This has been a big week in the pharmacy industry and healthcare in general.
First, let’s discuss the SARS-Cov2 vaccine (COVID vaccine). The FDA is expected to approve and begin shipment of the first doses to be ready for administration by Monday, December 14th, 2020.
The timeline is unprecedented and shows how quickly NEED SPARKS INNOVATION. I’m so impressed by what the scientists who have created this vaccine have achieved and the ingenuity of human creativity.
I’ve had many people ask me questions about the vaccine and how this ‘mass immunization’ is going to go, so I wanted to answer them as best I could through this platform.
Question #1: Will I personally be receiving the vaccine?
Answer: Yes, as a pharmacist, front-line healthcare worker, and healthy 33-year-old, I will be the first in line to volunteer to be a ‘guinea pig’. I have no idea when that will be, however, so until I can receive my doses I’ll continue wearing my mask and staying socially distanced.
I am proud to be a healthcare professional (most pharmacists ARE DOCTORS ya know) and in order for me to recommend and administer the vaccine, I feel it is important for me to receive my dose when the time comes. I believe in leading by example.
Question #2: How does the vaccine work, will it “change my DNA”?
Answer: This vaccine is what is known as an mRNA vaccine. That means the way it works is to “teach” your body how to handle this new threat. The vaccine is a very small piece of the SARS-Cov2 virus that bonds with your cells to give them a recipe to produce a peptide that is totally foreign to your body.
Still with me?
Ok, so once your own cell produces this peptide, your immune system will recognize it as dangerous, foreign and new and begin to create antibodies against it. You may have heard that people who’ve already had the virus have antibodies that help make them less likely to get the same virus again, this vaccine does essentially the same thing.
Antibodies don’t mean total immunity, however, it just means that your body gets a head start on “learning” how to fight the new virus.
All to say, it doesn’t change your DNA at all, it actually uses your DNA in a really, really smart way to boost your natural immunity.
Question #3: Why are pharmacists the ones administering the vaccine, shouldn’t it be nurses or doctors?
Answer: In the United States, we have a very “siloed” approach to modern healthcare. Normally, we think certain tasks are the property of one healthcare professional or another. This approach is short-sighted and old-fashioned.
It makes sense for pharmacists to not only administer this vaccine, but also to help fight it in other ways by offering rapid COVID testing, educating the public, and being the ‘most accessible healthcare provider’ for many Americans.
Pharmacist involvement in SARS-Cov2 vaccine administration makes sense for several reasons:
1.Drug Chain of Custody
Know that you understand how the vaccines work, you should know that mRNA is a very delicate protein that must be handled with extreme care and attention. The devil, really IS in the details here.
Moderna’s vaccine is placed in a vial that must be kept frozen in dry ice for shipping. Once the shipment is received it needs to be moved to a freezer for long-term storage. Before using, it must be moved to a refrigerator to thaw for 3 hours. After thawing, it can be drawn up in individual syringes and each vial contains enough vaccine for five doses. After being drawn up, it must be used within 2 hours to keep the integrity of the mRNA. Only THEN can it be injected into the patient.
Now that sounds like a lot of opportunities for ‘system failure’ doesn’t it?
Pharmacists, however, have this process down to an art form. Every single day, we receive shipments of medications from wholesalers (or directly from the manufacturer in this case) and require perfection in our record-keeping and systems.
It is already part of our workflow and simply makes the most sense from a process standpoint.
Another noteworthy point is that this vaccine requires two doses given 21 days apart.
That means the documentation and follow up dose must be very carefully managed. Much like a program, many pharmacies offer called Medication Synchronization (Med-Sync for short), pharmacists are extremely organized and have systems in place for tracking and filling patients’ medications, vitamins, and Immunizations
Also, in rural or medically underserved urban communities, it is much more common to see a pharmacy than a hospital or doctor’s office. Usually, these are locally-owned, small businesses, “mom and pop” pharmacies if you will.
In my home state, for example, 59 out of the state’s 75 counties are considered medically underserved.
Community Pharmacists are the ‘most accessible healthcare provider’ period.
When was the last time you tried to walk into a doctor’s office and asked to speak directly with the doctor without an appointment?
Since 2004, the minimum requirement to become a licensed pharmacist in the United States is a Doctorate degree in Pharmacy. Many pharmacists go on to receive even higher levels of training such as fellowships and board certifications, but at the minimum, anyone practicing in the past 16 years is a doctorate recipient.
Pharmacists are such an underused healthcare professional, but my hope is during the pandemic years and beyond, they will be tapped more and more to provide high-quality healthcare for patients.
Unfortunately, pharmacists have traditionally been relegated to roles that make pharmacists feel unappreciated and undervalued.
Pharmacists aren’t considered “providers” at the federal level which means they cannot bill insurance for their cognitive services.
Additionally, we are left out of many policy discussions even though there are around 300,000 practicing pharmacists in the United States and the shortage of physicians is expected to increase to nearly 50,000 through 2025.
How can things change?
- First, advocate for CMS to include pharmacists as providers so we can offer patients more expanded services that their insurance will pay for. Not only serving on the front lines battling the pandemic, but also other epidemics like diabetes, mental health, and cardiovascular disease.
- Second, develop a relationship with your pharmacist (especially the small-business owner ones).
- Third, send a letter to your representative urging them to consider giving pharmacists a bigger role in creating policies that improve the health of Americans.
Here’s an example my friend Eric Christianson posted on his blog that you can copy and paste to send to Joe Biden urging him to add a pharmacist to his healthcare Advisory Board (one pharmacist was included on the Trump administrations Health Team and none are included in President-Elect Biden’s).