

Challenges experienced in transforming vaccination for pharmacists.   

  • Turning pilot programmes into nationally applied vaccination services  
  • Regulatory obstacles that hamper policy change at national level (example of Belgium)  
  • Receiving the support needed to drive forward changes at national level  

Lessons learnt whilst transforming vaccination for pharmacists 

  • Pilot projects are a great opportunity to showcase the added value of involving pharmacists in the provision of vaccination services   
  • Expanding vaccination services can improve uptake (example – increase in flu vaccine delivery)  

Key vaccination-related legislative enablers and barriers emerging in the region 

  • Legislative changes are very much dependant on national factors, however linking success stories from other countries to the national context can help with brining about change.  
  • Patience and persistence are important since legislative change may take some time to be implemented.   
  • Changes in government could both be a barrier and an enabler.   

South East Asian Region

Regional needs and priorities identified to transform vaccination 

  • Pharmacovigilance of vaccines in monitoring and management.  
  • Advocacy to the government from national and international organizations 

Challenges experienced in transforming vaccination for pharmacists.   

  • Procurement through medical supply division,   
  • Need of central and regional storage for proper drug storage,  
  • Supply to end-user by medical officer of health, Hospital clinics, and Hospital wards in Patient care.   

Lessons learnt whilst transforming vaccination for pharmacists 

  • Gearing up for Covax-19, Dissemination of Covax news with adaptable guidance, tools, trainings, and advocacy materials.    

Key vaccination-related legislative enablers and barriers emerging in the region 

  • Importation of vaccine should be monitored by legislative authority in a transparent way.   

Eastern Mediterranean Region 

Regional needs and priorities identified to transform vaccination 

  • Ensure undergraduate course includes vaccination training.  
  • Provide post-graduate training for vaccination  
  • Development of guidelines & framework for vaccine delivery (ie setting in pharmacy, re-accreditation, logistics, cold chain)  
  • Lobbying of decision makers is a critical activity, and should be accompanied with development of training, guidelines, and framework of vaccine delivery, to ensure that decision makers can see the evidence of pharmacists being qualified to deliver vaccination.  
  • International organizations – such as WHO, UNICEF, FIP – provide significant support to the lobbying role of local organizations.  

Challenges experienced in transforming vaccination for pharmacists.   

  • Attitudinal barriers from other healthcare workers who currently provide vaccinations, especially where financial factors play a role  

Lessons learnt whilst transforming vaccination for pharmacists 

  • The development of pharmacist capacity should be developed prior to or during the lobbying process, so that pharmacist capacity to vaccinate exists or is being developed at the time that legislation or regulation empowers them to act.  

Key vaccination-related legislative enablers and barriers emerging in the region 

  • The primary legislation enablers are those that recognized pharmacists as vaccinators under the law.  
  • Other legislative factors include laws that control the distribution and funding of vaccines, ensuring these do not prevent pharmacists from participating.  

Western Pacific Region  

Regional needs and priorities identified to transform vaccination 

  • While most impediments are common across different countries (training, public perception, medical profession push-back) and potential solutions are also largely universal in nature, legislation is local (at least national and perhaps state based) and consequently processes to address legislative barriers vary country to country.  
  • The need for countries to roll out COVID-19 vaccination quickly (when it is available) will place a significant demand on existing credentialled vaccinators. This will put at risk usual vaccination programs and can be used as argument for pharmacist to be credentialled as vaccinators to back-fill gaps and maintain the common programs, even if they are not engaged in C19 vaccination.   
  • Do well what we should already be doing so that we have credibility when seeking to do new things: Strengthening pharmacists’ roles in maintaining cold-chain distribution and as a source of common vaccines plus our role in public promotion of vaccination need to be strengthened to establish a sound base for arguing for pharmacist administration of vaccines.   
  • Maintain comprehensive vaccination records including entry into electronic universal health records where applicable.   
  • Monitor and report both adverse events and measures of pharmacists’ performance.   

Challenges experienced in transforming vaccination for pharmacists.   

  • Resistance from other healthcare professions.  
  • Lack of access to funding for vaccination which is available to other health professions.   
  • Lack of space in pharmacies.   
  • Public perceptions and expectations regarding pharmacist services.  

