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Welcome to the California Immunization Coalition
Education Hour
Webinar Objectives
Discuss the role of pharmacists in improving access to immunizations, including in communities with limited access to primary and preventive care services
Describe at least one example of a campaign that has used pharmacists to expand access to immunizations
Discuss recent policy changes in California that relate to the provision of vaccines by pharmacists
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Strategies for Expanding Access to Immunizations: How Pharmacists Can Improve Access to Immunizations in our Communities
Audio Options for the Webinar Today
• Listen over your computer speakers
– Turn up your computer speakers
– Make sure they are not on Mute
• Plug in earphones or headset to computer or handheld device (phone or tablet )
– All lines will be on mute during the conference
– You may ask questions using the Q&A Panel
Submit Written Questions at Any Time Using the Q&A Panel
3) Click Send
2) Address your questions to All Panelists
1) Type your question into the box at the bottom
3) Click the “Send” Button
1.) Type your question into the small box at the bottom
2.) Address your question to “All Presenters”
3.) Click the Send Button
Frequently Asked Questions
1. Will I be able to get a copy of the slides after the webinar?
2. Will I receive a copy of the webinar recording?
Yes – a copy will be posted on ImmunizeCA.org site
Yes - a copy will be posted www.ImmunizeCA.org site
Strategies for Expanding Access to Immunizations: How Pharmacists Can Improve Access to Immunizations
in our Communities
Questions for Presenters?
Ask Questions
Here
The Role of Pharmacists as Vaccinators
Jeff Goad, Pharm.D., MPH
Professor and Chair, Department of Pharmacy Practice
Chapman University School of Pharmacy
Pharmacists are Health Care Providers in CA!
4050(c): pharmacists are health care providers who have the authority to provide
health care services
Place of flu vaccination (%) for children and adults, United States, early 2015–16 flu season
National Immunization
Survey-Flu and National
Internet Flu Survey
New Pharmacy Immunization Law
• Existing (B&P 4052 a.11)
• Any IZ and age pursuant to a protocol
• New: Independent (B&P4052.8)
• Initiate and/or administer (IN/IM/SC/ID)
• 3 years and older
• Routine vaccines
• ACIP recommended, published by CDC
Pharmacy Immunization Law (new and old)
• Initiate and/or administer
• Training
• An approved immunization training program
- Endorsed by CDC or ACPE
- Injection technique, indications/CIs, emergency mgmt.
• Maintain IZ training – 1 hr of CE q2 yrs
• BLS - maintain
• May initiate/admin Epi or diphenhydramine
BOP finalized August 26, 2016
Pharmacist Immunization Training
• Pharmacists and Student Pharmacists
• APhA Pharmacy-based Immunization Delivery Program
• 20 hours (8 live/12 self-study)
• 3 assessments
• 2 exams
• 1 observational skill (IM/SC)
• Covers all areas of “Pink Book” training +
• Pharmacy clinic operations
• Reporting, documentation
• BLS, BBP
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Mandatory IZ Law Documentation
• Vaccine administration record
• Pharmacy – readily retrievable
• Patient record (“yellow card”)
• Notification of vaccination
• PCP and/or Pre-natal provider
• Immunization registry (IIS)
• All within 14 days of administration
Documentation
• Screening
• VAR
• Consent
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• PPCP created by the Joint Commission of Pharmacy Practitioners in 2014
• Developed to promote consistency in how patient care is taught and practiced
• Adapted for immunization practice in 2016 at Chapman University
• Consistent with NVAC and CDC Standards for Adult Immunization Practice
• Assess
• Recommend
• Administer
• Document
The PPCP
Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. May 29, 2014.
Collect The pharmacist assures the collection of necessary
subjective and objective information about the patient
in order to understand the relevant medical history
and clinical status of the patient.
Information may be gathered and verified from
multiple sources, including existing patient records,
the patient, and other healthcare professionals. This
process includes collecting:
• Demographics
• Immunization records
• A current medication list
• Relevant health data
• Patient lifestyle habits, preferences, beliefs, health
and functional goals, and socioeconomic factors
Sources of Information
• Immunization Information Systems (IIS)
• Personal Immunization Record
• Pharmacy Dispensing System
• Primary Care Providers (PCP)
• Patient-Provided History
Assess The pharmacist assesses the information collected and
analyzes the need for vaccines according to the FDA and
ACIP.
