Spinning the globe from west to east: A mixed-method study to examine the impact of pharmacists on immunization advocacy and delivery in Asia Pacific

Published:April 30, 2021DOI:



      Global effort is key to prevent and control infections effectively. Whereas pharmacists’ involvement in the immunization neighborhood, collaborative effort to meet immunization needs of the public, has reduced burden of vaccine-preventable diseases in Western countries, the impact of pharmacist-involved vaccination advocacy and delivery in Asia Pacific remains unclear.


      To examine the evidence for impact of pharmacists on immunization advocacy and delivery in Asia Pacific and to assess Singaporean pharmacists’ experience in becoming immunizing pharmacists through the American Pharmacists Association’s Pharmacy-based Immunization certificate training program.


      A mixed-method study consisted of systematic review and survey was conducted. The systematic review was conducted by searching PubMed and Cumulative Index to Nursing and Allied Health databases from inception to March 2021. Randomized controlled trials and observational studies related to pharmacist-involved immunization advocacy and training conducted in Asia Pacific were included. Eligible studies were appraised for quality using CONsolidated Standards of Reporting Trials (CONSORT) and STrengthening the Reporting of OBservational checklists. In addition, a 20-item Likert-scale survey evaluated the pharmacists’ experience in becoming immunizing pharmacists in Singapore. Frequencies of each response to the survey items were analyzed.


      Six studies were eligible for inclusion; 2 assessing impact of pharmacist as immunizer, 3 reporting outcomes of pharmacist-involved vaccine advocacy, and 1 evaluating the structure of pharmacist immunization training. Although study quality was minimal, all studies echoed positive findings as a result of pharmacist-provided immunization advocacy and delivery. Of the 23 pharmacists completing the survey, 91.3% strongly agreed that quality training was important to become immunizing pharmacists.


      Although limited in number, studies conducted in Asia Pacific reported increased vaccination rates when involving pharmacists. Coupled with the enthusiasm to be trained in immunization advocacy and delivery as elucidated by the Singaporean pharmacists, pharmacists in Asia Pacific should also be advocated for their role in the immunization neighborhood as part of the global effort against vaccine-preventable infectious diseases.
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      Zheng Kang Lum, BSc (Pharm) (Hons), PhD Graduate Student, Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore


      Anhthai Doan Nguyen, BA, Public Health Student, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA


      John Szeto, BSc, Public Health Student, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, CA


      Jean-Venable “Kelly” R. Goode, PharmD, BCPS, FAPhA, FCCP, Professor, Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA


      Zhe Han, PharmD, BCPS, BCIDP, Senior Lecturer, Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore


      Joyce Yu-Chia Lee, PharmD, APh, FCCP, BCPS, BCACP, Health Sciences Clinical Professor, Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA