APhA's Pharmacy-Based Immunization Delivery

Pharmacy-Based Immunization Delivery is an innovative and interactive training program that teaches pharmacists the skills necessary to become a primary source for vaccine information and administration. The program teaches the basics of immunology and focuses on practice implementation and legal/regulatory issues. 

There are three components to the certificate training program:

• 12 hour (1.2 CEU) self-study modules with case studies and assessment exam 
• 8.0 hour (0.80 CEU) live seminar with final exam 
• Hands-on assessment of intramuscular and subcutaneous injection technique 
   

Self-Study Modules Description and Learning Objectives

The self-study learning activity is designed to ensure that all participants have an understanding of vaccine-preventable diseases and the role of pharmacists as vaccine advocates and administrators.  There are five learning modules that present in-depth information on immunology, practice implementation, and legal and regulatory issues as noted below, with appropriate references to the Centers for Disease Control and Prevention (CDC) resource publication, Epidemiology and Prevention of Vaccine-Preventable Disease.  The self-study program includes a self-assessment test and real-life case studies that are designed to help reinforce and evaluate participants' understanding of key information and concepts.

Module 1. Pharmacists, Vaccines, and Public Health

At the completion of this activity, participants will be able to:

• Describe the effects of immunizations on morbidity and mortality rates of vaccine-preventable diseases in the United States.
• Discuss Healthy People 2020 goals for vaccination rates in the United States.
• Explain the recent expansion of the role of pharmacists as vaccine providers and describe the status of pharmacists’ authorization to administer vaccines throughout the United States.
• Describe strategies for pharmacists to advocate for pharmacy-based delivery of vaccines.
• Discuss the role of pharmacists as immunizers in emergency preparedness activities.
• Identify resources that are useful for immunization providers and educators.

Module 2. Overview of Immunology and Vaccine Development

At the completion of this activity, participants will be able to:

• Identify the differences between active and passive immunity and describe key elements of each process.
• Explain how vaccines elicit an immune response and provide protection from disease.
• Describe the characteristics of and distinctions among live vaccines, inactivated vaccines, polysaccharide vaccines, and recombinant vaccines.
• Discuss the rationale for timing of vaccine administration and intervals between doses, including vaccine-vaccine spacing and vaccine-antibody spacing.
• Describe principles of herd immunity.

Module 3. Vaccine-Preventable Diseases

At the completion of this activity, participants will be able to:

• Describe the epidemiology, clinical features, and potential complications of diseases that can be prevented with vaccines.
• Identify vaccines available in the U.S. market for each vaccine-preventable disease and describe their features.
• Identify the contraindications and precautions for the use of vaccines available in the United States.
• Use recommendations from the Advisory Committee on Immunization Practices to identify target groups for receipt of each vaccine.

Module 4. Patient Care Considerations for Immunizing Pharmacists

At the completion of this activity, participants will be able to:

• Identify patients with immunization needs.
• Given a patient case, select appropriate vaccines using an immunization schedule from the Advisory Committee on Immunization Practices, and identify appropriate timing, doses, and routes of administration.
• Discuss the rationale for timing for vaccine administration and intervals between doses, including vaccine-vaccine spacing and vaccine-antibody spacing.
• Recall recommended patient screening questions for vaccination and identify valid contraindications for vaccinations.
• Educate patients about the benefits of vaccines and address common concerns about vaccines.
• Provide accurate information that addresses common myths about vaccines.
• Describe the roles of the Vaccine Adverse Event Reporting System in managing vaccine safety.
• Educate patients about potential adverse reactions following the receipt of a vaccine and how to manage them.
• Explain appropriate techniques for intramuscular, subcutaneous, intradermal, and intranasal administration of vaccines.
• Describe the signs and symptoms of adverse reactions to vaccines and procedures that pharmacists should follow to manage various adverse reactions.
• Describe appropriate documentation and follow-up after vaccine administration.

Module 5. Operating a Pharmacy-Based Immunization Program

At the completion of this activity, participants will be able to:

• Describe important considerations when deciding which vaccines to offer.
• Describe physical space requirements for a vaccine service.
• Discuss Occupational Safety and Health Administration regulations for the prevention of employee exposure to bloodborne pathogens and needlestick injury at worksites where immunizations are administered.
• Outline principles and procedures for vaccine storage and handling.
• Discuss workflow options for administering vaccines in pharmacy practice.
• Identify marketing strategies that can be used to promote a pharmacy-based immunization service.
• Explain potential options for obtaining reimbursement and compensation for vaccines and vaccine administration.
• Describe liability issues related to vaccine administration, including the Vaccine Injury Compensation Program

Live Training Seminar Description and Learning Objectives

The second part of the certificate training program is an active learning seminar focusing on pharmacy practice implementation.  The live training seminar is based on the experience of practitioners involved in immunization advocacy and administration.  The training seminar reinforces and expands on the self-study program and addresses areas such as immunization needs, legal and regulatory issues, and injection-technique training.  Participants will be expected to practice giving intramuscular and subcutaneous injections on each other.

After completing the live seminar, participants will be able to:

• Describe strategies for increasing immunization rates, including physician collaborations, community level activities, and immunization coalition activities.
• Review adult patient cases and make patient-specific recommendations based on the appropriate immunization schedule.
• Review a pediatric patient case and make patient-specific recommendations based on the appropriate immunization schedule.
• Demonstrate effective strategies for communicating with patients who have concerns about vaccines.
• Describe current evidence that explores the relationship between autism and vaccines.
• Describe a process for administering vaccines in a community pharmacy.
• Identify the signs and symptoms of adverse reactions that can occur after vaccination.
• Describe procedures for management of patients with adverse reactions to vaccination that constitute an emergency.
• List the steps for intranasal administration of the live attenuated influenza vaccine.
• Demonstrate appropriate intramuscular and subcutaneous injection techniques for adult immunization. 

All participants are strongly encouraged to obtain CPR or BCLS certification.  However, certification is not a prerequisite of the program.  A Certificate of Achievement is awarded to participants who successfully complete all program requirements.  The Certificate of Achievement is invalid, however, without written proof of current CPR or BCLS certification