Vaccination Covid-19

Abstract

Introduction: After the first vaccination campaign, a low vaccination coverage was observed in Brussels. This is linked to an accumulation of factors such as limited accessibility, confidence in the effectiveness and safety of the vaccine or in the public institutions combined with complicated transport solutions and a lack of vaccinators. These are significant barriers to improving immunization coverage, particularly in vulnerable neighborhoods.
 In order to increase coverage and also in the perspective of vaccinating everyone (vacci4all project), Common Community Commission (COCOM) has decentralized vaccination through temporary initiatives: local antennas, mobile teams, door-to-door visits, GP’s, awareness-raising by pharmacists, call-centers,...
 The results have reinforced the idea of decentralization to reach the most vulnerable. The idea of vaccination in pharmacies was explored, bringing new perspectives regarding long-term management.
 Method: 
 1. Pharma-on-tour
 Through an application system and the establishment of quality criteria, 5 pharmacies with
 experience in vaccination centers are integrated into the pilot project: doctors come to the
 pharmacy to vaccinate patients previously sensitized by the pharmacist. The pharmacists prepare the vaccines; the doctors administer them. The project is financed by the Brussels-Capital Region (BCR).
 2. Vaccipharma
 A few days after the publication of the March 11, 2022 law allowing pharmacists to vaccinate, the
 Vaccipharma project is launched: vaccination by pharmacists starts in 5 pharmacies that meet the quality requirements.
 3. Timesheet
 Without a remuneration framework, the acts of preparation and vaccination are still
 covered by the region on the basis of an hourly rate determined by Timesheets which are
 filled in by the pharmacists who keep track of the acts related to the vaccination which helped determine a remuneration in accordance with reality/practice.
 4. Implementation of the NIHDI remuneration framework and extension to the entire BRSince September 1, 2022, pharmacists can be remunerated for the acts of preparation of vaccine doses and vaccinations by the NIHDI. Any person, insured or not, can be vaccinated in a pharmacy.
 In addition to the vaccination in the pharmacy, the COCOM takes care of the delivery to the first line as well as the preparation and delivery to the nursing homes and communities.
 5. Extension of the project from 28 to 135pharmacies
 All Brussels municipalities have vaccinating pharmacies. Each pharmacy was inspected and given training to ensure the respect of the government's quality requirements.
 Results/Lessons learned: The need to focus on decentralized vaccination initiatives that combine proximity, quality and trust was reaffirmed. This is demonstrated by the fact that the preferred location for patients seeking a primary vaccination is the pharmacy. 
 This promising and sustainable project enables a local supplying and is a catalyst for first line vaccination in an infrastructure that provides a quality of reception and service in a place familiar to the public, with a very interesting cost-benefit-quality ratio. The individual approach and direct communication can increase vaccination coverage, particularly in vulnerable neighborhoods. A survey of patients reveals a high level of satisfaction both in terms of reception, booking, information received, privacy, proximity, ease, speed, accessibility and in the trust-based relationship.