Pharmacy investigator receives $1 million from CDC

Working to address health inequities and disparities, a Harrison College of Pharmacy faculty member is collaborating with the National Community Pharmacists Association to provide training and materials related to immunizations to community pharmacies around the country. To support her efforts, Salisa Westrick was recently awarded a $1 million grant from the Centers for Disease Control and Prevention (CDC).

For her project titled “Addressing Health Inequities and Disparities by Improving Immunization Practice Standards in Independent Community Pharmacies,” Westrick is leading a team that will identify and develop new tools and resources for independent community pharmacists with a goal of promoting immunization services and improving pharmacists’ knowledge of them. To further address inequities and health disparities, the team will also work closely with pharmacies in socially vulnerable communities.

“Community pharmacists are in a great position to help improve immunization rates and close disparities,” said Westrick, the Sterling Professor and head of the Department of Health Outcomes Research and Policy. “Community pharmacists are highly accessible to Americans in the U.S., with 93% of the population living within five miles of a community pharmacy. These independent pharmacies are essential to decreasing the rural and urban disparities in immunization rates as more than 75% of all pharmacies located in rural areas are independent pharmacies.”

Because of their accessibility to a large part of the population, these independent community pharmacies are ideal locations to many of those who are underserved. Further training of pharmacists in immunizations can help expand the service and make them readily available in some areas that may otherwise undergo without the service.

“Rural areas notwithstanding, community pharmacies are additionally well-positioned to provide immunization services to the medically underserved and other difficult-to-reach populations,” said Westrick. “The accessibility of community pharmacies and independent pharmacies alike provide strong reason to utilize their positioning as immunization service providers to reduce disparities in vaccination rates throughout the communities that they serve, as well as underserved populations they have access to.”

The project began this fall and will run through 2028. Included on Westrick’s team are John Beckner and Hannah Fish from the National Community Pharmacists Association (NCPA). Beckner is the senior director of strategic initiatives for the association, while Fish is its director of strategic initiatives. Both will assist with project management. Also on the team is David Ha, the manager of infectious diseases and antimicrobial stewardship at Stanford Health Care and a faculty member in the Division of Infectious Diseases and Geographic Medicine at Stanford University School of Medicine. He will provide expertise related to the development of the proposed education program.

The team has been working together since 2018 when they were awarded $1 million from the CDC for a project to improve immunization standards among independently owned community pharmacies.

The education program will be multi-modal and will include live video conferencing, home study and a live session at the NCPA’s annual convention.

Westrick says arming pharmacists with additional training in this area is vital because of the disparities seen in vaccination rates. Despite the availability of vaccines, adult immunization rates are 46.3% for flu, 70.1% for pneumococcal, 31.6% for shingles and 70.3% for tetanus.

From those numbers, vaccination rates were lower among minority groups. Using influenza data from 2021-22 as an example, coverage was 54% among white adults, 42% among Black adults, 38% among Hispanic adults and 41% among American Indian/Alaska Native adults. Similar trends are seen in COVID-19, pneumococcal, herpes zoster and Td/Tdap vaccination coverage.

“While everyone is susceptible to infectious diseases, these disproportionately affect racial and ethnic minority adults,” said Westrick. “For example, they have higher hospitalization rates due to influenza and lower immunization coverage than non-Hispanic white adults.”

NCPA is a nationwide organization, including more than 12,000 pharmacist owners, managers, pharmacy technicians, members of academia and many others. Partnering with NCPA, along with the support from the CDC, puts the project in a good position to enhance the implementation of immunization standards among independently owned community pharmacies.

“Independent pharmacies are in a unique position to impact and care for underserved populations,” said Westrick. “Pharmacy owners have strong roots in their communities and are frequently community leaders in public health.

“Together, with local health departments and health care professionals, independent community pharmacists can help improve immunization confidence and close the immunization gaps.”