Expanding the role of pharmacists for immunization

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Currently, pharmacists play a broader, integral part in the Philippine healthcare system. Their usual duty of dispensing medications and prescription drugs has expanded to other clinical services like health consultation, drug and medication information, health promotion, and adult immunization, among others. Moreover, as the COVID-19 pandemic continues, pharmacists are also among a special group of medical frontliners like doctors, nurses, and midwives, who are trained and certified to administer vaccines.

With this, the Philippine Pharmacists Association, Inc. (PPhA) conducted a summit highlighting pharmacists’ expanded role, particularly in its training and certification program as part of the “immunizers.” The event was held virtually and titled “The Journey of the Immunizing Pharmacist: Primed, Boostered, and Soaring.”

The first-ever “Immunizing Pharmacists” summit is a milestone for the industry, marking the Philippines’ inclusion among 36 countries that launched an immunizing pharmacist program. This program allows pharmacists to vaccinate people through the Immunizing Pharmacist Certification Program (IPCP). The program may prove helpful, especially during the pandemic, because it will allow more Filipinos to be vaccinated while expanding the role of pharmacists in improving public health.

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Immunization is critical because it may help prevent the spread of vaccine-preventable diseases, which maintains the public health and well-being of the population. Vaccines may also help achieve “herd immunity.” It occurs when a large portion of a community (the herd) becomes immune to a disease. The percentage of a community that needs to be immune in order to achieve herd immunity varies from disease to disease. The more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to help lower the spread.

Vaccination usually starts from infancy, but it should be continued throughout the entire life course since the risk of being infected can happen long past infancy, through childhood, and adulthood. Enhancing the public’s confidence in vaccines is essential to achieving a resilient public health environment through sustainable immunization programs. Collaboration between medical practitioners, the government, and the private sector is not just encouraged but is a necessary step to ensure proper and broad public awareness about the benefit of immunization.

A panel discussion led by PPhA representatives discussed how the ‘Immunizing Pharmacist’ came to be. Former PPhA president Dr. Olivia Limuaco shared Section 4-G of the Philippine Pharmacy Law (RA 10918). It says that pharmacists are accredited in “administering adult vaccines as approved by the Food and Drug Administration provided that they shall undergo the training on the safe administration of adult vaccines and management of adverse events following immunization. Pharmacists hold a certificate of training issued by an institution duly accredited by the Professional Regulation Commission (PRC); provided, further, that the safe administration of vaccines be part of the higher education curriculum for pharmacists.”

Through this law, pharmacists are expected to vaccinate people. However, Dr. Limuaco shared that pharmacists were initially hesitant because there were already other medical professionals certified to give vaccinations. Also, pharmacists feared the added responsibility on top of their primary duties. To quell doubts about the program, the PPhA went through a series of dialogues with the medical community and regulatory bodies. They reached out to various hospitals and clinics, the Food and Drug Administration, and the PRC to develop the IPCP. “We collaborated with different practitioners to prepare for the training program, including proper handling of vaccines and the vaccination itself,” she said.

Ms. Karen Grace Romero shared her insights as a US-certified immunizing pharmacist. Given her experience, she said there is a gap in the Philippines in the overall vaccination effort, not just for pandemic control but for other preventable diseases. That is why she decided to pitch the idea of the IPCP to the organization. She explained that in the United States, pharmacists could administer shots in pharmacies and are part of the immunizer medics, making medicines more accessible for everyone.

Ms. Romero believes that being an ‘immunizing pharmacist’ is an “additional skill to contribute to the improvement of public health by making vaccines accessible.” She added that the hesitancy was expected, as a pharmacist is usually trained to assist people in their medication and prescription, not as an actual practitioner of clinical services. “We should invest in ourselves more. It might be nerve-wracking, but our contribution as an immunizing pharmacist is greatly valued,” she said.

Dr. Imelda Peña of the University of the Philippines (UP)College of Pharmacy explained how they developed the idea of the ‘immunizing pharmacist’ pitched by Ms. Romero into a certification program. A total of six training modules were put-together as this is a new field for pharmacists in the Philippines, completed in 2016. “One of the challenges we have to face then was the established need to collaborate since there was fear among us if the stakeholders, especially the different medical doctors and nurses who are already administering shots, will accept the pharmacists as immunizers,” she said.

COVID-19 and beyond: What lies ahead for immunizing pharmacists?

Dr. Vicente Belizario, Dean of the College of Public Health of the University of the Philippines-Manila, spoke about the country’s current state in terms of its vaccination effort, not just for the COVID-19 pandemic but for others like pneumonia and HPV-related diseases. He said that in terms of the country’s status in controlling COVID-19 via vaccines, 2022 is at par with 2020-2021 because of the vigorous efforts by medical frontliners to vaccinate. However, according to Belizario, “the Philippines is still lagging behind other Southeast Asian countries in terms of primary doses against COVID-19.” He identified the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), SOCCSKSARGEN (Region 11), and Regions 5 and 6, where vaccination efforts should be focused.

Dr. Belizario also congratulated the organization for being able to mobilize for vaccination through Resbakuna sa Botika. In addition, he lauded how pharmacists innovated by conducting a tele-pharmacy service for those unable to travel. He also recognized the efforts of leading drugstores in amplifying their online delivery services.

A year after the launch of the Immunizing Pharmacist program, Hazel Faye Docuyanan shares the experience of Certified Immunizing Pharmacists as they administer their first vaccine to their patients.

She said that the first tries will always be memorable since this is a new skill that they have to learn as pharmacists. “If we want change, we have to be the change,” she said. Most pharmacists in her group expressed their gratitude for their patients’ trust, adding that being an immunizing pharmacist is a fulfilling role to do. “To know I can help people as an immunizing pharmacist makes it worthwhile,” said Ms. Docuyanan.

Mr. Bryan Posadas, National Program Manager of IPCP, expressed that the program is on its way to be integrated into the Pharmacy curriculum. He proposed that the certification program for Immunizing Pharmacists develop and grow its sub-branch of a pharmacist’s work. From developing training modules down to the branding, he hopes to standardize the program to be able to sustain the momentum.

This new role of pharmacists as vaccinators, being the most accessible healthcare professionals, would greatly help Filipinos throughout the pandemic and beyond.

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