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Lopes H, Baptista-Leite R, Hermenegildo C, Atun R. Digital Gamification Tool (Let's Control Flu) to Increase Vaccination Coverage Rates: Proposal for Algorithm Development. JMIR Res Protoc 2024; 13:e55613. [PMID: 39255031 DOI: 10.2196/55613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/27/2024] [Accepted: 06/20/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Influenza represents a critical public health challenge, disproportionately affecting at-risk populations, including older adults and those with chronic conditions, often compounded by socioeconomic factors. Innovative strategies, such as gamification, are essential for augmenting risk communication and community engagement efforts to address this threat. OBJECTIVE This study aims to introduce the "Let's Control Flu" (LCF) tool, a gamified, interactive platform aimed at simulating the impact of various public health policies (PHPs) on influenza vaccination coverage rates and health outcomes. The tool aligns with the World Health Organization's goal of achieving a 75% influenza vaccination rate by 2030, facilitating strategic decision-making to enhance vaccination uptake. METHODS The LCF tool integrates a selection of 13 PHPs from an initial set proposed in another study, targeting specific population groups to evaluate 7 key health outcomes. A prioritization mechanism accounts for societal resistance and the synergistic effects of PHPs, projecting the potential policy impacts from 2022 to 2031. This methodology enables users to assess how PHPs could influence public health strategies within distinct target groups. RESULTS The LCF project began in February 2021 and is scheduled to end in December 2024. The model creation phase and its application to the pilot country, Sweden, took place between May 2021 and May 2023, with subsequent application to other European countries. The pilot phase demonstrated the tool's potential, indicating a promising increase in the national influenza vaccination coverage rate, with uniform improvements across all targeted demographic groups. These initial findings highlight the tool's capacity to model the effects of PHPs on improving vaccination rates and mitigating the health impact of influenza. CONCLUSIONS By incorporating gamification into the analysis of PHPs, the LCF tool offers an innovative and accessible approach to supporting health decision makers and patient advocacy groups. It enhances the comprehension of policy impacts, promoting more effective influenza prevention and control strategies. This paper underscores the critical need for adaptable and engaging tools in PHP planning and implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/55613.
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Affiliation(s)
- Henrique Lopes
- NOVA Center for Global Health, NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ricardo Baptista-Leite
- NOVA Center for Global Health, NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
- Department of International Health, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Catarina Hermenegildo
- NOVA Center for Global Health, NOVA Information Management School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Rifat Atun
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
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Gauld NJ, Knapton C, Sinclair O, Grant CC. Promotion and COVID-19 lockdown increase uptake of funded maternal pertussis vaccination in pharmacy: A mixed methods study. PLoS One 2024; 19:e0307971. [PMID: 39208314 PMCID: PMC11361654 DOI: 10.1371/journal.pone.0307971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/12/2024] [Indexed: 09/04/2024] Open
Abstract
Pertussis vaccination is recommended during pregnancy to protect the baby. Pertussis vaccination was initially free to pregnant people through general practice and hospitals in New Zealand, but uptake was suboptimal. In one district funding of maternal pertussis vaccination was widened to community pharmacies in 2016. Eighteen months later promotion to pharmacies, midwives and pregnant people took place. In 2020 and 2021, COVID-19 lockdowns occurred. AIM To explore the effects of promotion and COVID-19 lockdowns on uptake of funded maternal pertussis vaccination in pharmacy, and awareness, use and opinions of promotional elements. METHODS Five years of pharmacy claims data were analysed and 12 pharmacists, 18 people eligible/recently eligible for maternal pertussis vaccination and 11 midwives were interviewed. RESULTS Provision of maternal pertussis vaccination increased during and after promotion. Qualitative data showed that pharmacists valued phone calls with information about maternal pertussis vaccination and recommendations for increasing uptake. Prompted by these calls, some pharmacists contacted midwives to inform them of funded maternal pertussis vaccination in the pharmacy (which midwives appreciated) and recommended pertussis vaccination to pregnant clients. Pharmacy staff reportedly were motivated to recommend this vaccination by being informed about it and having posters displayed in the pharmacy. Pregnant people valued healthcare professionals' conversations about maternal pertussis vaccination, but appeared to be uninfluenced by posters and promotional social media posts about this vaccination. During COVID-19, maternal pertussis uptake in pharmacies increased 31% March to May 2020 (before and during the first COVID-19 lockdown) versus the same time the previous year, then declined. CONCLUSION Promotion appeared to have a sustained effect on uptake of maternal pertussis vaccination in pharmacies. Pregnant people were most influenced by discussions with healthcare professionals. Pharmacists and pharmacy staff increased proactivity with maternal vaccinations after promotion to them. Promotion may need to be repeated over time.