Lessons learnt whilst transforming vaccination for pharmacists 

  • In-principle support from senior representatives of Departments of Health, regulators and legislators needs to be translated into tangible steps to change regulations.  
  • To achieve these steps, it is necessary to counter resistance from other healthcare professions 

Key vaccination-related legislative enablers and barriers emerging in the region 

  • Administration of vaccines by pharmacists may be unregulated – neither allowed nor prohibited by legislation, leaving a ‘grey area’.   
  • Legislative approval to access ‘prescription’ vaccines is necessary for trained pharmacist vaccinators to independently administer vaccines.    

Africa 

Regional needs and priorities identified to transform vaccination 

Advocacy:   

  • Advocate regulatory stakeholders and politicians on the asset which pharmacists represent to increase the vaccination coverage and on the absence of regulation for pharmacists to do so.  
  • Advocate the other healthcare professionals to raise awareness and establish a trustful collaboration  
  • Advocate the pharmacists to encourage them and provide support through professional associations, learned societies and others..  

Education:   

  • Organize practical hands on workshops on vaccination (learned societies, pharmacy schools/ university, FIP or other international organisations…)  
  • Vaccination training should be integrated to pre graduate pharmacy curriculum in the future  

Finances:  

  • The vaccination training must be budgeted  
  • Means need to be provided to ensure vaccines adequate storage  
  • The vaccination act must be financially compensated  

Challenges experienced in transforming vaccination for pharmacists.   

Challenge with the other healthcare professionals:  

  • Vaccination may be seen as within the purview of other healthcare professionals: perception of attempts to take over by pharmacists  

Challenge with pharmacists:   

  • Reluctance among some pharmacists  
  • Difficulties and acquiring new skills or reviving old ones  
  • Added responsibility for immunization  
  • Backfiring from possible ADRs  
  • Misunderstanding of legal provisions  

Logistic challenge:   

  • Respect of cold chain is a challenge in the African region  

Financial Challenges:    

  • Vaccination training not budgeted for by pharmacies  
  • Vaccination act to be compensated  

Lessons learnt whilst transforming vaccination for pharmacists 

Education is a key factor  

Key vaccination-related legislative enablers and barriers emerging in the region 

  • Sensitization of politicians and regulatory stakeholders.   
  • Partnership with health authorities  
  • Endorsement from supra national organisations (APF, FIP, WHO, WHOAfro…) for support in the process  

Americas  

Regional needs and priorities identified to transform vaccination 

  • COVID-19 altered regular/national vaccination plans because of budget restrictions and/or other priorities. There are needs to fulfil the gap that has been generated.  
  • In some cases, vaccination rates are needed to be improved.  
  • Pharmacists wish to participate of immunization programs in community pharmacist in several countries.  
  • Each country has a different context and perspective.  

Challenges experienced in transforming vaccination for pharmacists.   

  • Pharmacists need to be trained.  
  • Pre-graduate and postgraduate changes in education should be introduced to generate the pharmacist competence to deliver immunization services.  
  • National regulation should be changed in order to recognise the possibility of delivering immunization services at the community pharmacy.  

Lessons learnt whilst transforming vaccination for pharmacists 

  • It still exists an important percentage of the population in the Americas who has not suitable information about immunization programs and their advantages.  
  • Immunization vs COVID-19 offers a great opportunity to change actual situation.  
  • Immunization vs COVID-19 will be available with no cost to specific groups (health staff, older than 65 y, etc).  

Key vaccination-related legislative enablers and barriers emerging in the region 

  • The Ministry of Health is identified as the main enabler.  
  • To have community pharmacies integrated into the national health system, with a health role clearly defined.  
  • The Dean of the Pharmacy School, or a qualified person on his/her representation, (or the organization of pharmacies schools) should be part of the national committee where immunization services need to be introduced.  

Spotlight on Barriers to Pharmacists as Vaccination Providers

Considering not only the imperative of improving vaccination coverage but also the overall evolution of pharmacy as a profession towards a broader role primary health care, health promotion and disease prevention, it seems logical to expand the scope of practice of pharmacists to include a series of vaccine-related roles and particularly the administration of vaccines. 

However, this is an evolution that might not be immediately and universally understood or welcomed by several groups, including other health professions, the public or even some pharmacists themselves. 

Several barriers to pharmacists as vaccination providers have been identified. Counteracting these arguments with evidence of impact is a critical and ongoing activity to ensure pharmacists are accepted as vaccination providers in all settings and all jurisdictions 

The arguments presented below are often without foundation, often not based on fact, or are addressed by the imperative to build a sustainable framework for pharmacist vaccinators, including undergraduate education and ongoing professional development. What is important is to identify the barriers and arguments, compile the evidence and impact of pharmacists as vaccinators and the benefits this brings, so as to advocate effectively. 

