APhA recognizes 2015's Immunization Champions
Outstanding pharmacists, pharmacy organizations, and allies of pharmacy
The measles outbreak at Disneyland earlier this year is the latest of many recent reminders that public health needs pharmacists on the immunization team. As trusted health care providers and counselors in their communities, pharmacists can often reach patients that other health care providers cannot. They bring patients credible information and immunizations to protect against preventable diseases.
The Immunization Champion Awards recognize pharmacists, pharmacy organizations, and allies of pharmacy that make outstanding efforts to improve vaccination rates within their communities, across the country, and even abroad. Immunization Champions personally administer vaccines, coordinate clinics, train others to vaccinate, and promote legislation to expand pharmacists’ authority to vaccinate.
This year’s champions have taken their role as immunizers and advocates beyond the pharmacy and into rural areas, homeless shelters, underserved communities, workplaces, and schools. One winner worked tirelessly to ship vaccines to servicemen and women across the Middle East. Another raised vaccine rates in a low-income, rural town. Another championed the role of pharmacists in public health.
Immunization Champions volunteer countless hours to get vaccines to those who lack access. They form invaluable partnerships with government agencies, nonprofit organizations, universities, and their colleagues in other health professions to further their mission of eliminating vaccine-preventable diseases.
The APhA Immunization Champion Awards program is supported by Merck and Novartis Vaccines & Diagnostics.
Kelechi Aguwa, PharmD, is pharmacy manager and immunizations mentor at Kmart Pharmacy in Ironwood, MI. When he joined the pharmacy staff at Kmart in 2013 as a newly minted pharmacist, the store had no immunization program. Since then, Aguwa has dedicated himself to improving vaccination rates in the town.
“Rural America does not provide patient advocates to its patients. I consider myself a patient advocate first and a pharmacist second. I will do anything to provide cost-effective health care for my patients,” Aguwa said.
The rural setting brings with it unique challenges. High physician turnover is common and can interrupt care, including staying up to date with vaccines. Low health literacy can perpetuate misinformation and skepticism. Aguwa has seen the consequences of these challenges in staggeringly high influenza rates. He takes immunizations to the places his patients live and work. He provides vaccine education at schools, businesses, and senior centers. Aguwa is the go-to source for local nursing homes seeking vaccine information. He coordinated the first-ever onsite immunization clinic for teachers and students in four local school districts.
“Teachers can’t always afford sick days,” he said. “When they go to work with the flu, that’s the recipe for a mini-epidemic.”
Knowing that many community residents work in manufacturing and in the hotel industry, Aguwa coordinated immunization clinics at one of the area’s largest manufacturing facilities and at a local hotel. In the state that has the fourth-highest rate of parents refusing vaccines for their children, Aguwa has increased vaccination rates at his store.
Kenneth McCall, PharmD, helped Maine become the 50th state to make pharmacists immunizers. McCall knew, however, that if pharmacists were to have an impact, patients had to know what pharmacists could do. He coordinated events to raise public awareness of pharmacists’ new authority to immunize. Then, to help meet the demand he had helped create, McCall began to train pharmacists to administer vaccines. Chair of the Department of Pharmacy Practice at New England University College of Medicine, McCall leads several 24-hour immunization-training programs every year.
“I’ve been a human pin cushion many times while training students,” McCall said. “One of my greatest joys is to see our graduates providing immunizations in the community. I get my flu shot every year from one of our graduates.”
In 2012, McCall pushed to expand pharmacists’ scope of practice through legislation that would allow them to provide all CDC-recommended adult vaccinations. He coauthored legislation that defines pharmacy interns’ scope of practice to include supervised vaccine administration.
Student pharmacists under McCall’s supervision administer more than 2,000 vaccines every year to veterans at the U.S. Department of Veterans Affairs (VA). McCall has developed innovative programs to increase vaccination rates among veterans and their families. The partnership he created between Texas Tech University Health Sciences Center and the Amarillo Veterans Affairs Health Care System allowed pharmacists and student pharmacists to bring influenza vaccinations to veterans’ spouses.