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Affiliation(s)
- Natalie J. Gauld
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Cath Knapton
- Mid-Central Community Pharmacy Group, Hamilton, New Zealand
| | - Owen Sinclair
- Paediatrics, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Cameron C. Grant
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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Okoli GN, Righolt CH, Zhang G, Van Caeseele P, Kuo IF, Alessi-Severini S, Mahmud SM. A population-based, province-wide, record-linkage interrupted time series analysis of impact of the universal seasonal influenza vaccination policy on seasonal influenza vaccine uptake among 5-64-year-olds in the province of Manitoba, Canada. Vaccine 2024; 42:1571-1581. [PMID: 38360473 DOI: 10.1016/j.vaccine.2024.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Universal seasonal influenza vaccination policy (USIVP) was introduced in Manitoba, Canada in 2010. Its impact on seasonal influenza vaccine (SIV) uptake remains underexplored. METHODS We used population-wide data from Manitoba to assess the impact of the USIVP on SIV uptake. The study covered twenty influenza seasons (2000/01-2019/20). We summarized SIV uptake for influenza seasons before and after the USIVP. Utilizing a single-group interrupted time series analysis and appropriately accounting for autocorrelation, we estimated absolute change and annual trend in SIV uptake percentages among 5-17-, 18-44-, and 45-64-year-olds across strata of certain population socioeconomic and health-related characteristics following the USIVP. RESULTS Average SIV uptake percentage in all age groups was significantly higher after compared with before the USIVP. Following the USIVP, there was no significant absolute change in SIV uptake percentage among 18-44- and 45-64-year-olds overall; however, a significant decrease was observed among 18-44-year-old males in the higher income quintiles, across healthcare utilization, and in some regions of residence. A significant increase was observed among 5-17-year-olds in the lowest income quintiles, in Northern Manitoba, and among those with less healthcare utilization, and no chronic disease. Overall, there was mostly no significant annual trend in SIV uptake percentage among 18-44-year-olds, and while a significant upward and downward trend was observed among 5-17-year-olds and 45-64-year-olds, respectively, a significant downward trend was observed across all strata of population characteristics within all age groups in Northern Manitoba. CONCLUSIONS The USIVP in Manitoba was followed by an absolute increase in SIV uptake percentage only in some socioeconomically disadvantaged subpopulations among 5-17-year-olds. While there was mostly an upward annual trend in SIV uptake percentage among 5-17-year-olds, a downward trend was observed among 45-64-year-olds and across all age groups and subpopulations in socioeconomically disadvantaged Northern Manitoba. These findings are novel for Manitoba and require investigation and public health attention.
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Affiliation(s)
- George N Okoli
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; George and Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Geng Zhang
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul Van Caeseele
- Departments of Medical Microbiology and Infectious Diseases, and Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Cadham Provincial Public Health Laboratories, Manitoba Health and Seniors Care, Winnipeg, Manitoba, Canada
| | - I Fan Kuo
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Optimal Use and Evaluation, Ministry of Health, Government of British Columbia, Vancouver, British Columbia, Canada
| | - Silvia Alessi-Severini
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Folkins C, Gorman-Asal M, Brewster C, Foster R, Gulliver A, Thomson E, Singh P, Miah P, Magalhaes S, McDonald JT. Projected health and economic outcomes of extending public funding of pharmacy services to include administration of Pneu23 and Td/Tdap immunizations by pharmacy practitioners in New Brunswick. Can Pharm J (Ott) 2023; 156:215-224. [PMID: 37435502 PMCID: PMC10331360 DOI: 10.1177/17151635231176498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 07/13/2023]
Abstract
Background Although legislation permits New Brunswick pharmacy professionals to administer a wide range of immunizations, public funding for these services is currently limited to immunizations against influenza and COVID-19 and was recently extended to include pneumococcal immunization (Pneu23) in individuals aged 65 years or older. We used administrative data to project health and economic outcomes associated with the current Pneu23 program and with extension of public funding to include: 1) younger adults aged 19 years or older in the Pneu23 program, and 2) tetanus boosters (Td/Tdap). Methods Two model scenarios were compared: a Physician-Only model in which physicians remain the only practitioners to administer publicly funded Pneu23 and Td/Tdap, and a Blended model in which this service is also provided by pharmacy professionals. Immunization rates by practitioner type were projected based on physician billing data accessed via the New Brunswick Institute for Research, Data and Training in conjunction with trends observed with influenza immunization by pharmacists. These projections were used along with published data to estimate health and economic outcomes under each model. Results Public funding of Pneu23 (65+), Pneu23 (19+) and Td/Tdap (19+) administration by pharmacy professionals is projected to yield increased immunization rates and physician time savings compared with the Physician-Only model. Public funding of Pneu23 and Td/Tdap administration by pharmacy professionals in those aged ≥19 years would result in cost savings, owing primarily to productivity losses avoided in the working age population. Discussion Increased immunization rates, physician time savings and cost savings may be realized if public funding were extended to include administration of Pneu23 in younger adults and Td/Tdap, by pharmacy practitioners.
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Affiliation(s)
- Chris Folkins
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Madeleine Gorman-Asal
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Clark Brewster
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Rebecca Foster
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Adrienne Gulliver
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Emily Thomson
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Paramdeep Singh
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Pablo Miah
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Sandra Magalhaes
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick
| | - J. Ted McDonald
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
- Department of Political Science, University of New Brunswick, Fredericton, New Brunswick
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Sirois A, Deli GS, Parent AA, Bergeron DA. Enjeux actuels et pistes de solution pour améliorer les couvertures vaccinales antigrippales dans les milieux ruraux. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 34:833-836. [PMID: 37019796 DOI: 10.3917/spub.226.0833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
INTRODUCTION Despite the positive impact of vaccination on health, influenza vaccination rates worldwide remain low for certain population groups. In Quebec, vaccination rates among populations with chronic diseases remain below what is expected by public health. Since this situation is also noticeable in rural areas, it is necessary to reflect on the current issues associated with low vaccination rates in the rural population. PURPOSE OF RESEARCH The purpose of this commentary is to explore the importance of obtaining a multifactorial understanding of the problem raised in order to propose possible solutions to increase influenza vaccination rates among people living in rural areas.
