With global Sustainable Development Goals (SDGs) threatened by antimicrobial resistance (AMR), how can social science play a critical role in finding solutions?
Getting ahead of the game - the growing global impetus to improve vaccine coverage through pharmacists
Vaccination is one of the safest and most effective tools to prevent infection and improve the population's health. It is an essential tool for tackling antimicrobial resistance (AMR) as it significantly reduces the need for and use of antimicrobial medicines, in turn reducing the risk of developing resistant infections.
Vaccination is particularly important in lower resource settings where infectious disease is more prevalent and health systems are more fragile. Inadequate achievement of the sustainable development goals (SDGs), including access to clean water and sanitation, coupled with frequent challenges with irrational use, stockouts and substandard quality of antimicrobial medicines are significant factors that contribute to AMR.
It is estimated that vaccines prevent between two to three million deaths worldwide each year, with significant potential for this number increase further. Vaccines have the second greatest impact on public health, just behind clean water.
Although vaccinations have significantly reduced mortality and morbidity worldwide, their efficacy relies on a high uptake. Whether an individual chooses to be vaccinated or not is influenced by several factors such as health beliefs, risk-benefit perceptions, cost, waiting times, and ease of access to vaccinations.
Traditional public sector services are often subject to long waiting times, stockouts and considerable competing pressures from the high national disease burden. The COVID-19 pandemic not only demonstrated the need to maximise vaccine coverage and build resilience in the health system, but it has also led to the reduction in vaccination rates of many life-course diseases, resulting in outbreaks of previously controlled diseases such as measles.
As we try to catch up with routine vaccination programmes and prepare for mass-vaccination that will be required in future pandemics, it is important to consider the role of health care professionals across all sectors. Offering vaccines in easily accessible, community settings can increase uptake. As we see an increase in pandemics and the progression of AMR, vaccination use will only become more important as a cornerstone of public health. Leveraging all avenues to improve vaccination rates is therefore essential.
Image of a vaccine.
As we see an increase in pandemics and the progression of AMR, vaccination use will only become more important as a cornerstone of public health.
Global evidence has demonstrated that enabling pharmacists to vaccinate can increase coverage significantly. As accessible and trusted health care professionals in communities, they also have a key role in tackling vaccine hesitancy. A meta-analysis of 36 studies assessing the pharmacist’s role as administrators, educators and facilitators demonstrated an increase in vaccines coverage when pharmacists were involved in the vaccination process, regardless of role or type of vaccine.
The evidence is so strong that the International Pharmaceutical Federation (FIP) recently launched a call to action to expand the role of community pharmacists in vaccination globally to help improve vaccine coverage. The statement from the 2022 Commonwealth Health Ministers meeting also recognises the need to engage the whole health workforce to maximise vaccine coverage.
Community pharmacists in the UK, Australia, USA, Canada, South Africa, Argentina, Portugal, Philippines and Switzerland have all been involved in vaccination programmes for many years. More recently, pharmacists have been included widely in mass vaccination centres to help tackle the COVID-19 pandemic. This has prompted many countries to review the policy, legislation and practices around vaccination by community pharmacists, with the aim of maximising vaccine coverage.
An image of a person preparing a vaccine.
In the Commonwealth, Malaysia has led the way in granting authority for pharmacists to administer COVID-19 vaccinations, with Ghana and Nigeria being the most recent to announce changes in policy, and India currently piloting training of pharmacists as vaccinators. These are welcome developments with the potential to have a significant impact in reducing preventable infections and help preserve the effectiveness of our antimicrobial medicines.
“The recent development that grants Malaysian pharmacists the authority to administer COVID-19 vaccines is truly a remarkable milestone, one that serves as a testament to the vital role that these dedicated healthcare professionals play in our society. We applaud the government's decision to entrust pharmacists with this critical responsibility, and we remain optimistic that this marks only the beginning of a broader recognition and empowerment of pharmacists in Malaysia.
As we celebrate this significant achievement, we extend our heartfelt encouragement to pharmacists in other nations who are still striving to obtain the right to administer vaccines. We urge you to persevere in your advocacy efforts and continue demonstrating the indispensable contributions that pharmacists can make towards promoting public health. With resilience and steadfastness, we firmly believe that success will eventually follow, and the world will witness the full potential of this noble profession.”
Tan Zhi Shan, Sujata, Hon. Asst. Treasurer, Malaysian Pharmacists Society
”Equipping pharmacists to participate actively in vaccination sits well within Ghana's efforts at attaining UHC. This is because this move increases access to vaccines, supports the overburdened traditional vaccination workforce and improves versatility among the health workforce, thus improving access to preventive care among community members.”
Dr Mrs Joycelyn Azeez, Director of Pharmaceutical Services, Ministry of Health, Ghana
“Vaccination is a key public health intervention. In several countries, pharmacists are engaged in vaccination programmes and this has clearly demonstrated to improve vaccination coverage. Approving pharmacists as vaccinators in India will be a most welcome move. In India, there are more than 750,000 community pharmacies across the country, which remain an untapped potential as far as various public health interventions are concerned. Pharmacists in India need to be engaged as vaccinators with appropriate education, training and policies. This will not only increase the outreach of the vaccination programme but will also share the burden over the health system. Indian Pharmaceutical Association with support of FIP is working to make this happen.”
Mrs Manjiri Gharat, Vice-President, Indian Pharmaceutical Association and Vice-President, FIP
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As part of World Antimicrobial Awareness Week 2022 in November last year, Head of the Fleming Fund’s Expert Advisory Group Dr Catriona Waddington joined an esteemed panel of speakers from the AMR community at the symposium, ‘The rising tide of antimicrobial resistance – a high price to pay’ hosted by Ineos Oxford Institute, Oxford Martin School.