Arguments sometimes used against pharmacists gaining vaccination authority 

Arguments used by other healthcare professions 

  1. Fragmentation of care 
    1. It would lead to incomplete medical records/incomplete patient history
    2. Health care should be led by general practitioners 
    3. Doctors will have to manage the ill effects of pharmacist vaccination 
    4. It would only shift the demand but not improve vaccination coverage 
  2. It would be a lost opportunity for a holistic health care approach by doctors 
  3. Vaccination payments sustain general practice services 
  4. There is a finite supply of vaccines that would be spread too thinly across vaccination providers 
    1. This would disadvantage patients 
    2. Pharmacists would waste vaccines on healthy people 
  5. It is too costly to extend national cold-chain distribution service to pharmacies 
  6. Lack of competence of pharmacists: 
    1. Pharmacists are not trained in anatomy or public health 
    2. Pharmacists have no experience in managing anaphylaxis 
    3. Pharmacists cannot provide confidentiality 
    4. There would be no follow-up of patients 
    5. Pharmacists have no such training at undergraduate level 
    6. It is outside the scope of practice of pharmacy 
    7. Theoretical training is no substitute for real-life experience 
    8. The public cannot trust quality or competence in pharmacy 
    9. There would be an increased risk of shoulder injuries from incompetent vaccinators 
  7. Inappropriate facilities/lack of privacy in pharmacy 
  8. Pharmacies are profit-driven corporations 
    1. Pharmacy is retail, not health care 
    2. Waste of limited supplies on inappropriate patient groups 
  9. Vaccination rates are as good as anywhere — pharmacy participation is not necessary 
  10. There is no evidence that pharmacist vaccination improves overall coverage

Arguments used by pharmacists 

  1. Vaccine administration is outside our scope of practice — pharmacists reluctant to touch patients 
  2. Vaccination cannot be integrated into the pharmacy workflows 
  3. It would introduce a distraction from core function of dispensing and medicines management services 
  4. It is economically unsustainable 
  5. It requires too much upfront investment in consultation room, fridge space, training, adrenaline pens etc.. 

Arguments used by the public/media 

  1. Vaccines do not work 
  2. The urge to improve vaccination coverage is a conspiracy driven by the pharmaceutical industry 
  3. The side effects of vaccine are worse than the illness being prevented  

Arguments used to gain and support pharmacy vaccination rights 

  1. Health care should be multidisciplinary and interdisciplinary — and have the patient’s best interest at its centre. 
  2. There is no “fragmentation of care”, because pharmacies and the location of the premises are an ideal extension of healthcare systems and part of the healthcare team attending to each patient. The important element is that pharmacists have read-and-write access to patients’ immunisation records, as this enables them to record vaccinations and monitor vaccination coverage, and to measure the impact of their services. Also, when pharmacists have access to vaccination records, they can remind patients of their next vaccination needs, even when patients visit the pharmacy for other reasons 
  3. Pharmacists are knowledgeable about communicable diseases, vaccines and immunology, and can offer information and education to patients, and actively dispel myths and prejudices against vaccines through evidence-based advice. 
  4. Pharmacists are competent to administer vaccines and will only provide the service once they have received certified training for doing so. This includes the management of potential adverse events, such as anaphylaxis. In addition, anaphylaxis is an extremely rare reaction, and some countries where pharmacy-based vaccination has been available for several years have never had a single case of anaphylaxis. 
  5. Pharmacists who receive certified training for administering vaccines are at least as competent as other healthcare professionals to deliver this service and manage any potential adverse events. 
  6. Pharmacy is a well organised and dynamic profession, and its professional organisations have the capacity to reach out to practitioners, train and certify them, and engage practitioners to adopt this new role. 
  7. The role and scope of practice of community pharmacists is increasing to include a number of health promotion, disease prevention and disease state management services, aside from dispensing medicines and ensuring their responsible use. Community pharmacies function as a gateway and an integral part of healthcare systems. Their services contribute to improving the efficiency and sustainability of health systems, namely by preventing the saturation of other parts of the system, such as GP offices and emergency rooms. When necessary, they refer patients to other healthcare professionals or facilities. 
  8. Pharmacists are experts in medicines and in conveying advice in lay language and using different communication methods (e.g., oral, written, pictograms, different languages, etc.) 
  9. Pharmacists are familiar with the religious and cultural diversity of their communities. They address concerns and beliefs in a respectful manner and even develop materials addressing specific groups in the community. 
  10. Pharmacists can organise community reach-out activities and campaigns to inform and advise about vaccines in schools, community centres, workplaces, etc. 
  11. Pharmacists are highly trusted professionals, and one of the most accessible health care providers, with widespread presence across territories and convenient opening hours for both working and non-working patients. 
  12. Pharmacists are bound by a code of ethics: not only are their priorities to serve the healthcare needs of patients and contribute to the efficiency of health systems, but their professional ethics guide their access to and use of sensitive patient data. 
  13. Pharmacies follow good practice standards with regards to their facilities, ensuring patient privacy and appropriate storage conditions for all medicines, including those that require strict cold-chain management. In addition, pharmacies have the infrastructure, equipment and logistics in place to store and handle such products. 
  14. In many places, pharmacies are connected via electronic network systems that allow them to receive and access instantly information about vaccines, notifications of quality problems or recalls, shortages of vaccines, etc. 
  15. Patients value the ease of access to pharmacies when they need to be vaccinated and informed, and are often willing to pay for the service if it saves queuing, waiting times and taking time off work to visit a health care centre or GP. In addition, people visit a pharmacy far more often than they visit a physician’s office, which offers more opportunities to be reminded about vaccination and actually be vaccinated, and particularly to identify risk group patients. 
  16. The high accessibility of community pharmacies is not only about their territorial distribution, but is also about the close relationship they establish with the surrounding community. 