Mary Choy, PharmD, reaches patients far beyond the wards of New York City’s Metropolitan Hospital, where she is a clinical pharmacist. Choy is dedicated to eliminating health disparities among minority groups and low-income families.
She has organized health education events for Chinese seniors, where they can hear presentations about immunizations and other health topics in Cantonese. Choy spearheaded the first-ever pharmacist-led immunization clinic at Sunset Park’s Chinese-American Planning Council. Community leaders and Walgreens collaborated with Choy to market and organize an event that would bring in Chinese- and Spanish-speaking community members to get influenza vaccinations.
“Although there are many other avenues for receiving vaccinations in a big city like New York, these groups are underrepresented, and it is especially important to bring immunizations to communities where disparities exist,” Choy said.
People lined up at the door more than an hour before the clinic was set to open—a testament to the community’s need for such a program. Choy and her team vaccinated more than 120 people. An associate professor at Touro College of Pharmacy and an APhA-certified immunization trainer, Choy has trained more than 500 student pharmacists and pharmacists to be immunizers and vaccine educators.
Brandi Schuyler, PharmD, is chief of clinical operations for the U.S. Army Medical Materiel Center–Southwest Asia (USAMMC-SWA) in Doha, Qatar. Responsible for bringing vaccines to troops deployed across Southwest Asia, Schuyler must address challenges quite different from those pharmacists face on U.S. soil. Getting vaccines to the troops requires meticulous planning to make sure that not a single dose is wasted.
“Geographic location and the hostile environment add to the challenge, but we prepare for these situations,” Schuyler said.
Schuyler has orchestrated the transport of influenza vaccine to countries in the Middle East where temperatures average more than 100 degrees at the time of shipment. She must arrange for adequate refrigeration for the vials. She collaborates with others to determine the exact number of doses needed, a significant challenge when troops return home and deploy to the Middle East throughout influenza season.
Schuyler has coordinated the delivery of vaccines to troops in hostile areas that lack airplane access. She made herself available to Special Operations Command around the clock so that she could have the shipments ready for them on their schedule. Schuyler ensured 90,000 doses of influenza vaccine were distributed seamlessly to more than 200 locations in 14 countries.
Where she is posted in Qatar, Schuyler coordinated an influenza vaccine clinic where 900 military personnel were vaccinated in 3 days. Previous clinics had lasted a month.
Maria Young, BSPharm, immunizes patients at her independently owned University Pharmacy in Detroit, MI. But she reaches more patients outside her pharmacy and in the community. Through the many partnerships she has formed with community organizations and businesses, she maximizes her reach as an immunizer.
“As the health care arena shifts its focus to readmission and ACOs, [it has] left a door open for pharmacists to fill gaps,” said Young. “This is an opportunity for pharmacists to show our skills and address unmet needs in health care.”
Through The Children’s Center, Young provides immunizations to families facing poverty. She administers influenza vaccines at the annual St. John Armenian Health Fair. She provides vaccines and education to patients in a local medical group, which both increases vaccine access and expands Young’s role as a member of the health care team.
Young brings travel, influenza, tetanus–diphtheria–acellular pertussis (Tdap), and tuberculosis (TB) vaccines to employees, health profession students, and physicians at Wayne State University. She also brings immunizations to employees at several businesses and manufacturing facilities in Detroit. Through influenza, pneumonia, zoster, measles–mumps–rubella, Tdap, and TB vaccines, Young reaches about 8,000 patients per year.
Friend of Pharmacy
Paul Jarris, MD, is executive director of the Association of State and Territorial Health Officials (ASTHO) in Arlington, VA. The organization represents public health agencies in the United States, its territories and freely associated states, and the more than 100,000 public health professionals these agencies employ. Jarris has brought together state health agencies and pharmacists around the shared goal of improving public health. He believes public health professionals and health care providers cannot make their full impact without pharmacists.
“Patients look to their pharmacists for guidance on important health issues. Whether advising on how best to take medicines, reconciling medications from multiple physicians, or assisting in medication adherence, the pharmacist is a critical component of the health care team,” Jarris said.
