Increasing Access: Improving Immunization Rates by Leveraging Pharmacists

Included in those who jumped into action to provide vaccinations across the state were pharmacists, thanks to a dedicated statewide focus on expanding their role in providing vaccinations over the past few years. The effort is helping to increase the number of locations where Wisconsin residents can receive vaccinations, including vaccines for COVID-19, thanks to work led by the Pharmacy Society of Wisconsin.

“We view pharmacists as an important part of the immunization neighborhood,” said Sarah Sorum, Executive Vice President and CEO of the Pharmacy Society of Wisconsin.

Sorum is leading a 30-month, $489,121 AHW-funded project to promote systems changes in order to increase access to a wide variety of immunizations at pharmacies. Awarded in 2018 and funded through the AHW Policy, Systems, and Culture Change pathway, the Wisconsin Pharmacy Foundation is working in coordination with the Pharmacy Society of Wisconsin to lead a collaborative team in identifying solutions to the hurdles experienced by patients, pharmacists, and health care plans to improve Wisconsin vaccination rates, which were not meeting goals set by the state and federal government. 

Wisconsin’s pharmacists are key to increasing access to a wide variety of vaccinations. Often open late and on weekends, pharmacies provide a convenient and local option for those seeking immunizations. Data shows that 93% of people in the U.S. live within five miles of a pharmacy. Although pharmacists have been providing some vaccines for decades, vaccine offerings often varied widely between pharmacies.

“It made it hard for Wisconsinites to know where they could be vaccinated in their community,” said Erica Martin, director of practice and population health initiatives at the Pharmacy Society of Wisconsin.

In 2019, a new law expanded the ability of pharmacists and pharmacy students to administer all vaccines listed in the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practice schedules to patients at least 6 years old. 

This project set out to develop a consistent vaccination protocol and training for pharmacist-provided immunizations and pursue sustainable policy changes to include pharmacists.

Today, Wisconsin is at the forefront of utilizing pharmacists to respond to the need to increase vaccination rates, according to Sorum, and the collaboration, catalyzed by AHW support, could not have come at a better time.

“The investment that AHW provided over the last three years has allowed us to build some strong relationships and collaborations,” said Sorum. “We are now able to leverage connections to get the most updated information to pharmacists to make sure they are at the table to discuss logistic and operational challenges that need to be addressed for them to be meaningful providers for the COVID vaccine.”

Project collaborators include the MCW School of Medicine, MCW School of Pharmacy, Wisconsin Immunization Program at the Wisconsin Department of Health Services, the Wisconsin Council on Immunization Practices, health plan providers, and 21 community coalitions located throughout the state. These coalitions tackle issues regarding interdisciplinary partnerships and vaccine education.

 “We are now able to leverage connections to get the most updated information to pharmacists to make sure they are at the table to discuss logistic and operational challenges that need to be addressed for them to be meaningful providers for the COVID vaccine.”  – Sarah Sorum

A key part of their work has been training to build the capacity of pharmacists to administer vaccinations.

“We have really been able to ramp up our capacity for training and move our training exclusively online because of AHW’s support,” said Martin.

While previous training centered around an in-person class, the new online format allows training to be accessible to pharmacists statewide. As health providers prepared for an “all hands-on-deck” approach to administering the COVID-19 vaccine, the team saw an increase in the number of individuals enrolling in its online immunization administration training. 

Alongside the training, the project is working to enable efficiencies between pharmacists and the Wisconsin Immunization Registry (WIR), a statewide database used to centralize immunization histories for Wisconsin residents, while also working to address the lack of coverage by health insurance providers. 

The project team is working directly with insurers to change these policies. According to Martin, health insurance typically has two distinct sides: medical coverage and pharmacy coverage. While vaccinations on the medical side are often covered, it’s less common on the pharmacy side, making it critical that insurers change their policies in order to expand access across the state. 

“Insurers are very interested in talking about immunization access and immunization rates,” said Martin. “The relationships are built and we are continuing to collaborate on additional policy change to expand vaccine access.”

Throughout the project, MCW academic partners have been collecting data to track the project progress. In the coming months, the team plans to analyze and report their data.

“We want to continue our work because we know some of these changes take a long time to see in the population, particularly in the midst of the pandemic,” said Sorum. “This project has been positioning pharmacies to be another door to go through for immunization services.”