Role of new vaccinators/pharmacists in life-course vaccination.

BACKGROUND

Vaccines against diseases such as herpes zoster, pneumococcus and influenza are broadly recommended for older adults, but uptake is frequently low.

VACCINATION BOTTLENECK

Part of the reason may be that access to adult vaccination can be problematic, particularly for minorities and other under-served populations. Potential barriers include complex procedures, limited resources in healthcare systems and lack of structured infrastructure.

STRESS-TESTING EXPENDED VACCINATION

The Covid-19 pandemic necessitated rapid expansion of the infrastructure to deliver adult vaccination, and triggered the use of facilities including pharmacies, schools, faith-based organizations, community organizations, shops and hair salons, drive-through centres and mobile vaccination units.

IMPROVED ADULT VACCINATION SYSTEM

Although many such initiatives were temporary, they demonstrated the principle of effective expansion of adult vaccination and education to a range of new providers and settings. Of these, pharmacist involvement in immunization in particular has consistently been shown to be associated with increased immunization rates.

INTEGRATION OF NEW VACCINATORS

This review discusses results from attempts to expand and simplify the adult vaccination process, potentially allowing vaccination to be initiated by the recipient and completed in a single visit. These studies suggest that expanding adult vaccination access to new providers and/or new settings will require development of an integrated plan for preventive healthcare, covering areas such as setting target coverage rates, financial support, and development of immunization information systems accessible to all vaccination providers to maintain accurate immunization records and support interventions such as reminders.

The expansion of adult vaccination to settings outside of conventional doctors’ offices and hospitals showed that other settings, with appropriate controls, can safely be used for vaccinationAvailability of adult vaccination through a range of providers and settings could simplify the vaccination process, potentially allowing vaccination to be more easily initiated by the recipientHowever, in many countries this potential is not utilized due to the need for changes to basic infrastructure and legislation covering aspects such as vaccine education, payment for vaccination, and access to immunization information systems.