Providing Immunizations in Community Pharmacy

Angela Passamonte, PharmD. RPh, Clinical Programs Specialist at Retail Business Services joins the PQS Quality Corner Show to discuss the value of providing immunizations at a community pharmacy level with Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts.

Passamonte shares insight on topics including in-pharmacy pediatric vaccinations, receiving multiple vaccinations at one time, and new immunization opportunities on the horizon. 

Transcript

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00:00:00:21 - 00:00:32:04
Speaker 1
Pharmacists providing immunizations strengthens the health care system overall. It leads to better patient outcomes because we are seeing the pharmacist as truly a valuable member of that health care team and being able to expand their services and expand what Expand their reach into their communities using pharmacists helps alleviate strain on the medical community. They're able to focus on patients with very complex medical issues, and we know that we are trained and educated to provide these services.

00:00:32:04 - 00:00:56:22
Speaker 2
Welcome to the Pharmacy Quality Solutions Quality corner show where quality measurement leads to better patient outcomes. This show will be your go to source for all things related to quality improvement and medication use and health care. We will hit on trending topics as they relate to performance measurements and find common ground for payers and practitioners. We will discuss how the platform can help you with your performance goals.

00:00:57:07 - 00:01:32:05
Speaker 2
We will also make sure to keep you up to date on pharmacy quality news. Please note that the topics discussed are based on the information available at the date and time of reporting information or guidelines are updated periodically and we will always recommend that our listeners research and review any guidelines that are newly published. Buckle up and put your thinking cap on the quality Corner show starts now.

00:01:32:05 - 00:02:01:22
Speaker 3
Hello Quality Corner Show listeners. Welcome to the PQS podcast, where we focus on medication use, quality improvement and how we can utilize pharmacists to improve patient health outcomes. I'm your host, Nick Dortch. Today's episode is returning to a topic that is covered with admittedly a high degree of frequency on the show, but it happens to be one of my passions for community pharmacy practice, and it is a topic where we do get continued questions about covering more information.

00:02:02:07 - 00:02:33:06
Speaker 3
So this topic is none other than immunizations. And while the quality corner show has covered various aspects of vaccines in recent months and in recent years, this episode intends to take a specific approach about how pharmacists are addressing some of the most common questions and opportunities that may now appear. Our guest today is Dr. Angela Pace, M.A. and Angela is a clinical program specialist for Retail Business Services for RBC, which supports the immunization programs at Food Lion.

00:02:33:09 - 00:02:41:08
Speaker 3
Giant Food. Hannaford. Stop and Shop and the Giant Company. Angela, welcome to the show and how are you doing today?

00:02:41:16 - 00:02:44:21
Speaker 1
Good afternoon, Nick. Thanks so much for having me. Doing well and happy to be here.

00:02:45:10 - 00:02:59:08
Speaker 3
Excellent. Well, Angela, before we begin, we need to know a bit more about you and then what you do. So do you mind giving us a quick rundown on your career in pharmacy or background in health care and then what it is you do in your role today?

00:02:59:23 - 00:03:21:08
Speaker 1
Thanks, Nick. So I'm from upstate New York originally, and I have been part of the community pharmacy world since I started back as a pharmacy technician in high school. I've always loved the idea of being a pharmacist in my community and just being that trusted person that helps everybody and is so readily accessible. Everybody knows who their local pharmacist is, right?

00:03:21:12 - 00:03:43:10
Speaker 1
They've helped you out in some type of way over the years. So my career has been focused in the community retail space, but most recently in the retail support sector. And my current role at RBC, I received my PharmD from Wilkes University in Wilkes-Barre, P.A. in 2013, and I'm a registered pharmacist and licensed immunizing pharmacist in the state of Pennsylvania.

