Researchers analyzed the potential role of nonphysician health care providers to provide vaccine services outside of traditional health care settings.
According to vaccine advocates and professionals, employing the use of nonphysician health care providers (NPHPs) like pharmacists is crucial to increase the vaccination rates of US patients across the country. With the COVID-19 pandemic serving as evidence of NPHPs’ ability to administer vaccinations outside of traditional health care settings, experts suggest that their scope of practice and ability to further serve their communities with immunization access must be expanded.
“Health care disruptions caused by the [COVID-19] pandemic prompted policy leaders and health authorities to rapidly expand upon programs that had previously existed for diseases such as the influenza, including quickly increasing access to complementary nonclinical settings and allowing for COVID-19 vaccine administration by NPHPs, spurring accelerated and widespread access to the vaccine that served as a real-world test case for rethinking the traditional vaccine delivery paradigm,” wrote authors of a study published in the Journal of the American Pharmacists Association.1
According to data from the National Association of Attorneys General, by December 20, 2021, 72.8% of the US population received at least 1 dose of a COVID-19 vaccine. This was just months after the FDA approved Pfizer-BioNTech’s first vaccine. Conversely, at the same time in 2021, overall influenza vaccination rates of US adults were just under 40%.2-4
Owing to the increased immunization efforts throughout the COVID-19 pandemic, health care officials were able to employ the help of pharmacists, technicians, nurses, and even dentists to administer vaccines in hopes of herd immunity to stop the spread of the virus.
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However, outside of the ramifications from the COVID-19 pandemic, immunization uptake efforts in the US have shown to be difficult, with vaccine hesitancy on the rise because of various uncertainties amongst the population, as well as the regulatory gatekeeping of NPHPs to provide necessary vaccine services.
“Although vaccines are an effective, practical intervention for preventing infectious diseases, the US vaccination rates remain below national targets for certain age groups and vaccines, with vaccination coverage rate (VCR) disparities also persisting among racial and ethnic subpopulations. Therefore, there remains a critical need to increase vaccine uptake across the life course and, in so doing, reduce VCR disparities and achieve vaccination equity among the populace,” they continued.1
To gather evidence on how to successfully increase vaccination uptake, researchers interviewed various health care providers and immunization experts to offer their perspectives on NPHPs’ potential role in vaccine services and the barriers that may stand in their way. Individuals were only interviewed if they worked in vaccination administration or policy.
“Thirty-eight participants completed interviews. Participants reported that U.S. individuals have a positive view of vaccination at complementary sites and by NPHPs, especially since the COVID-19 pandemic, where vaccination was often performed by NPHPs at complementary sites,” according to the authors.1
Based on results of the study and the perspectives analyzed in the interviews, immunization in the US will be forever affected by the COVID-19 pandemic.
“Although these delivery systems existed before the COVID-19 pandemic for vaccination programs of diseases such as the influenza, participants noted how increased utilization of these delivery systems during the pandemic greatly increased their visibility and use by the general public. Of note, participants described how receptive patients were to ‘drive-thru’ vaccination locations in response to COVID-19, whereas this option was largely absent or underused before the pandemic,” they wrote.1
The COVID-19 pandemic created an unprecedented public health crisis that required the work of both clinicians and NPHPs to increase vaccination rates and reestablish healthy, interactive communities. But as the pandemic subsided, normal immunization processes were put back into place and overall access was stymied. On top of that, concerns about vaccine efficacy and respiratory diseases in general waned in the eyes of US patients.
According to a National Foundation for Infectious Diseases survey, under 20% of US adults expressed concern about COVID-19, respiratory syncytial virus (RSV), influenza, and pneumococcal disease.5 Furthermore, as the COVID-19 crisis halted, NPHPs were forced to retire to their normal functions and lost scope of practice provisions they were provided under the Prep Act. A pharmacist that participated and was interviewed in the study mentioned how regulations vary by state and many NPHPs are prohibited from administering vaccines, despite highlighting their capabilities during the COVID-19 pandemic.1
With recent reports showing that NPHPs like pharmacists are distributing more vaccinations than physicians,6 and the COVID-19 pandemic highlighting a prime example of pharmacists and other NPHPs’ immunization capabilities, allowing more individuals from various areas of the health care industry is crucial in boosting vaccine efforts in the US.
“Lessons from the COVID-19 pandemic demonstrated the value of meeting people where they are, both physically and emotionally, to ensure broad access to vaccination services with patient-centered and tailored approaches. These findings can be leveraged by immunization decision makers and policy advocates to inform strategies that can help close vaccination equity gaps and improve vaccine uptake,” concluded authors of the study.1
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