Emerging roles for pharmacists – all in a day's work

The value to public health outcomes of pharmacist-administered vaccinations is undeniable and the numbers speak for themselves. Australia's first pharmacist vaccination pilot in Queensland (QPIP) saw over 35 000 vaccinations administered to adults in community pharmacies in just over 2 years. The overwhelmingly positive uptake of this service, and consistently positive feedback from patients after the first year (QPIP1), saw the pilot extended from influenza vaccinations to include pertussis and measles vaccinations. The data collected during the pilot paved the way for pharmacist-administered vaccinations across the whole of Australia. Being a pharmacist was traditionally considered, and in many instances still is, a very 'hands off' profession. Only 3 years ago, most pharmacists would never have dreamed of being able to vaccinate. Yet who would have thought that simply penetrating someone's skin with a sharp metal object would so significantly change their relationship and trust in you? Certainly, the success of the pilot was due to the trust the community places in pharmacists, as well as pharmacists' accessibility, as key healthcare professionals. In the QPIP pilot, almost 14% of patients had never had an influenza vaccination before, and another 15% indicated they would not have received an influenza vaccine if the QPIP service was not available. This indicates pharmacists have an important role to play in increasing the uptake of vaccines in the community, particularly in reaching people who would not have otherwise been vaccinated. This is also especially important in rural, regional or remote regions where access to healthcare services is more difficult. Consistent with findings from QPIP1, the vast majority of people in QPIP2 were also happy to receive their vaccination from a pharmacy in the future (99.4%), and would recommend the QPIP service to other people (99.5%). Patients applauded the convenience and accessibility of the pharmacist in community pharmacies. The fact that they could receive a vaccination without an appointment was seen as a positive by patients. The impact pharmacists can have on increasing the overall vaccination rates in the community through accessibility alone must be recognised. These figures are not unique to Australia, as similar statistics have been noted in other jurisdictions around the world where pharmacists are immunisers, e.g. Canada, United Kingdom, United States, and New Zealand.1-5 The ability of pharmacists to safely and effectively administer injectable medication and manage adverse drug reactions, points to an opportunity for pharmacists to further contribute to delivering public health services beyond that of influenza vaccinations. This is of particular importance as suboptimal uptake of vaccinations is an ongoing issue in many areas of the community (e.g. at-risk groups), and an expansion of pharmacist vaccination services will help to achieve more effective herd immunity.6 Pharmacists can help to increase the uptake of other vaccines, such as for human papilloma virus (HPV), hepatitis A and/or B, adults who require catch-up or booster vaccines, travel vaccines, and also those with gaps in their childhood immunisation record. However, the opportunity for wider delivery of healthcare services to people in the community extends to that beyond vaccinations per se. These include application of our administration skills too, e.g. depot injections (such as contraception, anti-psychotics), vitamin B12 injections, and possibly in patients' homes, e.g. antibiotic infusions/home IV. So the value for pharmacists as immunisers is clear. As a profession, it is time for pharmacists to roll up our sleeves and ask, what's next?

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