Pharmacy-based vaccination is not a speculative or risky project with no evidence regarding its social value: it exists in at least 36 countries around the world according to FIP data from 2020. Ten respondents (2 from upper-middle income and 8 from high-income countries or territories) reported that the service is reimbursed by public health systems, and five reported the existence of reimbursement by private health systems. In addition, pharmacists play a role as vaccination advocates and educators in at least 34 countries. Enabling legislation to introduce it is being considered in an additional 16 countries.  

Barriers and enablers identified during the Transforming Vaccination Globally and Regionally Series 3 events 

Event 3.1: Regional needs and drivers for transforming vaccination: Europe 

  1. Pharmacists are important actors in making vaccines and vaccine information available to the public 
  1. Developing vaccination qualifications to make pharmacists competent to administer vaccines is a key factor for transforming vaccination 
  1. Best practice sharing can help with bringing about change at national level  
  1. Advocating about the advantages that diversifying the provision of immunization services through the involvement of pharmacists can add is an important tool for bringing about change   
  1. Collaboration between health care professionals is an enabler that should be utilised  

Event 3.2: Regional needs and drivers for transforming vaccination: South East Asian Region 

  1. Identification of needs in the Consideration for transforming vaccination. 
  1. Preparedness to rule out COVID-19, planning for COVID-19 vaccine deployment. 
  1. The Vaccine Readiness Assessment Tool (VIRAT) transformation to all countries by Ministries of Health with support from WHO and UNICEF. 
  1. Immunization through the existing health care system like Hospitals, Dispensaries, Paramedics etc. 
  1. Roll out Vaccine cold chain management logistics, well trained human resources by FIP developed training programs. 
  1. A proactive healthcare professional, preferably a pharmacist will have a huge impact on the likelihood of a patient to be vaccinated.    

Event 3.3: Regional needs and drivers for transforming vaccination: Eastern Mediterranean 

  1. Lobbying decision makers & legislators, including the involvement of international organisations to support the position of local pharmacist organisations.  
  1. Creation of guidelines for vaccination by pharmacists, framework for pharmacists’ roles within the health system, and accredited training at the same time as point 1, so that pharmacists are qualified and ready to contribute the moment that legislation catches up.  
  1. Inclusion of international organisations – WHO, UNICEF, and FIP – in the process of lobbying decision makers & development of training was a consistent theme.  
  1. Addressing opposition from others within the healthcare sector is an important part of removing barriers  
  1. Addressing vaccine hesitancy is an important aspect of improving vaccine uptake for all people, and is especially important in areas where reactions to vaccine programmes may be violent.  