Recognizing the barriers to making pharmacists full members of the health care team, Jarris has discussed provider status and immunization coverage with America’s Health Insurance Plans. Under his direction, ASTHO released a guidance document on how public health agencies could partner with pharmacies on the administration of the 2009 H1N1 vaccine. The result was a stronger partnership between pharmacy and public health in immunization efforts. Pharmacists administer vaccines under protocols with public health, conduct community surveillance, report to immunization registries with increased frequency, and receive referrals from public health departments.
Further expanding the role of pharmacy in public health, ASTHO has created advisory committees that include pharmacists on topics such as nonphysician immunizers and pharmacist distribution of pandemic vaccines.
Corporation or Institution
In the past year, Walgreens launched new initiatives and continued existing ones to improve vaccination rates in the United States and the developing world. Walgreens implemented the largest centralized pharmacy cloud-based electronic health record (EHR) system ever in use, Walgreens Cloud EHR. The platform gives pharmacists a real-time view of patients’ immunizations to ensure optimum counseling. Walgreens’ smart phone app gives patients access to their immunization records whenever and wherever they need them. The app can guide discussions about vaccines with physicians and other providers outside of the Walgreens pharmacy.
“With this type of tool, there is tremendous opportunity to continually educate patients on important vaccines and the ability to positively impact vaccination rates,” said Jason Rubin, BSPharm, Senior Manager of Immunizations.
Last year, 1,500 Walgreens pharmacies became Travel Centers of Excellence that offer comprehensive travel health consultations. Through a partnership with Novartis and APhA, Walgreens trained more than 8,000 pharmacists to provide the consults. In the program’s first 6 months, pharmacists provided more than 2,000 travel consultations.
The corporation’s partnership with the VA has allowed Walgreens to improve veterans’ access to influenza vaccines and other CDC-recommended vaccines. Through a partnership with the U.N. Foundation, Walgreens donated three million polio and measles vaccines to children in Tanzania. Walgreens is currently working with Medicare and other payers to advocate for expanding beneficiaries’ vaccine coverage to reflect new recommendations for pneumococcal vaccines for adults aged 65 and older. Walgreens immunizers have administered more than nine million vaccines.
H-E-B Pharmacy, a Texas-based independent chain, has cultivated an expanding immunization program over many years. “We created a grassroots campaign to encourage pharmacists to offer these important preventive services,” said Jose Cervantes, PharmD, assistant manager of Pharmacy Professional Services. In addition to creating educational videos for pharmacists and workflow processes, the company partnered with APhA to offer immunization training to its pharmacists.
H-E-B created a position to facilitate vaccine delivery. Immunization coordinators leave their in-store duties during influenza season to support immunizing pharmacists and oversee influenza campaigns. The coordinators work with churches, workplaces, and insurance brokers to organize onsite influenza vaccine clinics in a variety of locations.
Outside of influenza season, H-E-B pharmacies run immunization campaigns centered on such themes as back to school, travel, adults, and seniors. H-E-B offers free health screenings every second Saturday. This program brings in lower-income community members whom pharmacists counsel on the importance of vaccines.
The company takes quick action to address acute local needs. When a school district saw that many children hadn’t met immunization requirements, H-E-B partnered with the district and a local physician to immunize 100 students during a mass vaccine clinic.
“Without this partnership, these students likely would not have had access to another provider and may have missed several school days,” said Cervantes. The pharmacy also provided patrons of a local restaurant with quick access to hepatitis A vaccines after an employee was diagnosed with the condition.
Friends and colleagues of Garth Reynolds, BSPharm, say he is a living resource on immunization laws. In a race between Reynolds and Google, the pharmacist would be faster and more thorough when it comes to delivering evidence-based vaccine information, his peers say. Perhaps it comes from a lifetime in pharmacy.
Growing up, Reynolds worked with his parents in their small community pharmacy in southern Illinois. As a young man, he attended state and national pharmacy meetings with his parents.
Before he became executive director of Illinois Pharmacists Association, Reynolds was immunization program coordinator for Dierbergs Markets in Chesterfield, MO. In that role, he developed and managed the immunization and clinical programs at 28 stores and trained the providers who staffed the programs. Today, Reynolds capitalizes on his role with the state pharmacists’ association to promote immunizations and pharmacists as immunizers.