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Affiliation(s)
- Audrey Sirois
- Département des sciences de la santé – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Collectif de recherche sur la santé en région (CoRSeR) – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Programme Enfance-Jeunesse-Famille – Centre intégré de santé et des services sociaux du Bas-Saint-Laurent – CLSC de Rivière-du-Loup – Rivière-du-Loup (Québec) – Canada
- Centre de recherche – Centre intégré de santé et des services sociaux de Chaudière-Appalaches – Lévis (Québec) – Canada
| | - Gueu Sylvain Deli
- Département des sciences de la santé – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Collectif de recherche sur la santé en région (CoRSeR) – Université du Québec à Rimouski – Rimouski (Québec) – Canada
| | - Andrée-Anne Parent
- Département des sciences de la santé – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Collectif de recherche sur la santé en région (CoRSeR) – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Centre de recherche – Centre intégré de santé et des services sociaux de Chaudière-Appalaches – Lévis (Québec) – Canada
| | - Dave A Bergeron
- Département des sciences de la santé – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Collectif de recherche sur la santé en région (CoRSeR) – Université du Québec à Rimouski – Rimouski (Québec) – Canada
- Centre de recherche – Centre intégré de santé et des services sociaux de Chaudière-Appalaches – Lévis (Québec) – Canada
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Life Satisfaction and Influenza Vaccination Among Older Adults in Canada. Can J Aging 2022; 41:514-522. [PMID: 35899995 DOI: 10.1017/s0714980822000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Older adults have an increased risk of complications or death from influenza. Despite the benefits of vaccination for older adults, vaccination coverage among older adults ages 65 years and over is still below Canada's national target of 80 per cent. As health-care-seeking behaviours are influenced by several factors, including life satisfaction, we investigated the relationship between life satisfaction and influenza vaccination among older adults. A sample (n = 22,424) from the 2015-2016 Canadian Community Health Survey data was analysed using descriptive and multinomial logistic regression analyses. Higher life satisfaction was associated with a more recent influenza vaccination history. Vaccination differed by gender, age, and self-reported health status, as women, much older adults, and those with the poorest health status were more likely to be vaccinated. The study suggests an association between life satisfaction and influenza vaccination. More research into the factors that impact influenza vaccination in older adults is needed to increase vaccination coverage in the older adult population.
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Understanding the Impact of Approved but Unfunded Vaccine Status on Parental Acceptance of an Adjuvanted Seasonal Influenza Vaccine for Infants: Results from the Pediatric Influenza Vaccination Optimization Trial (PIVOT)-III. Vaccines (Basel) 2022; 10:vaccines10101769. [PMID: 36298633 PMCID: PMC9606895 DOI: 10.3390/vaccines10101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
The adjuvanted trivalent influenza vaccine (aTIV) provides enhanced protection against influenza for infants but is not publicly funded (NPF). The objective of this prospective cohort study of parents with children 6 through 23 months of age was to understand how NPF status influences parental perceptions of approved but unfunded vaccines and their intentions to vaccinate. At healthy baby visits, clinicians provided parents with information about influenza and vaccination. Before and after these interactions, a research nurse assessed parents’ intentions to vaccinate their children and their beliefs about the safety, efficacy, and necessity of vaccinating their children with aTIV in both publicly funded (PF) and NPF settings. Overall, 15 community practice clinics (n = 15 physicians) and nine public health clinics (n = 9 nurses) recruited 207 parents. The percentage of parents intending to immunize their children with aTIV decreased from 72% (vaccine PF, free of charge), to 42% (NPF, $25 per dose), to 27% (NPF, $50 per dose). Funding status strongly influenced whether parents perceived immunization with aTIV to be necessary, safe, and effective. Information on influenza and influenza vaccines should be provided to parents routinely to allow for well-informed decisions on the suitability of specific influenza vaccines for their child.
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Influenza Vaccination Coverage among Multiple Sclerosis Patients: Evolution over Time and Associated Factors. Vaccines (Basel) 2022; 10:vaccines10071154. [PMID: 35891321 PMCID: PMC9322179 DOI: 10.3390/vaccines10071154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
Our objective was to determine the influenza vaccination rate in a Spanish cohort of multiple sclerosis (MS) patients. A retrospective cohort study was carried out. Patients who attended the MS unit of the Lozano Blesa Hospital of Zaragoza between January 2015 and 2020 were included. The variables were obtained by reviewing the specialized and primary care records. Associations between receiving the vaccine in each flu season and the other variables were analyzed using bivariate analysis and multiple logistic regression models. A total of 260 patients were studied, with a median age of 31 years at the time of diagnosis. A total of 62.3% (162/260) were women. Vaccination coverage ranged from 20.4% in the 2015−2016 and 2016−2017 seasons to 41.5% in the 2019−2020 season (p = 0.000). Having been vaccinated in the previous season (ORa: 16.47−390.22; p = 0.000) and receiving a vaccination recommendation from the hospital vaccination unit (ORa: 2.44−3.96; p < 0.009) were associated with being vaccinated. The coverage is in an intermediate position compared to other countries. It is necessary to improve the referral system of these patients to the hospital vaccination unit because the information obtained by this service contributed to higher vaccination rates.
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Le LM, Veettil SK, Donaldson D, Kategeaw W, Hutubessy R, Lambach P, Chaiyakunapruk N. The impact of pharmacist involvement on immunization uptake and other outcomes: An updated systematic review and meta-analysis. J Am Pharm Assoc (2003) 2022; 62:1499-1513.e16. [PMID: 35961937 PMCID: PMC9448680 DOI: 10.1016/j.japh.2022.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022]
Abstract
Background The underutilization of immunization services remains a big public health concern. Pharmacists can address this concern by playing an active role in immunization administration. Objective We performed a systematic review and meta-analysis to assess the impact of pharmacist-involved interventions on immunization rates and other outcomes indirectly related to vaccine uptake. Methods A systematic literature search was conducted using MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases from inception to February 2022 to identify randomized controlled trials (RCTs) and observational studies in which pharmacists were involved in the immunization process. Studies were excluded if no comparator was reported. Two reviewers independently completed data extraction and bias assessments using standardized forms. Meta-analyses were performed using a random-effects model. Results A total of 14 RCTs and 79 observational studies were included. Several types of immunizations were provided, including influenza, pneumococcal, herpes zoster, Tdap, and others in a variety of settings (community pharmacy, hospital, clinic, others). Pooled analyses from RCTs indicated that a pharmacist as immunizer (risk ratio 1.14 [95% CI 1.12–1.15]), advocator (1.31 [1.17–1.48]), or both (1.14 [1.12–1.15]) significantly increased immunization rates compared with usual care or non–pharmacist-involved interventions. The quality of evidence was assessed as moderate or low for those meta-analyses. Evidence from observational studies was consistent with the results found in the analysis of the RCTs. Conclusion Pharmacist involvement as immunizer, advocator, or both roles has favorable effects on immunization uptake, especially with influenza vaccines in the United States and some high-income countries. As the practice of pharmacists in immunization has been expanded globally, further research on investigating the impact of pharmacist involvement in immunization in other countries, especially developing ones, is warranted.