Event 3.4: Regional needs and drivers for transforming vaccination: Western Pacific 

  1. Advocacy: Support from regional and global agencies is helpful in convincing domestic stakeholders.  
  1. Training and certification: Pharmacists have significant relevant knowledge which means additional training to satisfy credentialing as a vaccinator is not excessive.  
  1. Legislative issues. This is the impediment that has greatest variability across the Region with each country a unique situation.   
  1. Step wise roll out. Once vaccination by pharmacists is approved and initiated, a staged increase in the range of vaccines and the age range of recipients should be applied.  
  1. Public and healthcare professionals’ acceptance: Data that shows pharmacist vaccination leads to an increase in the percentage of the population vaccinated can be used to counter the medical profession’s argument that pharmacists are encroaching on their role.  

Event 3.5: Regional needs and drivers for transforming vaccination: Africa 

  1. Vaccination by pharmacists is permitted in Kenya, but not permitted in Cameroon nor in Ghana. It is not officially permitted in Algeria though practiced by some community pharmacists. 
  1. Importance of advocacy to politicians, other healthcare professionals and stakeholders on the added value of pharmacists in vaccination coverage  
  1. Importance of education to empower pharmacists as accountable 
  1. Vaccination by pharmacists must be legislatively recognised and financially compensated to be sustainable.  

Event 3.5: Regional needs and drivers for transforming vaccination: The Americas 

  1. In a country where immunization services have been introduced in community pharmacies, the contribution to improve the vaccination rates of non-obligatory vaccines have been achieved (like flu vaccine). 
  1. Pharmacist must be in the pharmacy, with suitable training (both at graduate or continuous education level) 
  1. Several countries expressed the importance of moving move forward to introduce immunization services in community pharmacies 
  1. To introduce immunization services requires a legislative framework, training opportunities for the pharmacist and technical requirements for the pharmacy (patient records and keeping the cold chain suitable). 
  1. It is important to learn/know international experiences of immunization services in community pharmacies, and how these could be transferred to local needs.  

Stakeholder Perspectives 

During my presentation, I was struck by how similar pharmacists are all over the world.  We are frontline providers of care for our patients, and often the most accessible point of care for individuals.

Pharmacists have a passion to serve patients and promote their wellbeing.  This puts pharmacists in virtually every country in the world in a highly visible position to advocate and administer immunizations.  Pharmacists have the knowledge to safely administer immunizations.  There are myriads of data to demonstrate this.

Additionally, we know that providing immunizations to at risk individuals is perhaps the single most cost-effective means to promote wellness and improve the quality of life and productivity of a population. 

Governments must recognize the impact that pharmacists could have on the health and economy of their countries through immunization and disease management programs.

Provision of immunizations should be considered a standard element of pharmacy practice in every country of the world.

 

Michael E. Klepser, PharmD, FCCP, FIDP
Professor – Ferris State University College of Pharmacy
Event 2.4 Pharmacist vaccinators and communicable disease management

 

A life-course approach to vaccination is the best approach for all.  Ending inequity to vaccines and vaccination across all ages must be at the forefront of conversations on health promotion and prevention. 

It is important to ensuring the best possible health, well being, function and quality of life for older adults and people of all ages.

Community pharmacists are vital to the improvement of uptake rates of vaccinations, and especially adult vaccination. Pharmacists must be prepared to partner with professional, patient and advocacy organisations in their advocacy efforts 

The link between vaccination services and the management of Non-Communicable Diseases in the community setting, including the promotion of adherence to treatments and a series of support services by pharmacists especially focusing on older adults. 

IFA and FIP are true collaborators and partners working to maintain and improve the health and well being of people of all ages create 

Vaccination throughout life is a cornerstone of public health and one of the most effective methods of preventing the spread of infectious disease. It saves not only millions of lives of healthy citizens as well as those most vulnerable, but also the livelihoods of tens of millions of families around the world. 

Pharmacists are that rare profession making the connection between persons most at risk of vaccine preventable diseases, such as older people and those with chronic conditions. They listen, advise, and promote the importance of adherence to treatments, and provide a series of support services that inherently optimise a person’s functional ability.