00:03:43:21 - 00:04:10:08
Speaker 1
After I graduated, I worked with Rite Aid for a year, and then I worked for the Giant Company, which is based in which is based in Central P.A., which is where I currently live. At the giant company. I was a floating pharmacist first, which really gave me the opportunity to participate in different and unique offerings, such as working on a pharmacist, created technician training manual, assisting with community vaccination events, and partnering with our dietitians to create an overall wellness destination.

00:04:11:03 - 00:04:43:07
Speaker 1
I then became the pharmacy manager for our Chestertown, Pennsylvania, store, where I was able to further create a vaccination destination within our community and continue to watch our patient population grow. We provided travel medication and vaccination consultations and partnered heavily with a local business that frequently conducted business overseas and needed those services. So while travel medicine was one of my passion projects in the vaccine space, we frequently provided those routine absolutely necessary vaccines to our community, which is really paramount to the overall community's health.

00:04:43:22 - 00:05:04:17
Speaker 1
We saw really great increases year after year, and that just proves the trust that our customers had for us for their vaccine needs. I was lucky enough to join RBC Retail Business Services in 2019 and in my current role as clinical program specialist, I help support those vaccination programs of the five local brands under Ahold, Delhaize. As you mentioned, Food Lion, Giant Food.

00:05:04:19 - 00:05:25:05
Speaker 1
Hannaford. Stop and Shop and the Giant Company. I work on many projects that play in the vaccination space, such as procurement and logistics, clinical education and protocol management. This allows the brands to provide unique care to each of their coverage areas. I have experience in managing the yearly influenza program and also providing support for the COVID 19 vaccine initiatives.

00:05:25:14 - 00:05:35:00
Speaker 1
Another responsibility that I have is keeping up to date on all things immunizations and consistently reviewing and creating those best practices. So that's what I've been up to.

00:05:35:18 - 00:06:01:12
Speaker 3
Like many others, Angela, there's no shortage of work in the pharmacy sector when it comes to improving patient care opportunities for patient outcomes. And what we're going to talk about today, specifically immunizations, a lot of new opportunities there. Some of this spurred on by the COVID pandemic, but also largely just expanding scope of practice for pharmacists and actually as well, the pharmacy technicians.

00:06:01:19 - 00:06:09:07
Speaker 3
But we're going to hold off until we get to our questions. But before we do that, we're going to pause for a moment and hear a quick message from the PQS team.

00:06:11:04 - 00:06:35:04
Speaker 2
Now it's time for the breakdown as quality corner show host little as three main topic questions. Our guests will have a chance to respond and there will be some discussion. To summarize the key points. This process will repeat for the second and third questions, which will wrap up the primary content for this the 14th. After that, it's expect to end on a closing summary, usually containing a bonus question.

00:06:35:19 - 00:06:40:16
Speaker 2
Now that we have the start of the process, let's jump into the questions.

00:06:42:12 - 00:07:11:11
Speaker 3
All right, Angela, this episode is focusing on some elements of immunizations, which may be new or newer for the pharmacy team. Now, to get started, I want to focus on actually the youngest patients in the pharmacy in those pediatric vaccines because of the COVID pandemic, many patients were not receiving some of those standard pediatric vaccines. And parents may look to their community pharmacy increasingly as a location for these vaccines to be provided.

00:07:11:19 - 00:07:27:11
Speaker 3
This can be new. This can be different. It's obviously a very different experience for providing a vaccine for someone under five years old versus for an adult. So what does this mean for the pharmacy team and what should pharmacists know about providing immunizations for the pediatric population?

00:07:27:20 - 00:07:47:04
Speaker 1
Right. There were many physician offices that were unable to open or had reduced hours during the pandemic for routine care. So especially early on, it's really important to triage all of those sick individuals, get them care quickly and efficiently. And unfortunately, it puts burden on the health care system overall and leads to those gaps in care that you mentioned, which includes vaccinations.

00:07:47:18 - 00:08:07:16
Speaker 1
So I think what this means for pharmacists is that we can play a bigger role and that our bigger role is highlighted at the highest level, right? We are positioned uniquely to offer vaccinations in a convenient place such as that pharmacy that's in your grocery store when you're already picking up food at convenient times, like nights and weekends for the pediatric population.

