Perspectives From Pharmacists, Educators on the Frontlines of COVID-19 Immunizations

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As a majority of advanced pharmacy practice experiences need to include direct patient care, immunizing provides students an opportunity to provide this care along with consultation around the COVID-19 vaccine and adverse effects.

How did a trio of experiential education directors/deans who work so closely together on student and preceptor issues have the same mindset to each get involved with COVID-19 immunizations? That is the question that Stacey Maravent, PharmD, CPh, Andrea Murzello, PharmD, and Jessica E. Lendoiro, PharmD, asked when they met to discuss this new venture.

The trio is excited to have the opportunity to provide direct patient care and to be able to use their training to vaccinate a portion of the population who truly needs to be immunized first. Through their affiliations with CVS and Walgreens, they have collectively immunized more than 2000 patients throughout Miami-Dade, Broward, and Palm Beach counties in Florida.

They are administering the vaccine in skilled nursing homes (SNFs), assisted living facilities (ALFs), and low-income elder living homes. Once CVS and Walgreens finish with clinics in the SNFs, ALFs, and elder living homes, they each plan to continue immunizing at clinics within stores to be able to reach more of the population.

Florida’s COVID-19 vaccination plan, determined by the governor, began in December with health care personnel with direct patient contact, long-term care facility residents and staff, persons 65 years and older and persons deemed extremely vulnerable to COVID-19 by hospital providers. The state is working to finish phase 1 immunizations and hopes to start with the general public before the summer.

As of February 12, Floridians had access to vaccines at nearly 800 pharmacy locations throughout the state. Residents can register for appointments through retail pharmacy websites. Phase 2 is set to begin this month after the state experiences a significant increase in availability of the vaccine.

The Florida residents who will be eligible to receive the vaccine in March are critical organizations and vulnerable populations at an increased risk of severe illness. Phase 3 is set to begin in April 2021, dependent on the supply of the vaccine. During phase 3 administration, the vaccine will be available to the general public.

“It is truly incredible to hold the vaccine in your hand and administer it to those at the most risk. We look forward to maintaining this effort throughout our own communities and families as the vaccination effort continues,” Maravent said.

Drs. Murzello, Lendoiro, and Maravent are all licensed immunizers as they provide training to students at their respective colleges of pharmacy: Larkin University, Lloyd L. Gregory School of Pharmacy at Palm Beach Atlantic University and Nova Southeastern University. In non-pandemic years, they facilitate the training course, teach students proper immunization techniques, and observe and assess students performing vaccinations as a live portion is required for certification. In 2021, in addition to training their students, they are also out in the community as an example to them, as well as their colleagues and families helping to ensure safety and wellness with a skill they can now share.

This experiential trio has worked tirelessly throughout the pandemic with both students and preceptors to innovate remote precepting resources and tools to ensure their students can progress through the curriculum and stay on target for graduation. The students are now back onsite at hospital, consulting, and community pharmacies administering immunizations alongside their preceptors.

As a majority of advanced pharmacy practice experiences need to include direct patient care, immunizing provides students an opportunity to provide this care along with consultation around the vaccine and potential adverse effects. Students also get to practice their techniques with preparing the materials and paperwork to ensure full compliance is met and help lead the vaccination effort.

“I want to convey to my students that with our profession we have the ability to jump right in and make a difference one patient at a time. What better way than to lead by example,” Lendoiro said.

Although students are on the front lines alongside their preceptors vaccinating, they are also involved with the Pharmacists’ Patient Care Process (PPCP). The PPCP, which is a patient-centered approach to optimize patient health, consists of 5 steps: collect, assess, plan, implement, and follow-up.

During the first step, the students collect the patient’s information with the COVID-19 vaccine intake form. For the next steps, the student assesses the patient to see whether they qualify to receive the vaccine, taking into account disease states, contraindications, and current medication therapy.

In the final steps, the student administers the vaccine to the patient and monitors them for a minimum of 15 minutes for any potential adverse effects.

“During the pandemic, nursing homes and assisted living facility residents have been closed off from their families and loved ones,” Murzello said. “It’s been a blessing to have a positive interaction with patients and make a difference in these facilities. Providing the COVID-19 vaccine gives the residents and staff a sense of security and hope that very soon there will be a return to pre pandemic life.”

About the Authors

Dr. Stacey Maravent is the Director of Experiential Education at Nova Southeastern University. She oversees Advanced Pharmacy Practice Experience Rotations for both their Fort Lauderdale and Palm Beach campus PharmD students. She is currently the President of the Palm Beach Society of Health Systems Pharmacists (PBSHP), past Chair of FSHP's membership affairs committee, and a liaison for Phi Lambda Sigma, Kappa Psi and the Palm Beach student chapter of NCPA.

Dr. Andrea Murzello is the Assistant Dean of Experiential Education at Larkin University, College of Pharmacy. She is a certified pharmacy regulatory specialist and is interested in providing strong foundations of both didactic and personal development for students. She remains active in several professional organizations such as the American Association of Colleges of Pharmacy (AACP) as the Experiential Education Section Membership Chair, Florida Society of Health-System Pharmacists (FSHP), and Florida Pharmacist Association (FPA).

Dr. Lendoiro is the Director of Experiential at Palm Beach Atlantic University, Lloyd L. Gregory School of Pharmacy (GSOP). She is actively involved with Florida Society of Health-System (FHSP) as a member of the Educational Affairs Council and is the President Elect for her local chapter Palm Beach Society Health Pharmacist (PBSHP). Dr. Lendoiro is also the Coordinator for the Immunization Training Program at GSOP, to ensure students are certified and ready to immunize in the field.