A new survey of 45 countries conducted by the International Pharmaceutical Federation Collaborating Centre at University College London found that 44% of these countries have community pharmacy locations offering vaccinations, demonstrating the expansion and growing acceptance of pharmacy immunisation services around the world. In Singapore, the National Immunisation Records (NIR) documents all records of vaccination for individuals below 18 years old. However, above this age, the current healthcare system lapses in maintaining the population records, including routine recommendation and follow-up of vaccination in adulthood.
Locally, pharmacists are deemed as an integral part of a holistic healthcare system. The involvement of pharmacists in immunisation can contribute to preventive healthcare. Pharmacists play a pivotal role in identifying patients who are targeted for certain vaccinations. They are also the best advocates concerning the efficacy and safety of vaccinations, as this profession is a highly trusted one.
The pharmacy can be a one stop solution for filling prescriptions as well as receiving vaccination jabs. However, while there is much to be gained for increasing immunisation by involving pharmacists on a greater level, certain challenges remain.
1. Safety concerns with regards to vaccinationOver the years, there have been many debates about the safety of vaccinations. One of the biggest concern is the possible link between autism and the thimerosal–mercury preservative that was found in vaccines, particularly the measles-mumps-rubella (MMR) vaccine. This myth was debunked in 2009 when the Institute of Medicine (IOM) conducted a thorough review and found no association between the two.
However, due to the long-standing misbelief, the public has generally remained wary of vaccinations, more so among young children. Pharmacists, in this regard, can play a role in educating their patients and debunking this myth, as the benefits of immunisation often outweighs the risks.
2. Limited resources raising prices of vaccinationIn public institutions, vaccinations are usually purchased in bulk, which makes these resources cheaper and readily available. In private community pharmacies and clinics, however, there is the challenge of maintaining stocks for vaccinations, as the demand may be lower and thus to patients may be charged at a higher price. It is a challenge for the nation to maintain a steady stream of the stock count and yet control the prices.
3. Difficulties in follow-up after the first injectionMany vaccinations, such as influenza and pneumococcal vaccination require a second jab. Given that the current national healthcare record system does not have a holistic immunisation tracking system, it will be a challenge for pharmacists to track the next due date for vaccination. Thus, to harvest the benefits of immunisation programmes in the long run, pharmacists encourage their patients to continue and persist in the programme.
Pharmacists can help patients make an appointment for their next jab, or hand out information on vaccination with each prescription. Also, immunisation posters should be placed prominently in the pharmacy waiting area – all of which serve as reminders for patients.
Among the Singapore population, those with chronic diseases such as diabetes, renal failure, COPD, as well as elderly patients who are 65 years old and above are the most vulnerable to infections. As such diseases are on the rise and the population ages, the importance of vaccination in adulthood also increases.
Pharmacists thus are needed more than ever to play a role in encouraging immunisation programmes among their patients, to contribute to the progress towards a healthier nation. MIMS
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2. Research into Causes and Treatment of Autism Spectrum Disorders. National Institutes of Mental Health Web site. www.nimh.nih.gov/health/publications/autism/research-into-causes-and-treatment-of-autism-spectrum-disorders.shtml. Accessed 30 December 2016.
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