00:08:07:16 - 00:08:39:16
Speaker 1
That way you're not pulling a child out of school. You could also manage side effects if they are present over the weekend and at home by making that process quick and simple for families of all shapes and sizes. The pharmacies can be a key driver in closing the vaccine gap that was created by that COVID 19 pandemic. Recent and severe data actually shows that pharmacies have been responsible for an increasing amount of vaccinations over the last five years, and very importantly, states that have expanded pharmacists, authority and vaccinations lead to higher overall vaccination rates.

00:08:40:02 - 00:09:03:10
Speaker 1
As far as preparing for this group, pharmacists can use some of the same due diligence that they do in assessing adults and their eligibility. So the same thing for children, assessing the eligibility, the product selection and dosing for children's vaccines. Regarding the process of vaccination itself, the locations have those private rooms that can assist in creating a comfortable area for vaccination.

00:09:04:02 - 00:09:38:22
Speaker 1
Overall distraction techniques can be used anywhere and are particularly helpful for that age group. So some of those things can be tactile items like you've seen those little poppet toys, other handheld items like a traditional teddy bear. Does does just well being useful to help those children overcome some of the anxiety. One thing that we've also seen is the organization Hope for Henry, which is an organized action that aims to reduce needle phobia in children and by creating almost like a game, like a journey through the vaccination process, you can really engage the child in their health care journey.

00:09:39:24 - 00:10:01:23
Speaker 1
When the pharmacist engages in educating that child on the vaccine process, the child can be empowered and understand it. Even though they might be very young. I know in my extended family we had kids that were really excited to show off those COVID vaccine Band-Aids the next day in school, and I think that's a really great mix of their parents and their pharmacists being able to walk them through that process.

00:10:02:08 - 00:10:31:03
Speaker 3
Excellent. Thank you, Angela, for the rundown. And before we move on, want to cover, I guess, kind of one question for you as it relates to pediatric vaccines opportunities, Are there any specific guidelines or updates that pharmacists that parents and caregivers should be aware of as it relates to pediatric vaccines? And maybe this is just thinking through because guidelines can change, but is there basically one shop should be that should be the true source for identifying this information going forward?

00:10:31:22 - 00:10:55:23
Speaker 1
Right. There's a lot of information out there. I'm having a great one stop shop. It is paramount. And having all of these things become a little easier to digest. So immunization schedules by the CDC and that's where the place the place that we want to direct people to the immunization schedules are updated yearly. And we expect an update actually pretty soon, right around this time of year.

00:10:56:06 - 00:11:19:00
Speaker 1
And this would include the addition of COVID 19 vaccine on the recommended schedule. And there are always some small updates and changes every year. So you can be certain that is being looked at constantly and reviewed. So more to come in 2023, but we do pay close attention to that final word of the ACP, which is the advisory committee on Immunization Practices for their final guidance.

00:11:19:13 - 00:11:42:08
Speaker 1
And that guidance helped shape immunization protocol agreements that allow pharmacists and in some states also interns and technicians, the authority to administer those vaccines from the parent side of things. Staying up to date with the schedule is really best completed by having those regular discussions with the health care team. And that health care team includes pediatricians, specialists and pharmacists.

00:11:42:24 - 00:12:06:09
Speaker 3
Excellent. Thank you, Angela. And moving to our second question or topic for today. As a population, as a nation, as a world, we've gone through now a few combined flu seasons where patients may be asking about whether or not they can receive a flu shot and either the COVID vaccine or a COVID booster. So we are still in that flu season.

00:12:06:09 - 00:12:25:02
Speaker 3
Now, as of the time of recording in this episode, which is January, with the episode released in February. So this question is still pertinent for now and for for this year, this season. But how does this interaction work and what are the general rules about patients receiving vaccines at or around the same time when they're coming in to the pharmacy for a visit?

