Fighting off the flu

It’s official: flu season is here.

It's a dreaded time of year when many of us succumb to fevers, coughing, aches and pains and find ourselves indisposed for days at a time. On top of the frustrating and debilitating symptoms of influenza, flu season also brings busy clinics, lengthy wait times to receive influenza immunizations and the risk of hospitalization and death in the most severe cases.

Each year, demand for flu shots is high and it can be difficult for individuals to get convenient access to trained providers. Worse than that, however, is the number of individuals who fail to get vaccinated, contributing to the widespread distribution of the illness.

To increase access to these important vaccinations, Nova Scotia passed legislation in 2013 allowing trained pharmacists with an injection permit to administer the influenza vaccine. The 2013-2014 influenza season was the first in which members of the public were able to receive provincially-funded flu shots from pharmacists.

The Dalhousie College of Pharmacy is studying the impact pharmacists have on influenza vaccinations. Preliminary data from the 2013-2014 flu season being evaluated by Dalhousie Pharmacy Professor Jennifer Isenor and her colleagues indicates that the number of influenza vaccines administered increased by 15.8 per cent. Pharmacists administered about 20 per cent of the nearly 392,000 influenza vaccines provided in Nova Scotia, mostly for the 24-to-64 year old age group.

A role for Dalhousie’s College of Pharmacy

The College of Pharmacy is playing a key role in training pharmacists and pharmacy students to provide vaccinations. Dalhousie offers the only pharmacy program in the Maritimes, and therefore carries the responsibility of providing this training for professionals across the region.

The College of Pharmacy has a very active Continuing Pharmacy Education Division which offers training and resources to working pharmacists across the Maritimes.

The College’s Immunization and Injection Administration Training Program (IIATP) started in 2009 in response to the H1N1 outbreak. The course consists of 16 online modules, which typically take between eight and 20 hours to complete. These modules provide pharmacists with the relevant background information and theory required to be an immunization provider. Dr. Isenor notes many pharmacists already have a considerable amount of background knowledge going into the course. These modules, then, “ensure everyone is on the same page.”

The online course is followed by an eight-hour day of practical training. This training is intended to compliment the modules and past experience, and to ensure all pharmacists have the knowledge and skills required to prepare and administer injections. In the practical training, pharmacists are taught the proper techniques for providing both intramuscular and subcutaneous injections in the usual administration sites for most adult vaccinations.

This training is also provided to students in their fourth year at the Dalhousie College of Pharmacy. Once they’ve completed the training, these students can provide injections under the direct supervision of a qualified pharmacist.

Furthering knowledge through research

Dr. Isenor and her research team have been conducting several studies examining the impact of having pharmacists provide vaccinations. The results obtained so far all appear to be positive.

Preliminary results of a systematic review of the literature have shown that the addition of pharmacists as immunizers increases vaccination coverage. Although the majority of studies were from the United States, similar results have been obtained from studies in Nova Scotia and British Columbia. So far, the research suggests that pharmacists are making significant contributions towards ensuring that a greater number of individuals are being vaccinated, hopefully contributing to significant public health benefits.