Article on COVID-19 by PharmAchieve CEO published in Globe and Mail Article

The Globe and Mail published an opinion article written by PharmAchieve's team. It was published at a time when no COVID-19 vaccines had yet been approved.

Opinion: Distributing a COVID-19 vaccine could become a big problem

Hooman Katirai, Rida Bukhari and Sahana Alphonsus - SEPTEMBER 03, 2020 - Globe and Mail

Hooman Katirai is the CEO of PharmAchieve, a provider of training for pharmacists and nurses. Rida Bukhari is a pharmacist and senior manager at PharmAchieve. Sahanna Alphonsus is a registered nurse at NurseAchieve and Michael Garron Hospital.

It is estimated that one or more COVID-19 vaccines will be available by the end of this year for emergency use and that they will be available to the general public by mid-2021. Delivering these vaccines to the population will be a major challenge. One helpful way to understand the magnitude of the challenge is to compare the COVID-19 vaccine to the flu vaccinations that take place in Canada every season.

The first difference lies in the high public demand. In a typical flu season, about 4 out of 10 Canadians will get the flu shot. But about 7 out of 10 Canadians have indicated, in a June poll by ACS/Leger Marketing, that they will “definitely” get the COVID-19 vaccine. Another important difference is the number of doses. The flu shot requires a single dose, while the vast majority of COVID-19 vaccine candidates appear to require two doses.

A two-dose COVID-19 vaccine means we will need to administer 3.5 times more doses of the COVID-19 vaccine than the doses in a typical flu vaccine season. But the need for a flu shot still remains. Will people want more or less of the flu vaccine during a pandemic?Australia might provide some clues. It’s currently in the midst of its flu season. By May 31st, Australia had administered 1.6 times more flu shots than the same time last year. Assuming we go the way of Australia, when both a two-dose COVID-19 and the flu vaccine are accounted for, 5.1 times the doses of a regular flu vaccination season will be required. But is our healthcare system equipped to deliver this many doses in a timely fashion?

Unfortunately, the system was already under strain even prior to the pandemic. In a 2018 national survey conducted by Dalhousie University, 25 per cent of physicians and over 30 per cent of pharmacists agreed or strongly agreed that they did not have enough time to deliver vaccinations to adult patients. To make matters worse, delivering doses during a pandemic requires additional personal protective equipment and screening, which can slow down the process. If nothing is done, the outcome is predictable: quintupling demand on an already strained system will result in long wait times for the general public to get the COVID-19 vaccine, even when it is available. Some people will become ill with COVID-19 while waiting for their vaccine. This will result in preventable hospitalizations and deaths while delaying the economic recovery. But if we act now, we can increase the number of healthcare professionals who can deliver injections and avoid long wait times.

We have already sought to bring back retired nurses and physicians to fight the pandemic, so the logical next place to look is the pharmacists, which are already the most accessible healthcare providers. But unlike physicians and nurses, pharmacists must complete additional training before they can administer injections. It is estimated that about a third of pharmacists lack this training.

Each pharmacist with injections authorization can vaccinate about 70 patients a day. For every 1,000 additional pharmacists that become injection-certified, the healthcare system’s maximum capacity to deliver injections increases by 1.5 million doses per month – certainly enough to make an impact. But instead of taking steps to increase the availability of injections-certified pharmacists, no government action appears to have been taken. In fact, in some cases, we’ve gone backwards. For example, owing to a cut announced prior to the pandemic, the Ontario Ministry of Health and Long-Term Care discontinued funding to the Allied Health Professional Development Fund in 2020. This program would have fully paid the tuition of all the courses pharmacists need to get their injections certification (about $600 to $1,500). This cut should be immediately reversed.

Another action that can be taken is to add injections to the scope of practice of regulated pharmacy technicians. Under this proposal, regulated pharmacy technicians who complete injections and immunizations training would also be permitted to deliver injections under the supervision of pharmacists – a proposal already adopted by three American states and being considered by at least one province in Canada.

How fast we recover from the pandemic depends in part on how quickly we can administer the vaccine. Governments and regulatory bodies need to act now to increase the number of skilled healthcare professionals who can administer the injections or we will all pay the price.