00:12:25:08 - 00:12:47:07
Speaker 1
Great question. So receiving multiple vaccines at one visit such as your flu and your COVID booster, that's safe and effective. It also reduces the chance that an individual might forget to come back for a really important vaccine. So receiving multiple vaccines in one visit saves time for the individual. You can save time driving back to the pharmacy. You can save time filling out your paperwork twice.

00:12:47:12 - 00:13:09:24
Speaker 1
And it also allows the pharmacy to save time and, you know, be able to take care of more people by providing you multiple vaccinations in your one appointment. Pharmacist Review all the vaccinations that a patient would request during their visit and they determine which of those a patient can safely receive together. Some vaccines do have specific guidelines on receiving multiple of them on the same day.

00:13:09:24 - 00:13:24:09
Speaker 1
Those are going to be your live vaccines, but a majority can be given together without issue. And most often if multiple vaccinations are indicated, they're given in separate arms or if they must be on the same separated anatomically.

00:13:25:08 - 00:14:01:03
Speaker 3
Great. Angela, I appreciate the information and definitely some opportunities there for patients to be able to receive and get a full evaluation from their pharmacist according to the guidelines, what the patient may be comfortable with as well at their time visiting the pharmacy. Now, Angela, I will move us to our third question for today's episode and for those listeners who have been checking into our show so far in the 2023 calendar year, you know where ending our discussion with our guest on a specific third question, just a little bit tailored to the guest, we have each episode.

00:14:01:10 - 00:14:14:10
Speaker 3
So Angela, for you, this in regards of this episode, I want to talk about I want to hear from you. What does pharmacist or what do pharmacist providing immunizations, what does that mean for improving patient health outcomes?

00:14:15:02 - 00:14:40:14
Speaker 1
It's a great question, Nick, and I think it has two parts. So very quickly my mind goes to reducing the incidence of vaccine preventable diseases, safe and effective vaccines that we have, reduce the chance that people, one, get these diseases and two, that they have complications from those diseases if they do get it. We're lucky to have these tools so readily available to improve these health outcomes.

00:14:40:14 - 00:15:12:07
Speaker 1
And it's really important that we educate, you know, our health care teams and the population on where to get these and why they're so important. Secondly, I think that pharmacists providing immunizations strengthens the health care system overall. It leads to better patient outcomes because we are seeing the pharmacist as truly a valuable member of that health care team and being able to expand their services and expand what span their reach into their communities can Using pharmacists helps alleviate strain on the medical community.

00:15:12:15 - 00:15:19:20
Speaker 1
They're able to focus on patients with very complex medical issues, and we know that we are trained and educated to provide these services.

00:15:21:02 - 00:15:42:11
Speaker 3
Absolutely agree there, Angela. And now I do have actually one final question for you, somewhat related to this topic, but want to think a little bit about what's on the horizon, what's coming ahead. So are there any potential new immunization opportunities that we as pharmacists should be on the lookout for as we go throughout the course of this 20, 23 year?

00:15:43:02 - 00:16:12:11
Speaker 1
Yes. And always there always there's always something being studied. And you can find some really great information out there to see what's in current studies and where each phase is. But I think I want to highlight the most right now, the RSP vaccines, either of interest as you come further into 2023, as you said, you know, at this time of the episode here, we are still within that flu time frame.

00:16:12:22 - 00:16:42:21
Speaker 1
And as we've probably heard throughout the fall and winter, the chance of RSV combining with COVID 19 and flu poses that triple TMX situation where respiratory viruses are circulating at the same time and packs a really nasty combination punch there. We already have available vaccines for COVID 19 and for flu. So that next obstacle to overcome is really the the RSV vaccine.

00:16:43:14 - 00:16:53:15
Speaker 1
So we expect to see new RSV vaccines later this year. And pharmacies will definitely be able to play a part in providing those to the community is excellent.