This process includes assessing:
• Age
• Current and past health conditions, medications
• e.g. level of immunocompetence
• Pregnancy status
• Lifestyle
• Occupation
• Travel
• Current health status
• Allergies
• Vaccination history
Plan • Patient specific
• PCP collaboration
• Determine education needs
• Dispel myths
• Minimize financial barriers
• State scope of practice
• Make strong vaccine recommendations
• Integrate motivational interviewing
Proactive Vaccination
• Reactive vaccination: patients ask for a vaccine
• Proactive vaccination: pharmacist identifies patients in need of a vaccine
• Use Collect and Assess steps to identify patients
• Use Strong Recommendations and Motivational Interviewing to persuade people to get vaccinated
Implement The pharmacist implements the care plan in collaboration
with other health care professionals, as needed, and the
patient or caregiver. During the process of implementing
the care plan, the pharmacist:
• Consider state law
• Administer vaccines
• Consider workflow and space
• Supplies and storage
• Documentation
• VAR, screening form, consent, IZ record, PMS
record, provider communication
• Coordination of care
• Referrals
• Communication with other providers
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APhA-NASPA Pharmacist Immunizer Survey, 2015
Follow-Up: Monitor and Evaluate The pharmacist should have systems in place and training for
appropriate monitoring and management of possible adverse
reactions.
This process includes the continuous monitoring and
evaluation of:
Having a written emergency plan
Stocking epinephrine and diphenhydramine
Report to VAERS and VERP
Establish a system for boosters and completion of series
Great opportunity to improve access of care
Many retail pharmacies offer off-site clinic
Types of clinics ◦ Workplace
◦ Community
◦ In Store
Workplace clinics for private and public facilities
Health fairs in local counties
Homeless shelters
Nursing Homes
Social gatherings organized by HOA
Airports
5k Walk/Runs
Types of vaccines offered ◦ Flu, Tdap, Td, Pneumonia, MMR, Hepatitis A/B,
Meningitis, and many others
Available throughout the year ◦ 1 month minimum notice with the exception of an
outbreak
Accepts private insurance except for Kaiser Accepts Medicaid and Medicare except for adolescents
All immunizers are APhA Certified
Update to CAIR
No Set Up Fee
All payments are processed via patients insurance
We provide vendor insurance for incidents
Flexible dates
Large outreach potential in large and small counties throughout the country ◦ Over 4,000 stores nationally
Triage table to
distribute paperwork
and determine whose
supply to use
Patient will follow
organizers guidelines
to receive vaccine
Patient will follow
Walmart’s guidelines to
receive vaccine
Can Walmart pharmacists use the counties vaccine supply? ◦ Unfortunately we cannot. Walmart pharmacists can only
immunize using supplies brought in by Walmart associates
Can Walmart staff the table? ◦ We can bring additional personnel to staff the triage table to
help guide patients to the correct immunizer
Does Walmart donate vaccines to clinics? ◦ At this time Walmart does not
Are there any events coming up that simulate these clinics? ◦ We have an event on Saturday September 23rd from 10am to
2pm called Walmart Wellness Day
Contact your local pharmacy and see what opportunities they can offer
See what their process and procedures are to establish a clinic
Establish dates, times, and locations
For additional information or to find a local Walmart to setup a clinic
Bill Huynh
916-834-2007
Strategies for Expanding Access to Immunization
August 24, 2017
Moving Your Brand and Message into the Community Moving Your Brand and Message into the Community
2011 NIVDP Launched
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Need to eliminate flu vaccination coverage disparities Partnership has grown to 1,266 Vaccination clinics in 95 cities Over 1.4 million uninsured
people vaccinated
Moving Your Brand and Message into the Community
Collaborations with Pharmacies and
Pharmacists
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Moving Your Brand and Message into the Community
Leveraging with Community Partners
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Moving Your Brand and Message into the Community Moving Your Brand and Message into the Community 39
Lessons Learned Relationships matter Trust is essential Coordination is ongoing
Frequently Asked Questions
1. Will I be able to get a copy of the slides after the webinar?
2. Will I receive a copy of the webinar recording?
Yes – a copy will be posted on ImmunizeCA.org site
Yes - a copy will be posted www.ImmunizeCA.org site
Question and Answer Session
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Please Complete Online Evaluation!
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Thank you
Chapman University
Walmart
National Influenza Vaccination Disparities Partnership
