Role of pharmacies in Polish vaccination strategy: Plenty of room for progress

Poland is still struggling with low rates of flu vaccination as a result of lingering inefficiencies obstructing the immunisation of citizens, despite efforts to improve the accessibility of vaccines.

The number of people with prescriptions forgoing flu vaccination is indicative of the need to simplify procedures, enhancing the role of pharmacies in the drive to ramp up Poland’s immunisation performance, according to experts.

Vaccinations in pharmacies are conducted in many countries across Europe. Facilitating access to vaccines brings numerous benefits to the healthcare system and contributes to reducing overall treatment costs.

In Poland, pharmacies began administering vaccines in 2021 with the Sars-CoV-2 shots. Pharmacists have vaccinated approximately 5% of the population against COVID-19 so far.

However, starting from July 1, 2023, the option of vaccinating against COVID-19 in pharmacies was removed, following the lifting of the “state of epidemic” or epidemic threat in Poland.

Access to vaccination against COVID-19 for individuals aged 18 and above in pharmacies was only reinstated on December 1, even though pharmacists were authorised to perform vaccinations against influenza and pneumococcal disease from November 1, 2023.

For individuals aged 65 and above, a single-dose regimen is fully reimbursed by the National Health Fund (NFZ).

For individuals aged 18 to 64, vaccinations against the flu are subject to a 50% reimbursement, while pneumococcal vaccinations are administered at the full cost. Additionally, people in this age group also have to consider that the pharmacist may also charge them for the cost of the vaccination service.

Poland’s vaccine problems

However, despite the accessibility of vaccination services at pharmacies, the system appears to be plagued by inefficiencies, resulting in a concerning number of individuals foregoing the influenza vaccine.

In the previous flu vaccination season, only approximately 5.5% of the population in Poland opted for the jab. For seniors, the rate was only 23%. This is significantly low, as the World Health Organisation recommends a vaccination rate of at least 75% among seniors. Predictions suggest that the statistics will not get any better this year.

One of the main issues appears to be the lengthy patient journey from the decision to get vaccinated to the actual administration of the vaccine.

“In the case of flu vaccinations, the patient must first obtain a prescription and then proceed to the pharmacy to purchase the vaccine,” Prof. Adam Antczak, chairman of the Scientific Council of the Nationwide Program for Combating Infectious Diseases (OPZG), explained to Euractiv.

Although a pharmacist can also issue a prescription, such a vaccination always comes with a 100% cost. Pharmacists are not authorised to provide discounted prescriptions.

The complex regulations and additional costs lead to many individuals ultimately opting out of vaccination.

According to data presented by OPZG, in the time between a prescription for flu vaccination is issued to the actual jab at the pharmacy, up to 130,000 people, or over 8% of all individuals who received a prescription from a doctor, decide to forgo the vaccination.

“One way to improve this situation could be the introduction of reimbursable pharmaceutical prescriptions. This would allow patients to receive a prescription without the need to visit a doctor, significantly enhancing convenience and access to vaccinations,” Prof. Antczak told Euractiv.

But it is not only vaccine beneficiaries who have problems.

In Poland, for pharmacists to administer vaccinations in pharmacies, many organisational requirements must be met, posing a significant burden in terms of time and cost. Pharmacists note that during the pandemic, procedures were much simpler and faster.

“It is worth considering simplifying procedures and providing support for pharmacists to encourage the opening of vaccination points in pharmacies,” said Prof. Antczak.

Pharmacy vaccinations across Europe

Data reveals that, as of 2020, vaccinations in pharmacies were available in 13 European countries.

For instance, in France, where the average flu vaccination rate is 52-55%, pharmacists  receive proper training and then can provide any vaccination from France’s ‘vaccination calendar’ to individuals over the age of 11, with a few exceptions.

In Poland, pharmacy vaccinations are restricted to individuals aged 18 and above, with children and adolescents under 18 only eligible for vaccination in primary healthcare facilities. However, experts anticipate that the accessibility of vaccinations in pharmacies for younger age groups is just a matter of time.

In addition to influenza vaccination, several other vaccines are available in pharmacies in many European countries. “In the United Kingdom, pharmacists administer vaccines against 16 different diseases, while in France against 12,” Prof. Antczak said.

A shift towards pharmacy vaccination

Pharmacies are the most easily accessible places where patients can be quickly and safely vaccinated, benefiting the population at large. Another important aspect supporting the expansion of vaccinations in pharmacies is the fact that they attract individuals who have never been vaccinated before.

For example, 23% of those vaccinated against the flu in the local pharmacy received the vaccine for the first time, and interestingly, 83% of them belonged to the high-risk group for severe illness, according to a report by PSI (Pharmaceutical Society of Ireland).

[By Dr Paulina Mozolewska, edited by Vasiliki Angouridi/Zoran Radosavljevic | Euractiv.com]

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