00:16:53:15 - 00:17:24:04
Speaker 3
Yeah, that's been an item that's been on my radar and for many pharmacies as well. But something that was mentioned last summer during a podcast episode with another guest focusing on what to expect for the 2023 2024 immunization season. So definitely something that we're keeping tabs of and waiting more information, guidance with those opportunities. Certainly the triple dynamic, I believe it was that you had mentioned as certainly had an impact here on our health care providers and our public health system.

00:17:24:04 - 00:17:44:04
Speaker 3
So great opportunities there. Well, Angela, with that, I do want to wrap us up, and I appreciate you coming on the show today to talk about some of the the hottest topics when it comes to immunizations, when it comes to opportunities with the pharmacy team and immunizations. I'll give us a quick summary before we jump to our true closing.

00:17:44:04 - 00:18:09:18
Speaker 3
And a couple of fun questions for you. But we started off talking about the pediatric population right now. Because of the last few years, there have been gaps in pediatric immunization rates. And this is certainly an opportunity where pharmacies and the pharmacy teams have an opportunity to help close those gaps. There can be some reluctance from members of the pharmacy team who haven't necessarily provided vaccinations for this population before.

00:18:10:00 - 00:18:38:01
Speaker 3
So, you know, having closed off spaces, private council rooms, etc., could be very helpful. And then, as Angela had shared, there are different distraction techniques that can be used with the patients, with these small patients and with their parents to help so that this process can go smoothly when it comes to additional information. As Angela had said, paying close attention to the Advisory Committee on Immunization Practices is going to be great for understanding what's to come for that.

00:18:38:01 - 00:19:06:04
Speaker 3
Population also talked about different vaccines and receiving them at the same time, by and large, that these can be done at the same time. However, I always refer to guidance from groups like A.P. for further information. And then coming up, there's definitely opportunities for pharmacists to provide to continue providing vaccinations for things like tetanus, shingles, pneumococcal, and then hopefully fingers crossed here as we go throughout the year 20, 23 calendar year for RSV.

00:19:06:16 - 00:19:27:01
Speaker 3
So for more information there, definitely check out the ACP guidelines and website. That's the recommendation of check out the latest and greatest information. But now Angela, we get to the end of our episode where we like to talk about things that are perhaps perhaps not pharmacy or health care focus, but a little bit about you and how you think about things.

00:19:27:01 - 00:19:31:24
Speaker 3
So these are meant to be somewhat quick, rapid fire questions. Are you ready to begin?

00:19:32:07 - 00:19:32:22
Speaker 1
I'm ready.

00:19:33:16 - 00:19:43:15
Speaker 3
Excellent. Well, starting question number one, it'll be interesting because we're recording this episode almost middle of the afternoon. Is it better to be a morning person or a night owl?

00:19:43:22 - 00:19:54:03
Speaker 1
I'm going to answer this one as morning person, but I am a night owl, so it's definitely better to be a morning person. But you hit me right in my stride here for for my day. So I'm good.

00:19:54:24 - 00:20:04:21
Speaker 3
It's funny. I think I'm usually about the opposite. I typically am up early in the morning whether or not I'm effective at being awake in the morning and doing things, that's a different conversation.

00:20:05:02 - 00:20:07:02
Speaker 1
Understandable.

00:20:07:02 - 00:20:11:00
Speaker 3
The next question Do you prefer to read the book or watch the movie?

00:20:11:14 - 00:20:12:12
Speaker 1
I'm going to go with book.

00:20:12:21 - 00:20:21:17
Speaker 3
Excellent. Okay. Do you have any off the top of your head, do you have any key examples of where you believe this to really be? A great example of the book being better than the movie?

00:20:22:04 - 00:20:30:20
Speaker 1
I'm going to have to go with Harry Potter. You know, I read all of those. I'm of that generation. I read all of them. And I have to say that books kind of did it better.