“Pharmacists are the most accessible health care provider in the community, and in some communities, they are the only health care provider,” Reynolds said. “They have the opportunity to provide care to their patients more than any other provider.”
Reynolds leads letter-to-the-editor campaigns and makes television appearances to support legislation to expand pharmacists’ scope of practice as immunizers. He builds bridges between pharmacy and nursing, pediatrics, and other medical groups to promote the role of pharmacists on the immunization team. His presentations for state and county public health departments have advanced pharmacists’ capacity for collaboration with public health to improve vaccination rates.
An MBA student and a pharmacist at Walgreens in Lansdale, PA, Mayank Amin, PharmD, manages to volunteer up to 40 hours of his time each week. He wants to ensure that everyone learns the importance of immunizations and that everyone who wants vaccines can get them. “As catalysts who promote health awareness, pharmacists have a commitment to serve the people in their communities,” he said. “This commitment begins with each pharmacist taking action.”
Through BAPS Charities, an international service organization, Amin conceived and launched the annual Children’s Health and Safety Day in Lansdale, PA, in 2011. Today, the health fair takes place at locations around the country. Amin manages the fairs at 25 of those locations, which reach more than 10,000 families. To increase the fair’s capacity to provide vaccine education, Amin partners with pharmacy schools. Students from these schools counsel attendees at Children’s Health and Safety Day.
Michelle Obama’s Let’s Move campaign has recognized the health fair. The National Institute of Health’s We Can program uses Children’s Health and Safety Day as a model. Through BAPS, Amin has advocated for vaccination drives that have reached more than 15,000 people. When charitable donations of vaccines for these drives ran out, Amin persuaded Walgreens, his employer, to begin offering immunizations free of charge to uninsured people.
“As a volunteer for BAPS Charities, I am able to work on projects that make a difference in the communities we live in,” Amin said. “There is nothing more rewarding than to be able to help others.”
Safeway brings free vaccines to a diverse group of underserved populations through innovative programs and partnerships with universities, professional organizations, nonprofits, and faith-based organizations. At a soccer camp in Los Angeles, Safeway pharmacists brought vaccines to inner-city families and provided hands-on immunization training to student pharmacists. In Phoenix, Safeway delivered influenza vaccinations to restaurant and salon workers and others whose jobs require a high degree of public contact. Denver-area Safeway pharmacists overcame the challenge of publicizing vaccine clinics to homeless people.
Partnering with Volunteers of America, the two organizations devised a strategic marketing plan that brought more than 160 homeless people in for vaccines. Community partners in Northern California helped Safeway administer vaccinations to nearly 500 underserved Hispanic and Vietnamese people who didn’t speak English. Their efforts drew an additional 135 homeless individuals.
Through other events around the country, Safeway pharmacists have partnered with community organizations to provide vaccines for at-risk youth, immigrants, and retired military personnel. Safeway’s commitment to bringing vaccines to those who otherwise could not access them is based on simple immunology, according to James McCabe, director of Patient Care Services. “What we do for one patient, we do for all, to protect the broader community,” he said.
Pharmacy Team Member
Louis Jimenez is a pharmacist technician and assistant manager at Walgreens in Chandler, AZ. Recognizing the needs of patients who may never walk through the doors of Walgreens, Jimenez created a partnership between his store and St. Vincent de Paul Society, a local charitable organization. The charity’s mission is to help feed, clothe, house, and heal members of the state’s indigent population. Jimenez saw a place for pharmacy in this mission.
“Everyone deserves a chance to receive immunizations,” Jimenez said. “The more flu shot clinics we open, the more people we can reach.”
Through the relationship Jimenez forged, he and his pharmacy team provided 50 free health screenings that included blood pressure, cholesterol, body mass index, and glucose readings. The team provided 200 free influenza vaccinations to homeless individuals.
Jimenez also capitalized on Walgreens’ access to the community by carrying out a food and funding drive for St. Vincent de Paul Society in Phoenix-area Walgreens stores. His efforts helped raise more than $2,000 and an additional $300 worth of canned food.