Abstract
Objectives: To explore community pharmacies’ experience with two models of distribution for publicly-funded influenza vaccines in Ontario, Canada—one being publicly-managed (2015–2016 influenza season) and one involving private pharmaceutical distributors (2016–2017 season). Methods: Online surveys were distributed to community pharmacies across Ontario during the 2015–2016 and 2016–2017 influenza seasons with sampling proportional to Ontario Public Health Unit catchment populations. Quantitative data were analyzed descriptively and inferentially and qualitative data were summarized for additional context. Results: Order fulfillment appeared more responsive with the addition of private distributors in 2016–2017, as more pharmacies reported shorter order fulfillment times (p < 0.01); however, pharmacies reported significantly more days with zero on-hand inventory in 2016–2017 (p < 0.01), as well as more instances of patients being turned away due to vaccine unavailability (p < 0.05). In both seasons, a similar proportion of pharmacies reported slower order fulfillment and limited order quantities early in the season. Improved availability early in the season when patient demand is highest, more vaccines in a pre-filled syringe format, and better communication from distributors on product availability dates were recommended in qualitative responses. Conclusions: Introducing private distributors for the management and fulfillment of pharmacies’ orders for the publicly funded influenza vaccine appeared to have mixed results. While key concerns surrounding the frequency, responsiveness, and method of delivery were addressed by this change, challenges remain—in particular, acquiring sufficient vaccine early in the season to meet patient demand. As pharmacies become more prominent as vaccination sites, there are several opportunities to ensure that patient demand is met in this setting.
Highlights
Publicly funded vaccinations in Canada were completely managed within the public sector, from ordering and distribution through administration by public health departments or physician offices
The earliest and the most widespread public–private partnership (PPP) taking advantage of pharmacists as immunizers in Canada has involved integrating their services with annual influenza vaccination programs [4]
The first survey took place before the changes to Ontario’s influenza vaccine distribution strategy and captured the 2015–2016 influenza season; this survey was distributed in February 2016 and received responses through the end of March 2016
Summary
Publicly funded vaccinations in Canada were completely managed within the public sector, from ordering and distribution through administration by public health departments or physician offices. Multiple Canadian jurisdictions have outsourced components of their publicly funded vaccination strategies to the private sector, including parts of vaccine distribution and administration. The earliest and the most widespread public–private partnership (PPP) taking advantage of pharmacists as immunizers in Canada has involved integrating their services with annual influenza vaccination programs [4]. The first Canadian province to build such a relationship with pharmacists was Alberta in 2007, with several other provinces making pharmacists part of their publicly-funded influenza programs in subsequent years [4]. As a result of these relationships, pharmacies are the primary site for influenza vaccinations across Canada, and in Ontario—the most populous jurisdiction—the involvement of pharmacists as influenza immunizers since 2012 has led to improved influenza vaccination rates and a predicted societal net positive financial impact [4,5,6]
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