Qualitative analysis of community pharmacy-based COVID-19 immunization service operations.

Background: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has generated worldwide impacts while positioning community pharmacies as easily accessible immunizers to rollout the COVID-19 vaccine.

Objectives: This study describes community pharmacists' experiences, success stories, and lessons learned from providing COVID-19 immunization services.

Methods: This study was conducted in February to March 2022 using semistructured interviews with licensed pharmacists practicing full-time in Alabama community pharmacies. Transcribed interviews' content analysis was conducted by 2 independent coders in ATLAS.ti software.

Results: Nineteen interviews were completed. Pharmacists' experiences in the implementation of COVID-19 immunization services are described across 4 themes: (1) on-site and off-site immunization locations, (2) roles and responsibilities of pharmacy personnel, (3) vaccine storage and administration, and (4) vaccine waste reduction and immunization uptake strategies. This study found that pharmacists' ability to adapt is vital to maintaining their ability to offer immunization services and other services. Pharmacists' capacity for adapting is exemplified through their ability to acclimate to becoming a primary hub of outpatient health care services, accommodating to COVID-19 social distancing and vaccine guidelines, and disseminating a novel vaccine with varying supply and demand. In addition, pharmacies gathered and maintained waitlists of patients and adopted an appointment-based model as to predict, plan, and provide for patients. Pharmacists also used reactive techniques and workflow aspects to dissuade COVID-19 vaccine waste such as in contacting interested patients on waitlists or switching to a walk-in acceptance model. The COVID-19 pandemic elicited unprecedented alterations to the legal, health care responsibilities granted to pharmacy staff with participants describing pharmacy technicians as making a considerable impact to pharmacies' workflow.

Conclusions: Pharmacists stepped up as frontline providers during a time of public health emergency with their diverse experiences granting policy makers and researchers much to learn from as, in their communities, pharmacists have continued to increase access to care during a national health crisis.