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. 2023 Dec 7;17(1):2285955.
doi: 10.1080/20523211.2023.2285955. eCollection 2024.

Impact of pharmacist interventions on immunisation uptake: a systematic review and meta-analysis

Mohamad Hafiz Abd Rahim  1 , Siti Hajar Mahamad Dom  1 , Mohd Shah Rezan Hamzah  1 , Siti Hawa Azman  1 , Zahirah Zaharuddin  1 , Mathumalar Loganathan Fahrni  1   2
Affiliations

Impact of pharmacist interventions on immunisation uptake: a systematic review and meta-analysis

Mohamad Hafiz Abd Rahim et al. J Pharm Policy Pract. .

Abstract

Background: Under-utilisation of immunisation services remains a public health challenge. Pharmacists act as facilitators and increasingly as immunisers, yet relatively little robust evidence exists of the impact elicited on patient health outcome and vaccination uptake.

Objective: To evaluate the influence of pharmacist interventions on public vaccination rate.

Methods: SCOPUS, PubMed, and Web of Science were searched from inception to April 2023 to retrieve non- and randomised controlled clinical trials (RCTs). Studies were excluded if no comparator group to pharmacist involvement was reported. Data extraction, risk of bias assessments, and meta-analyses using random-effect models, were performed.

Results: Four RCTs and 15 non-RCTs, encompassing influenza, pneumococcal, herpes zoster, and tetanus-diphtheria and pertussis vaccine types, and administered in diverse settings including community pharmacies, were included. Pooled effect sizes revealed that, as compared to usual care, pharmacists, regardless of their intervention, improved the overall immunisation uptake by up to 51% [RR 1.51 (1.28, 1.77)] while immunisation frequency doubled when pharmacists acted specifically as advocators [RR 2.09 (1.42, 3.07)].

Conclusion: While the evidence for pharmacist immunisers was mixed, their contribution to immunisation programmes boosted public vaccination rate. Pharmacists demonstrated leadership and acquired indispensable advocator roles in the community and hospital settings. Future research could explore the depth of engagement and hence the extent of influence on immunisation uptake.

Keywords: Vaccination; advocator; immunisation; pharmacist; primary prevention.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow chart for study selection. RCT, randomised controlled trial.
Figure 2.
Figure 2.
A detailed description of the ROB assessment for RCTs.
Figure 3.
Figure 3.
Summary plot of ROB assessment for RCTs.
Figure 4.
Figure 4.
A detailed description of the ROB assessment for non-RCTs.
Figure 5.
Figure 5.
Summary plot of ROB assessment for non-RCTs.
Figure 6.
Figure 6.
Overall impact of pharmacist’s involvement on immunisation uptake.
Figure 7.
Figure 7.
Subgroup analysis on the impact of pharmacist intervention on immunisation uptake according to their roles as immunisers, advocators, or both.
Figure 8.
Figure 8.
Subgroup analysis of the impact of pharmacist interventions on immunisation uptake according to setting (hospital, community, or institution).
Figure 9.
Figure 9.
Funnel plot demonstrating the presence of publication bias (overall effect size).
Figure 10.
Figure 10.
Funnel plot demonstrating the presence of publication bias (subgroup analysis of pharmacist roles).
Figure 11.
Figure 11.
Funnel plot demonstrating the presence of publication bias (subgroup analysis of study setting).
See this image and copyright information in PMC

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