Expansion of community pharmacies' role in public vaccine delivery to children: Opportunities and need.

Despite the positive impact pharmacists have had on access to vaccines, only a limited number of community pharmacists and pharmacies are able to participate in most federal- and state-supported vaccine programs. In this commentary we (1) review vaccination services currently provided by community pharmacists in the United States, (2) highlight regulatory, reimbursement, and role-based barriers to community pharmacists' participation in the vaccines for children (VFC) program, a cornerstone program to support vaccinations of children in the United States, and (3) suggest changes to support and improve VFC participation for all health care providers. For the purposes of this commentary, community pharmacies are defined as retail pharmacies not associated with a health care system, hospital, or clinic.

Key policy and programmatic factors to improve influenza vaccination rates based on the experience from four high-performing countries.

BACKGROUND: Many countries consistently fail to achieve the target influenza vaccine coverage rate (VCR) of 75% for populations at risk of complications, recommended by the World Health Organization and European Council. We aimed to identify factors for achieving a high VCR in the scope of four benchmark countries with high influenza VCRs: Australia, Canada, UK and USA. METHODS: Publicly available evidence was first reviewed at a global level and then for each of the four countries. Semi-structured interviews were then conducted with stakeholders meeting predefined criteria. Descriptive cluster analyses were performed to identify key factors and pillars for establishing and maintaining high VCRs. RESULTS: No single factor led to a high VCR, and each benchmark country used a different combination of tailored approaches to achieve a high vaccine coverage. In each country, specific triggers were important to stimulate changes that led to improved vaccine coverage. A total of 42 key factors for a successful influenza vaccination programme were identified and clustered into five pillars: (1) Health Authority accountability and strengths of the influenza programme, (2) facilitated access to vaccination, (3) healthcare professional accountability and engagement, (4) awareness of the burden and severity of disease and (5) belief in influenza vaccination benefit. Each benchmark country has implemented multiple factors from each pillar. CONCLUSION: A wide range of factors were identified from an evaluation of four high-performing benchmark countries, classified into five pillars, thus providing a basis for countries with lower VCRs to tailor their own particular solutions to improve their influenza VCR.