Individual characteristics associated with support of in-pharmacy vaccination: Preliminary findings from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study

Effective December 2008, New York State (NYS) passed legislation authorizing pharmacists to administer flu and pneumococcal vaccinations to adults. Since pharmacies are easily accessible and have flexible hours of operation, in-pharmacy vaccination may increase access and reduce racial/ethnic disparities in flu vaccination rates, particularly among the elderly – a population highly susceptible to influenza-related morbidity and mortality. Many pharmacies in NYS participate in the Expanded Syringe Access Program (ESAP) that allows pharmacies to sell non-prescription syringes to reduce transmission of blood-borne disease. Therefore, we used data from ESAP-registered pharmacies in the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study, a community-based, randomized intervention examining expanding the public health pharmacy role on the wellbeing of drug users who purchase syringes through ESAP. Using PHARM-Link baseline pharmacy data, we examined pharmacy staff characteristics associated with support of in-pharmacy vaccination.

ESAP-registered pharmacies selected from ethnographically mapped areas of high drug activity in New York City were considered eligible if they sold syringes via ESAP without additional requirements, had regular and new ESAP customers. A 10-minute baseline survey was administered to syringe selling pharmacy staff. To assess inclusion in the multivariable model, significant bivariate associations determined by chi-square statistics were performed.

Of 376 pharmacy staff, most were technicians (57.7%). Technicians were more likely to be female and Hispanic while pharmacists were more likely to be male and Asian or Pacific Islander. Overall, 85% of pharmacy staff supported in-pharmacy vaccination. In the bivariate analysis, technicians were less likely to support in-pharmacy vaccination than pharmacists, but those who supported ESAP, in-pharmacy HIV testing and provision of HIV testing referrals, and medical and drug-treatment referrals were significantly more likely support in-pharmacy vaccination. After adjustment, technicians remained less likely to support in-pharmacy vaccination (AOR: 0.38 (95% CI: 0.18-0.83)), and those who supported in-pharmacy HIV testing were 10.1 (95% CI: 4.88-21.05) times more likely to report support in-pharmacy vaccination.

These data suggest that educational initiatives among technicians that stress their importance as public health providers could improve the implementation of in-pharmacy vaccination since technicians are integral to daily pharmacy operations. Pharmacy staff supportive of other in-pharmacy public health services were supportive of in-pharmacy vaccination and may be more aware of and committed to the community's needs. Future research is needed to determine barriers and feasibility of providing in-pharmacy vaccinations including pharmacy technician concerns, time constraints, knowledge on procedures, space, or other factors limiting expansion of programs in pharmacies.