00:20:31:14 - 00:20:49:17
Speaker 3
Okay. Full disclosure, I've only ever read the first Harry Potter book as someone who had already read The Lord of the Rings, by the time those came out, I found that a little bit disappointing. Now, with more maturity, I'm willing to give them a second try. So I yes, I might be one willing to do that. Angela Next question is a little bit health care focus.

00:20:49:21 - 00:20:52:17
Speaker 3
What is your recommendation for living a healthy life?

00:20:53:12 - 00:21:18:11
Speaker 1
I think it's going to be sustainable. Changes. So I think trying to make one healthy decision at a time versus this overhaul of your entire routine or, you know, a diet exercise, you know, it pays off to keep you motivated if you can make pioneer changes and just make us a stop and say, maybe I'll choose this today and really, you know, applauding yourself for that small work that pays off in the end.

00:21:18:24 - 00:21:28:12
Speaker 3
Okay. Excellent. And then our last question. What is one goal that you are currently working towards here in the beginning of the 2023 year?

00:21:28:19 - 00:21:51:24
Speaker 1
So I'm looking this year to further my education. So as I mentioned, my you know, my time has been spent in community and retail pharmacy and I've been lucky to experience a couple of other things here at RBC. So I really want to take some additional training in business or I.T since I'm able to work with great people in those avenues and just looking to get back to some education this year.

00:21:52:24 - 00:22:15:20
Speaker 3
That's an excellent goal. I always I do some work in mentoring with students myself and I continue to be really passionate in that area. One thing that I always remind folks is whether it's the pharm.d or even getting being licensed as a pharmacist, right? That's the entry level ticket to being a working health care professional. There is an expectation, right, whether it's learning new disease states, new medications.

00:22:15:20 - 00:22:34:05
Speaker 3
That's why we do some of the C each and every year, why we have to do C, But then there's also parts that we can do to build ourselves up, whether it's professionally, personally. So I'm a big advocate, whether it be formal education, additional graduate level degrees or even just informal training. So definitely kudos to you for that.

00:22:34:05 - 00:22:38:10
Speaker 3
Angela, you and I will have to keep in touch to see how that goes throughout the course of the year.

00:22:38:16 - 00:22:49:00
Speaker 1
Definitely always a lifelong learner. And I think in health care that you're always learning and it's really important to understand that your learning is never finished and to keep pushing yourself towards something new all the time.

00:22:49:17 - 00:23:17:00
Speaker 3
Absolutely correct. Could not agree more. And Angela, with that, we'll wrap up today's episode. I do thank you very much for joining on the Quality Corner show. But before we close, if our listeners have a question for you about what we discussed today, opportunities for pharmacy, where they can look at for immunization guidelines or anything else possibly related to quality immunizations, pharmacy, etc., what is the best way that they can contact you?

00:23:17:15 - 00:23:27:21
Speaker 1
Of course. So my email is Angela.Passamonte@retailbusinessservices.com I'm happy to take any questions and I really appreciate you having me on the show today.

00:23:28:23 - 00:23:45:06
Speaker 3
Excellent. Thank you Angela We'll look forward to talking with you again. But for our listening audience, we have now wrapped up this episode of The Quality Corner Show. We thank you for joining us today and we hope you listen to our next episode. Thanks for listening. We have one final message from the PQS team.

00:23:46:05 - 00:24:07:01
Speaker 2
The Pharmacy Quality Solutions Public Morning Show has a request for you. Our goal is to spread the word about how quality measurement can help improve health outcomes. And we need your help in sharing this podcast to friends and colleagues in the health care industry. We also want you to provide feedback. Ask those questions and suggest health topics you'd like to see covered.

00:24:07:20 - 00:24:31:03
Speaker 2
If you are a health expert and you want to contribute to the show or even talk on the show, please contact us using email info@pharmacyquality.com. Let us know what is on your mind, what we can address so that you are fully informed. We want you to be able to provide the best care for your patients and members, and we wish all of you listeners out there well.