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Affiliation(s)
| | | | | | | | | | | | - Nathorn Chaiyakunapruk
- Correspondence: Nathorn Chaiyakunapruk, PharmD, PhD, Professor. Department of Pharmacotherapy, University of Utah College of Pharmacy, 30 S 2000 E, Salt Lake City, UT 84112.
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Shukla A, Welch K, Villa A. Assessment of the willingness of dentists in the state of Indiana to administer vaccines. PLoS One 2022; 17:e0267167. [PMID: 35439280 PMCID: PMC9017890 DOI: 10.1371/journal.pone.0267167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human Papillomavirus associated oropharyngeal cancers have been on the rise in the past three decades. Dentists are uniquely positioned to discuss vaccination programs with their patients. The goal of this project was to assess the readiness of dentists in the state of Indiana in being able to administer vaccines. METHODS An 18-question online survey was sent to licensed dentists in the state of Indiana. Mantel-Haenszel chi-square tests, followed by multivariable analyses using ordinal logistic regression were conducted to assess providers' comfort levels and willingness to administer vaccines in both children and adults, by provider characteristics (practice type, location, and years in practice). RESULTS A total of 569 completed surveys were included for data analyses. Most dentists (58%) responded positively when asked if they would consider offering vaccinations in their office, if allowed by state legislation. In general, dentists working in academic settings and federally qualified health centers were more agreeable to offering vaccination in their practice. The level of agreement with "Dentists should be allowed to administer HPV, Influenza, Hep A and COVID 19 vaccines" for both children and adults decreased with increased years of practice. More than half of the respondents (55%) agreed that dental providers were competent to administer vaccines and needed no further training. CONCLUSION The study results suggest the willingness of dentists in the state of Indiana to offer vaccinations in their practices, if allowed by legislation. PRACTICAL IMPLICATIONS Dental providers can be a unique resource to add to workforce for improving vaccination efforts.
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Affiliation(s)
- Anubhuti Shukla
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, United States of America
| | - Kelly Welch
- Team Maureen, North Falmouth, Massachusetts, United States of America
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California, United States of America
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Lohan L, Cool C, Viault L, Cestac P, Renard E, Galtier F, Villiet M, Avignon A, Sultan A, Breuker C. Impact of Hospitalization in an Endocrinology Department on Vaccination Coverage in People Living with Diabetes: A Real-Life Study. Medicina (B Aires) 2022; 58:medicina58020219. [PMID: 35208544 PMCID: PMC8879927 DOI: 10.3390/medicina58020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/17/2022] [Accepted: 01/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives: Vaccination coverage is suboptimal in people living with diabetes. The objectives of this study were to determine the impact of hospitalization on vaccination coverage and the variables associated with vaccination during hospital stay. Materials and Methods: This observational study was conducted from May 2019 to December 2019 in the Endocrinology-Nutrition-Diabetes Department of the University Hospital of Montpellier, France. This department encompasses three medical units, two of which have a full-time clinical pharmacist involved in the multidisciplinary management of patients. All adult diabetic patients who completed a questionnaire about vaccines were prospectively included by a clinical pharmacist and followed until department discharge. Coverage at the time of admission for the tetanus, diphtheria, pertussis (Tdap), pneumococcal, influenza, and herpes zoster vaccines was assessed from patient interviews and/or contact with the general practitioner and/or with the community pharmacist. Multivariable logistic regression analysis was performed to identify the factors associated with a vaccination update during the hospital stay. Results: A total of 222 patients were included (mean age: 59.4 years, 68.5% type 2 diabetes). Vaccination coverage increased by 26.7% (47.3% to 59.9%), 188.0% (10.8% to 31.1%) and 8.9% (45.9% to 50.0%), respectively, for the Tdap, pneumococcal and influenza vaccines during hospital stay. Female sex, admission to a diabetes care unit with a full-time pharmacist, favorable feelings about vaccination, unknown immunization coverage for pneumococcal vaccines, and evaluation and recording of vaccine coverage at admission in the patient medical records were associated with at least one vaccination during hospital stay. Conclusions: Our real-life study highlights that hospitalization and multidisciplinary management (i.e., physician-pharmacist) may be key points in the diabetes care pathway to improve vaccination coverage, especially for patients with advanced diabetes and comorbidities.
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Affiliation(s)
- Laura Lohan
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
| | - Charlène Cool
- Department of Pharmacy, Toulouse University Hospital, 31059 Toulouse, France; (C.C.); (P.C.)
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse (UPS), 31059 Toulouse, France
| | - Loriane Viault
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
| | - Philippe Cestac
- Department of Pharmacy, Toulouse University Hospital, 31059 Toulouse, France; (C.C.); (P.C.)
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse (UPS), 31059 Toulouse, France
| | - Eric Renard
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Florence Galtier
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Maxime Villiet
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
| | - Antoine Avignon
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Ariane Sultan
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
- Endocrinology-Diabetology-Nutrition Department, University of Montpellier, 34295 Montpellier, France; (E.R.); (F.G.); (A.A.)
| | - Cyril Breuker
- Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France; (L.L.); (L.V.); (M.V.)
- Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France;
- Correspondence: ; Tel.: +33-467-338-562; Fax: +33-467-338-112
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12
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Ammeter T, Lang P, Czock A. Overview of the influenza vaccination activities and legal frameworks in 26 Swiss cantons during the influenza season 2019/20. Vaccine 2022; 40:1702-1706. [DOI: 10.1016/j.vaccine.2022.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/18/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
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13
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Youssef D, Abou-Abbas L, Farhat S, Hassan H. Pharmacists as immunizers in Lebanon: a national survey of community pharmacists' willingness and readiness to administer adult immunization. HUMAN RESOURCES FOR HEALTH 2021; 19:131. [PMID: 34689762 PMCID: PMC8542355 DOI: 10.1186/s12960-021-00673-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/08/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Since the focus of healthcare has shifted toward prevention, pharmacists were highly encouraged to expand their practice to include immunization services. Our study aimed to assess the knowledge, attitudes and beliefs of community-based Lebanese pharmacists, in addition to their willingness to expand their practice scope to include vaccine administration. METHODS A cross-sectional study was conducted during the phase preceding the arrival of the COVID-19 vaccine in Lebanon between 1 and 31st December 2020. Using a stratified random sampling method, data were collected from Lebanese community pharmacists (CPs) through an online survey that included information on socio-demographic characteristics, clinical experience, willingness to administer vaccines, knowledge about vaccination, attitudes towards immunization, reasons supporting utilizing pharmacists as immunizers and the requested elements to incorporate immunization in pharmacists' practice scope. Multivariable analyses were performed to identify the factors associated with knowledge. RESULTS A total of 412 community pharmacists participated in this survey. Of the total, 66.5% of the surveyed CPs are willing to administer vaccines. The majority of them (89.8%) had an overall good level. Out of all, 92.7% showed a positive overall attitude score toward immunization, 95.4% agreed that community pharmacists can play an important role in advertising and promoting vaccination. The main needed elements for implementing immunization services in pharmacies listed by participants were: support of health authorities (99.3%), statutory allowance (82.8%), patient demand (95.4%), pharmacist's interest (96.1%) and continuous education and training workshops on immunization. Older CPs (50 years and above) [aOR = 0.703, CI 95% (0.598-0.812)] and those working in Bekaa and North have lower knowledge score than their counterparts. High educational level [aOR = 1.891, CI 95% (1.598-2.019)], previous experience in immunization [aOR = 3.123, CI 95% (2.652-4.161)] and working in urban areas [aOR = 3.640, CI 95% (2.544-4.717)] were positively associated with a good knowledge level. CONCLUSION Most of Lebanese community pharmacists are willing to offer immunizations. The expansion of the pharmacists practice scope to include provision of immunizations required a national plan that encompasses strengthening knowledge, training, certification for eligibility to administer vaccines, enhancing pharmacovigilance and statutory reform.
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Affiliation(s)
- Dalal Youssef
- Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon.
- Research Center for Population Health (BPH), Institut de santé publique d'épidémiologie et de développement (ISPED), Bordeaux University, Bordeaux, France.
| | - Linda Abou-Abbas
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Epidemiological Surveillance Unit, Ministry of Public Health, Beirut, Lebanon
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14
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Mohammed H, McMillan M, Andraweera PH, Elliott SR, Marshall HS. A rapid global review of strategies to improve influenza vaccination uptake in Australia. Hum Vaccin Immunother 2021; 17:5487-5499. [PMID: 34623221 PMCID: PMC8904008 DOI: 10.1080/21645515.2021.1978797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This study aimed to identify effective strategies for improving the uptake of influenza vaccination and to inform recommendations for influenza vaccination programs in Australia. A rapid systematic review was conducted to assimilate and synthesize peer-reviewed articles identified in PubMed. The National Health and Medical Research Council (NHMRC) Hierarchy of Evidence was used to appraise the quality of evidence. A systematic search identified 4373 articles and 52 that met the inclusion criteria were included. The evidence suggests influenza vaccination uptake may be improved by interventions that (1) increase community/patient demand and access to influenza vaccine and overcome practice-related barriers; (2) reinforce the critical role healthcare providers play in driving influenza vaccination uptake. Strategies such as standing orders, reminder and recall efforts were successful in improving influenza vaccination rates. Community pharmacies, particularly in regional/remote areas, are well positioned to improve influenza vaccine coverage. The findings of this rapid review can be utilized to improve the performance of influenza immunization programs in Australia and other countries with comparable programs; and recommend priorities for future evaluation of interventions to improve influenza vaccination uptake.
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Affiliation(s)
- Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Mark McMillan
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Prabha H Andraweera
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Salenna R Elliott
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, Australia.,Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, Australia
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15
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Disparities in maternal influenza immunization among women in rural and urban areas of the United States. Prev Med 2021; 147:106531. [PMID: 33771563 DOI: 10.1016/j.ypmed.2021.106531] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/15/2021] [Accepted: 03/21/2021] [Indexed: 11/22/2022]
Abstract
Pregnant women and their infants are at high risk of influenza-associated complications. Although maternal immunization offers optimal protection for both, immunization rates remain low in the U.S. Women in rural communities may represent a difficult to reach group, yet immunization rates among rural-residing women have not been well evaluated. We analyzed data from the 2016-2018 Phase-8 Pregnancy Risk Assessment Monitoring System for 19 U.S. states, including 45,018 women who recently gave birth to a live infant. We compared the prevalence of influenza vaccination prior to or during pregnancy and receipt of a vaccine recommendation from a healthcare provider for rural vs. urban-residing women. We used average marginal predictions derived from multivariate logistic regression models to generate weighted adjusted prevalence ratios (aPR) and corresponding 95% CIs. Of the 45,018 respondents, 6575 resided in a rural area; 55.1% (95% CI: 53.3, 56.9) of rural-residing women and 61.3% (95% CI: 60.6, 61.9) of urban-residing women received an influenza vaccine prior to or during pregnancy. The prevalence of vaccination was 4% lower among rural-residing women (aPR: 0.96; 95% CI: 0.93, 0.99). The greatest difference in rural vs. urban immunization rates were observed for Hispanic women and women with no health insurance. Our results indicate that pregnant women residing in rural communities have lower rates of immunization. To prevent maternal and infant health disparities, it is important to better understand the barriers to maternal immunization along with efforts to overcome them.
