Vaccine Promotion Strategies in Community Pharmacy Addressing Vulnerable Populations: a Scoping Review

Abstract

Abstract Context: Social determinants of health drivers of vaccine inequity and leading to higher risks of complication from infectious diseases in under vaccinated communities. In many countries, pharmacists have gained the rights to prescribe and administer vaccines, which contributes in improve vaccination rates. Little is however known on how they define and target vulnerable communities. Objective: The purpose of this study is to describe how vulnerable communities are targeted in community pharmacies. Methods: We performed a systematic search of the Embase and Medline database in August 2021 inspired by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA ScR). Articles in English, French or Spanish addressing any vaccine in a community pharmacy context and that target a population defined as vulnerable were screened for inclusion. Results: A total of 1039 articles were identified through the initial search and 63 articles met the inclusion criteria. The vast majority of the literature originated from the North America (n = 54, 86%) and was addressed influenza vaccination (n = 29, 46%), pneumonia (n = 14, 22%), herpes zoster (n = 14, 22%) or human papilloma virus (n = 14, 22%). Lifecycle vulnerabilities (n = 48, 76%) such as age and pregnancy were most often used to target vulnerable patients followed by clinical factors (n = 18, 29%), socio-economical determinants (n = 16, 25%) and geographical vulnerabilities (n = 7, 11%). The most frequently listed strategy was providing a strong recommendation for vaccination, promotional posters in pharmacy, distributing leaflet/bag stuffers and providing staff training. A total of 24 barriers and 25 facilitators were identified. The main barriers associated to each vulnerable category were associated to effective promotional strategies to overcome them. Conclusion: Pharmacists prioritize lifecycle and clinical vulnerability at the expense of narrowing down the definition of vulnerability. Some vulnerable groups are also under targeted in pharmacies. A wide variety of promotional strategies are available to pharmacies in order to overcome the specific barriers experienced by various groups.