Is pharmacy a vaccination barrier?


Study reveals GPs’ concerns over pharmacists’ participation in influenza vaccinations  

Pharmacist involvement is perceived by GPs to be a barrier to the effective delivery of influenza vaccination to high-risk adults in a general practice setting.

A series of detailed interviews conducted by researchers found that while survey participants reported having the capability, opportunity and motivation to effectively deliver influenza vaccination to high-risk adults there were perceived barriers that may be leading to sub-optimal outcomes in at-risk groups. 

Barriers identified included time pressures, complexity of patient consultations, difficulty reaching high-risk younger adults, issues related to optimal timing of influenza vaccination, inconsistent vaccine supply and pharmacist involvement in vaccination.

The full interviews, by researchers from the University of Sydney and the University of Notre Dame Sydney, were conducted with six general practitioners and eight practice nurses, recruited from “diverse locations across Australia”.

The GPs and GPNs all raised concerns regarding pharmacies providing influenza vaccination for high-risk adult populations.

Pharmacy influenza vaccination was mentioned by all participants in the study, the authors said. While some recognised the benefits, most notably increasing access, there was “consistent concern about governance and continuity of care. These concerns were perceived as barriers.”

“While there was some acknowledgement that allowing pharmacists to administer influenza vaccine had positive outcomes, including increased access and opportunity to receive a vaccination, participants also noted what they perceived as a disruption and barrier to the individual’s continuity of care”.

“I am concerned about potential hazards… how would a pharmacist manage someone who has a syncopal collapse because they have freaked out because they are having a needle or if they have an allergic reaction? How do they manage confidentiality and medical records?,” one of the GPs in the study said.

“The other problem with the pharmacy program is that there is fragmentation of healthcare so we are not getting info that patients have had vaccines and so we are flagging people down to say come and get your vaccine but they have already done it but we don’t know what they have had”.

Although other models such as council-run clinics exist, the same level of concern was not raised. This may be due to council-run clinics being an established service run by nurses with or without GPs, while pharmacist vaccination is new and involves a different professional group, the study authors suggested.

“If all pharmacists were required to provide details of vaccinations to a patient’s nominated GP, as is already the case in Victoria, Queensland and the Australian Capital Territory (although the extent of compliance monitoring is unclear), this could partly address these concerns and avoid the need to check AIR data, which are known to be underreported for influenza vaccination,” they said.

The research was published in the Australian Journal of General Practice. 

 

 

 

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12 Comments

  1. Phil Willis
    06/09/2021

    Seems like a small sample size albeit the same old prejudices cropping up from the GP/Nurse fraternity failure to accept pharmacists can deliver vaccinations in a effective, safe & efficient manner.

  2. Jim Tsaoucis
    06/09/2021

    we are all suppose to be on the same team…yeah??

    • Phil Willis
      06/09/2021

      I think they expect us on their team but not vica versa

  3. hazem elshekehiby
    06/09/2021

    It seems that GPs need to be educated about how pharmacies run and how we maintain records much better than other entities, also they need to do extra work to check the AIR.

  4. Nicholas Logan
    06/09/2021

    I am concerned about potential hazards… how would a GP or nurse manage someone who has a syncopal collapse because they have freaked out because they are having a needle or if they have an allergic reaction? How do they manage confidentiality and medical records?

    • Phil Willis
      06/09/2021

      Particularly when they vaccinate in carparks with patients still in cars …. must be very difficult to manage

    • Geoff
      07/09/2021

      Pharmacies have had plenty of anxiety syncope practice with ear piercing and everyone has been ok

    • Michael Ortiz
      07/09/2021

      Hello Nick. It is interesting that Vaccination in Pharmacy is an issue. You might find this NSW Health document DATED 1 SEPTEMBER 2021 very interesting
      NSW Pharmacist Vaccination Standards
      https://www.health.nsw.gov.au/immunisation/Documents/pharmacist-new-standard.pdf
      A pharmacist immuniser in NSW may administer the following vaccines to the specified
      age ranges:
      • Influenza vaccine: Individuals aged 10 years and over
      • Measles – mumps – rubella combination vaccine (MMR): Individuals aged 16
      years and over
      • Diphtheria – tetanus – pertussis combination vaccine (dTpa): Individuals aged 16
      years and over
      • SARS-CoV-2 (COVID-19) vaccines – provisionally approved:
      – Vaxzevria (ChAdOx1-S) COVID-19 vaccine (‘AstraZeneca vaccine’):
      Individuals aged 18 years and over
      – Comirnaty (BNT162b2 [mRNA]) COVID-19 vaccine (‘Pfizer vaccine’):
      Individuals aged 16 years and over
      – Spikevax (elasomeran) COVID-19 vaccine (‘Moderna vaccine’): Individuals
      aged 18 years and over

      KEEP UP THE GREAT WORK and VACCINATE, VACCINATE VACCINATE

      • Geoff
        08/09/2021

        Hi Michael, as per my previous post there really is no issue with vaccination in pharmacy- the original article is about a couple of comments from a self- selection of 6 GPs so not randomly selected, adequate or representative. The article in the AJGP did not single out pharmacy vaccination as a major barrier to vaccinating those under 65 years- it was this article in the AJP by Chris Brooker that made it the headline. Is it just lazy journalism to beat up a nothing story with an inflammatory headline or is there some reason to promote a dispute where none exists?

  5. Mike Kaluschke
    06/09/2021

    I thought AIR enabled continuity of care with knowing who was vaccinated and who was not? Anecdotally many of my patients use multiple surgeries. If you have to wait a few weeks to see your GP then you do have one “up your sleeve”.

  6. Geoff
    06/09/2021

    This article heading would seem to be largely fake news/ click bait… GPS were concerned with half a dozen issues not just with pharmacist vaccination which was listed at the bottom. Also, of the 23 comments listed in the study only 2 we’re about pharmacy. Would have been good journalism to include a link to the original article- Aust Journal of General Practice Volume 50, Issue 9, September 2021.
    Limitations on the study are that invitations were sent to all GPs on the Healthed mailing list with just 6 being recruited- hardly valid sample. Just as easy to conclude that GPS were not concerned at all with pharmacist vaccination.
    The study noted that about 46% of vaccinations in >65 year olds are on the AIR but the actual estimate of those vaccinated is 70%. Pharmacy in 2019 vaccinated only about 2.7%- clearly it is GPs or GP run clinics who are failing to report to the AIR and causing the fragmentation of care that was attributed in a comment to pharmacist vaccination.

  7. Love
    07/09/2021

    They also failed to recognise that pharmacists in other parts of the world have been administrating vaccines for far longer than in Australia. In North America, pharmacists can administer all vaccines and write prescriptions for certain prescription-only vaccines. I’m sure if GPs are use to it in those countries, then so can GPs here.

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