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16
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Stoecker C. Shooting from the 'Scrip: Scope of Practice Laws and Access to Immunizations in the Pharmacy Setting. Vaccines (Basel) 2021; 9:vaccines9050444. [PMID: 34063185 PMCID: PMC8147434 DOI: 10.3390/vaccines9050444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
In the past two decades, most states in the United States have added authorization for pharmacists to administer some vaccinations. Expansions of this authority have also come with prescription requirements or other regulatory burdens. The objective of this study was to evaluate the impact of these expansions on influenza immunization rates in adults age 65 and over. A panel data, differences-in-differences regression framework to control for state-level unobserved confounders and shocks at the national level was used on a combination of a dataset of state-level statute and regulatory changes and influenza immunization data from the Behavioral Risk Factor Surveillance System. Giving pharmacists permission to vaccinate had a positive impact on adult influenza immunization rates of 1.4 percentage points for adults age 65 and over. This effect was diminished by the presence of laws requiring pharmacists to obtain patient-specific prescriptions. There was no evidence that allowing pharmacists to administer vaccinations led patients to have fewer annual check-ups with physicians or not have a usual source of health care. Expanding pharmacists’ scope of practice laws to include administering the influenza vaccine had a positive impact on influenza shot uptake. This may have implications for relaxing restrictions on other forms of care that could be provided by pharmacists.
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Affiliation(s)
- Charles Stoecker
- Department of Global Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
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17
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Trent MJ, Salmon DA, MacIntyre CR. Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines. Aust N Z J Public Health 2021; 45:385-390. [PMID: 33818843 DOI: 10.1111/1753-6405.13094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/01/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To estimate the proportion of influenza vaccines administered in non-medical settings in Australia in 2019 and identify factors associated with vaccination site. METHODS We surveyed 1,444 Australian adults online in October 2019. To identify factors associated with vaccination site, we used Pearson's chi-square test. We used thematic analysis to describe responses to the question, 'Please explain why you chose to get vaccinated there'. RESULTS Most participants (73%) received the influenza vaccine in a medical setting, while 13% received it at a pharmacy and 14% at their workplace. Being vaccinated in pharmacy was associated with being under 65 years of age (p<0.01), marital status (p=0.01), and not having a high-risk comorbidity (p<0.01). Workplace vaccination was associated with being under 65 (p<0.01), household income (p<0.01), not having a regular general physician/practice (p=0.01), having private insurance (p<0.01), and not having a high-risk comorbidity (p<0.01). There was no association between site of vaccination and first-time vaccination (p=0.71, p=0.22). CONCLUSIONS Despite new policies allowing pharmacists to administer influenza vaccines, most Australian adults are still vaccinated in medical settings. Pharmacy and workplace vaccination settings were more common among younger adults without high-risk comorbidities. Implications for public health: Workplaces, pharmacies and other non-medical settings may provide an opportunity to increase influenza vaccination among healthy, working-age adults who might otherwise forego annual vaccination. Pharmacies may also provide a convenient location for the rollout of the COVID-19 vaccine, particularly in medically underserved areas.
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Affiliation(s)
- Mallory J Trent
- Biosecurity Program, The Kirby Institute, University of New South Wales
| | - Daniel A Salmon
- Departments of International Health and Health, Behavior and Society, Institute for Vaccine Safety, Bloomberg School of Public Health, Johns Hopkins University, United States
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales
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18
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Where are the keys to improve vaccine uptake in adults and elders in European countries? Aging Clin Exp Res 2021; 33:1123-1131. [PMID: 31900875 DOI: 10.1007/s40520-019-01443-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 12/09/2019] [Indexed: 11/27/2022]
Abstract
Improving vaccination of the elderly is one of the most important challenges in the coming years, as it was for infant's decades ago. Insufficient vaccine uptake in the elderly can be considered a concern with regard to the burden of vaccine preventable diseases in this growing population. The purpose of this paper is to have an overview on the different steps involved in decision policy making from the regulatory agencies until people are vaccinated. Examples of different policies within European countries will be compared for influenza, streptococcal and zoster infections. For each step, key improvements to increase vaccine uptake in this specific population will be proposed.
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Bai Y, Tao X. Comparison of COVID-19 and influenza characteristics. J Zhejiang Univ Sci B 2021; 22:87-98. [PMID: 33615750 PMCID: PMC7885750 DOI: 10.1631/jzus.b2000479] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023]
Abstract
The emergence of coronavirus disease 2019 (COVID-19) not only poses a serious threat to the health of people worldwide but also affects the global economy. The outbreak of COVID-19 began in December 2019, at the same time as the influenza season. However, as the treatments and prognoses of COVID-19 and influenza are different, it is important to accurately differentiate these two different respiratory tract infections on the basis of their respective early-stage characteristics. We reviewed official documents and news released by the National Health Commission of the People's Republic of China, the Chinese Center for Disease Control and Prevention (China CDC), the United States CDC, and the World Health Organization (WHO), and we also searched the PubMed, Web of Science, Excerpta Medica database (Embase), China National Knowledge Infrastructure (CNKI), Wanfang, preprinted bioRxiv and medRxiv databases for documents and guidelines from earliest available date up until October 3rd, 2020. We obtained the latest information about COVID-19 and influenza and summarized and compared their biological characteristics, epidemiology, clinical manifestations, pathological mechanisms, treatments, and prognostic factors. We show that although COVID-19 and influenza are different in many ways, there are numerous similarities; thus, in addition to using nucleic acid-based polymerase chain reaction (PCR) and antibody-based approaches, clinicians and epidemiologists should distinguish between the two using their respective characteristics in early stages. We should utilize experiences from other epidemics to provide additional guidance for the treatment and prevention of COVID-19.
