Caden Alder

Vaccinations, one of the greatest public health achievements, prevent more than 2 million deaths worldwide each year.

Coronavirus disease 2019 (COVID-19) had a substantial impact on adult and childhood vaccination rates in 2020 by increasing interest in influenza vaccinations to avoid a dual pandemic. However, many barriers and concerns regarding vaccine administration persist, including limited accessibility and lack of safe care because of health care provider shortages.

Recognizing the need for patient education and increased opportunities to receive immunizations, the American Pharmacists Association Academy of Student Pharmacists (APhA-ASP) established the Operation Immunization program. Since 1997, more than 1.4 million individuals have been immunized by the over 17,880 certified pharmacy student immunizers from 121 schools. Methods codeveloped and implemented by pharmacy students at Idaho State University (ISU) in partnership with the Idaho Immunization Coalition were designed to effectively, safely vaccinate Idahoans against influenza, using a drive-through model of care.

PharmD students at the ISU College of Pharmacy, in partnership with health care providers across the state, led a charge to improve access to influenza vaccine, trialing administration strategies that support social distancing measures and reduce COVID-19 transmission. Planning of the 4 drive-through immunization clinics began in July 2020. The initial step involved development and approval of protocols by the ISU-COVID Workgroup. The ISU COVID-19 response team was responsible for ensuring that the proposed protocols, safety measures, and workflows mitigated risk to health care providers, patients, and students participating in the DRIVE-RX event.

Training videos, developed by the APhA-ASP Operation Immunization team, detailed step-by-step safety protocols and required workflows such as patient screening, personal protective equipment use, and emergency procedures in the case of COVID-19 exposure and/or protester involvement. Training videos and competency assessment questions were added to the online learning platform for students to complete prior to event participation. Each ISU student volunteer was also required to attend a live online meeting that outlined the organizational workflow of the clinic, responsibilities, and roles of each station and student, and addressed potential patient concerns and questions.

The website SignUpGenius was used to schedule volunteers to assist at the 4 strategically located vaccination events in Idaho: October 3, 2020, in Meridian; November 21, 2020, in Pocatello; December 6, 2020, in Caldwell; and December 12, 2020, In Nampa. Each site chosen was accessible, well known to the community, and supported directional traffic flow, allowing for coordinated entry and exit.

All organizations and students involved helped set up the event and participated in a mock drive-through prior to the start of the clinic. Upon entering a standard parking lot, drivers were stopped for COVID-19 screening and were asked to wear masks. Patients were then directed to the first parking spot, where they filled out consent forms and told student pharmacists which vaccine they would prefer. Once the forms were completed, cars would pull forward into the next parking spot for patients to receive the vaccine. All students were monitored by a preceptor according to state guidelines. If patients had not received the vaccine before, they were instructed to wait 15 minutes to monitor for any adverse effects, such as allergic reactions or fainting. Finally, drivers were directed toward the exit (see figure).

Idaho Governor Brad Little and First Lady Teresa Little were first in line for their influenza shots, highlighting the importance of getting immunized while encouraging community involvement. More than 650 immunizations were administered by the 98 students during the 9-hour Meridian event, 200 immunizations were administered by 20 student pharmacists during the 4-hour Pocatello event, 34 immunizations were administered by 9 students during the 4-hour Nampa event, and 140 immunizations were administered by 4 students during the 4-hour Caldwell event.

Although drive-through clinics have been done in the past, this idea is innovative because it combined the use of pharmacy students to efficiently administer influenza vaccine safely to multiple individuals. To administer vaccines more effectively and reduce the spread of COVID-19, as well as waiting times, community pharmacies have encouraged patients to make appointments online. This has led many pharmacies to implement drive-through vaccination clinics. Furthermore, rural states, such as Idaho, have limited access to health care services. Therefore, using student pharmacists can mitigate structural inequities through the provision of health care services.

The ISU clinics administered more than 1000 vaccines in 21 hours during 4 events throughout Idaho. These influenza clinics reached underserved populations and guaranteed everyone an influenza vaccine, regardless of insurance status or ability to pay. Pharmacy students are an untapped resource that can be successfully used not only in vaccination efforts but also in future COVID-19 pandemic efforts, especially in vaccination administration. These events demonstrate that this model can be applicable in both large- and small-scale events in an effective and safe manner that broadens the availability of vaccines to our communities.

Anecdotally, we found that 3 students working in each immunization bay, with 1 students working in the consent form area, is the most efficient setup for this drive-through clinic. This allowed for less overlap of responsibilities and clearly defined roles. The number of students assigned per bay was further tailored to best fit the city/town in which the event would take place.

There remains an increasing need for health care workers who are able and willing to provide vaccinations, especially the new COVID-19 vaccine, to the public. Using student pharmacists in immunization efforts not only improves vaccine access for the public but also serves as a unique opportunity for students to gain clinical experience and use their skills as trained immunizers. The success of these student pharmacist-led drive-through clinics indicates that implementation of similar events may be beneficial for COVID-19 vaccinations.

This effective and safe model of care delivery showed potential for COVID-19 immunization efforts, exponentially increasing the workforce and expediting vaccination delivery. Since implementing the drive-through influenza vaccination clinics, pharmacy students in Idaho and Alaska—where ISU operates a pharmacy program in partnership with the University of Alaska Anchorage—have been assisting in COVID-19 vaccination efforts in hospitals, clinics, and other community sites.

is a PharmD candidate at Idaho State University (ISU) College of Pharmacy in Pocatello and the APhA-ASP Chapter Operation Immunization chair.

 is a PharmD candidate at ISU College of Pharmacy.

 is a PharmD candidate at ISU College of Pharmacy and the APhA-ASP Chapter president.

 is a PharmD candidate at ISU College of Pharmacy and the APhA-ASP Chapter finance vice president.

 is an associate professor of pharmacy at ISU College of Pharmacy.

 is assistant dean and director of experiential education at ISU College of Pharmacy.

Articles

Idaho State University partners with the Idaho Immunization Coalition to effectively and safely vaccinate patients against influenza.