 

Jane Barratt
Secretary General – International Federation on Ageing, Canada
Event 2.6 The Role of Pharmacist Vaccinators in improving access to and equity in healthcare outcomes

Pharmacies play a key role in extending access points to vaccination services, particularly via extended hours and accessibility in rural areas where access to primary care providers may be more sparse (in the U.S. context)  

Pharmacists can also act as an additional educational resource for patients seeking vaccine information – ideally vaccine education in pharmacies can be tailored to be culturally appropriate for especially hard-to-reach groups, which is important from an equity perspective (i.e. providing additional interventions for populations that may have a higher need for vaccination / greater burden of disease) 

Barriers to pharmacy vaccination include financing and billing issues, scope of pharmacist vaccination authority, and occasional supply issues – stakeholders should address these issues to reduce barriers to pharmacy vaccination so pharmacists can continue to promote vaccine equity 

To address vaccine hesitancy, vaccine messaging must be harmonized across stakeholder groups and pharmacy orgs should be included in these stakeholder discussions early and often 

Alexandra Ruth
Doctoral Student – Johns Hopkins Bloomberg School of Public Health, USA
Event 2.6 The Role of Pharmacist Vaccinators in improving access to and equity in healthcare outcomes

Pharmacists have long provided a significant contribution to the delivery of healthcare around the world through their expertise in medicine and medicines management. The addition of vaccination to the scope of practice for pharmacists has over decades, in many countries provide an opportunity to expand access to immunisation services in the community. Now, more than any time in the face of the COVID19 pandemic we see that contribution and the role of pharmacists in vaccine administration as more important than ever.

Investment in the training of students, qualified pharmacists (existing workforce) and technicians to provide vaccinations is paramount for the future of the profession. The addition of further skills in the administration of medicines, clinical skills in patient assessment and management and the value provided by the increasing involvement in these key public health and primary care activities is essential.

Every pharmacist can play a role in advocating with patients, the community and health services and political agencies to increase vaccination provision generally, but also for the role of pharmacists in this critical health activity. Pharmacists – you can! 

Dr Lisa Nissen
(BPharm, PhD), AdvPracPharm, FPS, FHKAPh, FSHP
Professor (Head), School of Clinical Sciences, Queensland University of Technology
Event 1.6 Transforming our workforce: Evolving the pharmacist’s qualification

Acknowledgements

Programme speakers and moderators (in order of appearance) 

Series 1: Leonora O’Brien; Ema Paulino; Paul Sinclair; Samira Shammas; Indrė Trečiokienė; Manjiri Gharat; Yong Pei Chean; Faraz Ashraf; Dalia Dawoud; Helena Rosado; Sofía Segura;Ross McKinnon; Colin Pouton; Nikolai Petrovsky; Giovanni Pauletti; Ronald T. Piervincenzi; Ralph Altiere; Ian Bates; Lisa Nissen; João Guedes; Romeo C. Ongpoy; Jane Hanrahan; Omotayo Carolyn Olayoe; Mitch Rothholz; Han Zhe; Allie Jo. Full affiliations can be found under each series 1 event here.  

Series 2: Arit Udoh; Desak Ketut Ernawati; Hanne Merete Andresen; Andi Shirtcliffe; Greg Eberhart; Jorge Batista; Marwan Akel; Barbel Holbein; Sofía Segura; Pamela Logan; Scarlett Pong; Ellen Schafheutle; Chima Amadi; Walter da Silva João; Howard Rice; Shane Jackson; Michael Klepser; Sabiha Essack; Alfonso Pereira Céspedes; Manjiri Gharat; Philip Howard; Debra Goff; Jane Barratt Alexandra (Ali) Ruth; Lars-Åke Söderlund; Ramesh Walpola; John Hertig; Alpana Mair. Full affiliations can be found under each series 2 event here. 

Series 3: Stephanie Kohl; Alain Delgutte; Monika Derecque-Pois; Mary Ann Sant Fournier; Lieven Zwaenepoel; Mesut Sancar; G. Sumalatha; Ashok Soni; Rao Vadlamudi; Lalith Senarathna; Kampanart Huanbutta; Yagya Prasad Neupane, Exchairman; Manisha Shridhar; Nadia Al Mazrouei; Samira Shammas; Ziad Nassour; Zeid Kilani; Alaa Hayallah; Faraz Ashraf; Mohammed Al-Nuzili; Adi Al-Nuseirat; John Jackson; Parisa Aslani; Gilda Sebua-Saljay; Peter Guthrey; Prosper Hiag; Jacqueline Surugue; Nilhan Uzman; Yvonne Yirenkyiwaa Esseku; Redouane Soualmi; Nahil Dave. Full affiliations can be found under each series 3 event here. 
 

FIP Leadership, members & partners 

FIP President Dominique Jordan; FIP Executive Committee & Bureau; FIP Members; FIP Partners; and the Regional Pharmaceutical Forums & regional leaders.

 

 FIP Transforming Vaccination Programme Project Team 

Events, Marketing and Communications Team  

Sponsor & supporter Pfizer