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Affiliation(s)
- Yu Bai
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Xiaonan Tao
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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20
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Readiness and Willingness to Provide Immunization Services after Pilot Vaccination Training: A Survey among Community Pharmacists Trained and Not Trained in Immunization during the COVID-19 Pandemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020599. [PMID: 33445750 PMCID: PMC7828205 DOI: 10.3390/ijerph18020599] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/30/2022]
Abstract
Background: Immunization rates among the adult population in Poland are below desired targets, urging the need to expand this service in the community. During the COVID-19 pandemic, the ultimate goals for limiting the spread of the infection are vaccines against SARS-CoV-2. Pharmaceutical companies are in a race for the fastest possible way to deliver vaccines. Community pharmacists in Poland are recognised as an accessible yet underutilised group of medical professionals. Therefore, involving pharmacists in vaccinations may have beneficial results for the healthcare system. Objectives: The objectives of this study were to assess the readiness and willingness of community pharmacists following the Pharmacist Without Borders project who had either been trained or not in providing immunization services, and to identify the factors that may support the implementation of such services in Poland. Methods: This study was conducted among pharmacists between February and August 2020 in Poland. A survey was developed to determine their readiness to provide vaccination services in their pharmacies, to recognise any barriers to vaccinations, as well as the factors necessary to implement vaccination services in Polish pharmacies. Results: A total of 1777 pharmacists participated in the study, comprising 127 (7.1%) pharmacists trained in vaccinations during the Pharmacists Without Borders project and 1650 (92.9%) pharmacists not participating in the workshops. Pharmacists participating in the workshops more often indicated that providing vaccinations in community pharmacies would improve the overall vaccination rate (p = 0.0001), and that pharmacists could play an important role in advertising and promoting vaccinations (p = 0.0001). For the pharmacists not participating in the workshops, they indicated to a much greater extent possible barriers affecting the readiness to provide vaccinations in pharmacies. They most often pointed out that vaccination services would result in a significant workload increase (p = 0.0001), that pharmacies were not adapted to immunization, and that there were not enough training courses for pharmacists (p = 0.0001). Conclusion: The pharmacists working in community pharmacies indicated many advantages of vaccinations in pharmacies. This study identified barriers to the introduction of vaccinations and factors necessary to implement these services in pharmacies. The pharmacists trained during the immunization programme of the Pharmacists Without Borders project showed a greater readiness to provide immunization services.
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21
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Alves da Costa F, Rydant S, Antoniou S. The patient pathway in cardiovascular care: A position paper from the International Pharmacists for Anticoagulation Care Taskforce (iPACT). J Eval Clin Pract 2020; 26:670-681. [PMID: 31994273 DOI: 10.1111/jep.13316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/17/2019] [Accepted: 10/21/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. METHODS It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. RESULTS Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self-management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. CONCLUSION On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care.
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Affiliation(s)
- Filipa Alves da Costa
- Centre for Interdisciplinary Research Egas Moniz (CiiEM), University Institute Egas Moniz, Campus Universitário, Caparica, Portugal.,Research Institute for Medicines (iMED.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Silas Rydant
- Meduca, Royal Pharmacist Association of Antwerp (KAVA), Antwerp, Belgium
| | - Sotiris Antoniou
- Department of Pharmacy, Barts Health NHS Trust, UCL Partners, London, UK
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22
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Yemeke TT, McMillan S, Marciniak MW, Ozawa S. A systematic review of the role of pharmacists in vaccination services in low-and middle-income countries. Res Social Adm Pharm 2020; 17:300-306. [PMID: 32295736 DOI: 10.1016/j.sapharm.2020.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pharmacists' role in vaccination has expanded in some countries with pharmacists having greater authority to perform various immunization activities, from vaccine storage, vaccine adverse event reporting, vaccination education and advocacy, to vaccine administration. However, pharmacists' present involvement in vaccination services is poorly understood across low- and middle-income countries (LMICs). OBJECTIVE To identify and synthesize evidence on pharmacists' roles in offering vaccination services in LMICs. METHODS We searched three databases (PubMed, Embase, Scopus) and the gray literature to identify articles which described pharmacist involvement in vaccination services in LMICs. We abstracted data on reported roles of pharmacists in vaccination, as well as relevant country, vaccines, and populations served. RESULTS From the initial 612 records we identified, twenty-five (n = 25) studies representing 25 LMICs met our inclusion criteria. The most commonly reported role of pharmacists in vaccination across identified LMICs was vaccine advocacy and education (n = 15 countries). Pharmacist administered vaccination and storage of vaccines at pharmacies was reported in 8 countries. An additional 6 countries reported allowing vaccination at community pharmacies by other healthcare professionals. Immunization related training for pharmacists was reported or required in 8 countries. Fewer studies reported that pharmacists have access to patient immunization records in their respective LMICs (n = 6 countries) or had reported pharmacist involvement in vaccine adverse event reporting (n = 4 countries). CONCLUSIONS Pharmacists have the potential to play an important role in increasing access to vaccines and improving coverage, yet evidence of their role in vaccinations remains limited across LMICs. Greater documentation of pharmacists' involvement in vaccination services in LMICs is needed to demonstrate the value of successful integration of pharmacists in immunization programs.
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Affiliation(s)
- Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephen McMillan
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Macary Weck Marciniak
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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23
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Isenor JE, Kervin MS, Halperin DM, Langley J, Bettinger JA, Top KA, Lalji F, Slayter K, Kaczorowski J, Bowles SK, Waite NM, Halperin SA. Pharmacists as immunizers to Improve coverage and provider/recipient satisfaction: A prospective, Controlled Community Embedded Study with vaccineS with low coverage rates (the Improve ACCESS Study): Study summary and anticipated significance. Can Pharm J (Ott) 2020; 153:88-94. [PMID: 32206153 DOI: 10.1177/1715163519900221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jennifer E Isenor
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Melissa S Kervin
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Donna M Halperin
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Joanne Langley
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Julie A Bettinger
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Karina A Top
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Fawziah Lalji
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Kathryn Slayter
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Janusz Kaczorowski
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Susan K Bowles
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Nancy M Waite
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
| | - Scott A Halperin
- Canadian Center for Vaccinology (Isenor, Kervin, D. Halperin, Langley, Top, Slayter, Bowles, S. Halperin), Dalhousie University, IWK Health Centre and Nova Scotia Health Authority, Halifax.,College of Pharmacy (Isenor, Bowles), Dalhousie University, Halifax.,Department of Pediatrics (Langley, Top, S. Halperin), Dalhousie University, Halifax.,Department of Community Health and Epidemiology (Langley, Top), Dalhousie University, Halifax.,Department of Medicine (Slayter, Bowles), Dalhousie University, Halifax.,Department of Microbiology and Immunology (S. Halperin), Dalhousie University, Halifax.,Rankin School of Nursing (D. Halperin), St. Francis Xavier University, Antigonish, Nova Scotia.,Vaccine Evaluation Center (Bettinger), British Columbia Children's Hospital and University of British Columbia, Vancouver.,Faculty of Pharmaceutical Sciences (Lalji), University of British Columbia, Vancouver, British Columbia.,Department of Family and Emergency Medicine (Kaczorowski), University of Montreal, Montreal, Quebec.,School of Pharmacy (Waite), University of Waterloo, Kitchener, Ontario
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24
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Bach AT, Kang AY, Lewis J, Xavioer S, Portillo I, Goad JA. Addressing common barriers in adult immunizations: a review of interventions. Expert Rev Vaccines 2019; 18:1167-1185. [PMID: 31791159 DOI: 10.1080/14760584.2019.1698955] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Low levels of adult vaccination have been documented in the United States and globally. Research has been conducted to identify reasons for low immunization rates; however, the most useful studies are those that implemented interventions for identified barriers to evaluate their impact on rates of immunization. Identifying successful interventions provides immunization providers with evidence-based methods that can be utilized to increase the uptake of recommended vaccines.Areas covered: This review focuses on known barriers to adult immunizations and the interventions available in the literature to overcome these barriers. It outlines interventions that may increase vaccine uptake in the adult population through addressing barriers related to lack of vaccine knowledge, cost, access, provider and practice-based challenges, and racial and ethnic disparities.Expert opinion: Improving adult immunization rates is critical to protecting a population against vaccine-preventable diseases. Those interventions that appeared to increase immunization rates in the adult population included education and reminders about vaccination using text and telephone calls, low-cost or subsidized vaccines, easy access to immunization services, and understanding the cultural and social needs of different racial and ethnic populations. It is likely that an evidence-based multimodal approach using different categories of interventions is necessary to significantly improve adult immunization rates.
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Affiliation(s)
- Albert T Bach
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Amy Y Kang
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Jelena Lewis
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Sharon Xavioer
- Assistant Professor of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
| | - Ivan Portillo
- AHIP Health Sciences Librarian, Leathery Libraries, Chapman University, Irvine, CA, USA
| | - Jeffery A Goad
- Chair of the Department of Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, USA
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25
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Isenor JE, Bowles SK. Opportunities for pharmacists to recommend and administer routine vaccines. Can Pharm J (Ott) 2019; 152:401-405. [PMID: 31762853 DOI: 10.1177/1715163519878473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jennifer E Isenor
- College of Pharmacy and Faculty of Medicine, Dalhousie University.,Canadian Center for Vaccinology, Halifax, Nova Scotia
| | - Susan K Bowles
- College of Pharmacy and Faculty of Medicine, Dalhousie University.,Canadian Center for Vaccinology, Halifax, Nova Scotia
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26
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Fabiani M, Volpe E, Faraone M, Bella A, Rizzo C, Marchetti S, Pezzotti P, Chini F. Influenza vaccine uptake in the elderly population: Individual and general practitioner's determinants in Central Italy, Lazio region, 2016-2017 season. Vaccine 2019; 37:5314-5322. [PMID: 31331778 DOI: 10.1016/j.vaccine.2019.07.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Elderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly's individual characteristics. METHODS We used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016-2017 influenza vaccination campaign (1 Oct. 2016-31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level. RESULTS Overall, vaccination coverage at the end of vaccination campaign was 50.6%. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master's degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians. CONCLUSIONS Our results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs' attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.
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Affiliation(s)
- Massimo Fabiani
- Department of Infectious Diseases, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy.
| | - Enrico Volpe
- Regional Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi 7, 00145 Rome, Italy
| | - Maurizio Faraone
- Regional Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi 7, 00145 Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy
| | - Caterina Rizzo
- Bambino Gesù Paediatric Hospital, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Stefano Marchetti
- Italian National Institute of Statistics (ISTAT), Via Cesare Balbo 16, 00184 Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy
| | - Francesco Chini
- Regional Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi 7, 00145 Rome, Italy
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27
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Machado A, Kislaya I, Santos AJ, Gaio V, Gil AP, Barreto M, Namorado S, Antunes L, Matias Dias C, Nunes B. Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions. Vaccine 2018; 36:5265-5272. [DOI: 10.1016/j.vaccine.2018.07.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
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