key: cord-0831948-fstyu3a8
authors: Doyno, Cassandra R.; Fitzgerald, Jill M.; White, C. Michael; Sobieraj, Diana M.; Zacchera, Michael
title: “Innovative Partnership in Connecticut to Expand Eligible Health Care Professional Certification to Administer COVID-19 Vaccines”
date: 2021-08-13
journal: J Am Pharm Assoc (2003)
DOI: 10.1016/j.japh.2021.08.013
sha: 696af1beb86576525454ea979ac8cbd24e1ad7e1
doc_id: 831948
cord_uid: fstyu3a8

Background On December 7, 2020, the Acting Commissioner of the Connecticut Department of Public Health (DPH) issued an order authorizing eligible health care professionals to administer COVID-19 vaccines provided they complete a vaccination-training program. The University of Connecticut School of Pharmacy was approached to collaborate with DPH to create a certification program to meet the needs of this order. Objectives To utilize a unique, pharmacist-led practice model to increase the number of competent vaccinators to administer the COVID-19 vaccine, and to reduce vaccine hesitancy with timely vaccine information. Practice description A didactic and in-person training program was developed, with an evaluation completed by a vaccination-certified pharmacist. Additionally, faculty members, staff and students developed short videos answering questions about COVID-19 vaccines. Practice innovation We are aware of no other such programs utilizing pharmacists and pharmacy students as primary creators of training and certification of health care professionals to administer the COVID-19 vaccine. Evaluation Methods Success was gauged by the rapid increase in number of eligible health care professionals who completed the developed training program and became certified as COVID-19 vaccinators. When addressing vaccine hesitancy, success was defined by the number of videos created and number of views and likes the videos received. Results As of April 30, 2021, 1834 health care professionals registered to administer the COVID-19 vaccine. A total of 1195 (65%) participants completed the online training developed by pharmacists, and 872 participants (48%) attended pharmacist-led in-person competencies. As of July 29, 2021, efforts resulted in 14,972 views and 257 “Likes” for 79 videos promoted through social media platforms. Conclusion A partnership between the Connecticut DPH and the UConn School of Pharmacy allowed the rapid increase in capacity to administer the COVID-19 vaccine to citizens of Connecticut. Patients are receptive to accessing health information that pharmacists create on social media.

Familiarity and confidence in the school's capabilities to undertake this endeavor occurred 72 despite pharmacists being regulated by the Department of Consumer Protection (DCP) rather than DPH. 73

The UConn School of Pharmacy has been involved in several projects partnering with DPH over the years 74 in medication therapy management, cardiovascular care, and smoking cessation [3] [4] [5] [6] . In several of these 75 DPH projects, the school utilized a network of independent and chain pharmacies as well as community 76 health workers to impact community outcomes 7, 8 . sessions were secured by partnering with firehouse/paramedic training facilities, schools of dentistry and 120 dental hygienist training, and others. One or more faculty members who were registered pharmacists and 121 certified to provide vaccinations led each in person session. Pharmacy students certified as vaccinators 122 supported faculty with a ~2:1 ratio of students to faculty and ~3:1 ratio of participants to faculty. 123

Training sessions at each evaluation event lasted for ~30 minutes for 3 trainees per instructor and focused 124 on techniques for reconstituting, drawing up, and intramuscularly administering the COVID-19 vaccine. 125

Faculty used a competency checklist to verify that each participant was able to demonstrate complete 126 competency with each of these steps, in addition to proper techniques for sterilization and disposal of 127 sharps and other waste. These checklists were then uploaded to the DPH site to finalize the certification 128 process and then the new COVID-19 vaccinators could register for statewide DPH vaccination clinics. Overall, pharmacist-faculty and students were involved in 59 total in-person competency evaluation 181 events that took place one or more times in 9 total locations throughout the state of Connecticut from 182 January 16 to April 30. Each evaluation event lasted an average of 3 hours and consisted of 1 to 2 183 pharmacists and 2 to 4 students per site (Table 1) . 184

We developed videos on 26 distinct COVID-19 vaccine topics. All videos were recorded in the 186 English language and several were then translated into Spanish, Mandarin, Cantonese and Polish to total 187 79 produced videos. Of this total, 26 videos (33%) were created Jan 1 to 15, 36 (46%) were created Jan 188 16 to 31, 4 (5%) were created Feb 1 to 14, 9 (11%) were created Mar 1 to 15, and 3 (4%) were created 189

Mar 16 to 31. One additional video (1%) was made and released since Apr 1. After the videos were 190 uploaded to YouTube, 12 videos were shared using the School of Pharmacy's social media platforms 191 (Twitter, Facebook and Instagram) and by the faculty, student, and staff members that chose to do so on 192 their personal social media accounts. Salient videos were sent to applicable university cultural centers and With strong support from the state and our partners, the pharmacy faculty created a targeted educational 208 program. Along with pharmacy students, a group of vaccination-certified pharmacy faculty traversed the 209 state and provided the in-person component of the training and certification process. We were able to 210 identify so many willing health care professionals to receive this training, and rapidly certify them before 211 the large influx of vaccine availability. This unique program model allowed the State of Connecticut to 212 stay a step ahead of the supply, not a step behind. By April 30, 2021, 55% of Connecticut's population 213 has received at least one dose of a COVID-19 vaccine, and 35% was fully vaccinated 9 . Nationally, 44% 214 of the population has received one dose, and 28% was fully vaccinated 10 ( Figure 1A) . Connecticut is 215 among the top state performers in COVID-19 vaccine rollout and ranks second in the percentage of the 216 population being fully vaccinated 11 . 217

Throughout the process of the program roll out, there were some barriers and challenges that our 218 group faced. First, the pace as to which the program was rolled out had to meet the demands of the State's 219 phased vaccine roll out. This was challenging as there was very little time to plan, so we quickly 220 developed a "plan as we go" strategy for all certification events. This included developing an all-inclusive 221 site through our University system that soon to be vaccinators were able to find all information regarding 222 date, time and location of events. Pharmacy faculty and vaccine trainees were able to sign up for these 223 events and receive any related communication through this platform. Additionally, due to the rapid 224 development of the program, faculty and student availability and scheduling to fill the needs of different 225 geographical locations was at times challenging. Faculty resorted to locations that were closest to their 226 home locations, which was relatively even throughout the state, given Connecticut's smaller overall size. 227

This could in the future pose a problem with larger states. Finally, we recognized during the certification 228 portion that another barrier was the strategy for dissemination and replenishment of training supplies. We 229 started with a single central location for supplies but shortly identified this as a barrier as it required travel 230 by faculty to a location that was in some cases not close to event locations. This was mitigated by creating 231 three carts of supplies that were fully stocked to meet the needs of the events. We then tried to extrapolate 232 needs and determine a replenishment pathway that minimized travel around the state to get or drop off the 233 carts. By the fourth round of certification events, we felt the process was able to meet the needs of each 234

Pharmacists and pharmacy students have been an incredible resource for the public health battle 236 against COVID-19 in the United States. Pharmacists have adapted their skill set to the needs brought on 237 by COVID-19, including vaccinating the public and facilitating COVID-19 testing 14 . In addition, 238

pharmacists have a duty to counter the COVID-19 infodemic by providing up to date and scientifically 239 based information to consumers 15 . Misinformation negatively impacts intent to vaccinate against COVID-240 241 audience and provide credible sources of information to those otherwise dependent on social media to 242 encourage browsing away to those sources 17 . At the same time vaccine conversations peaked in social 243 media platforms (January 2021 18 ), we implemented our social media campaign to address vaccine 244 hesitancy, which was accessed and shared by a number of consumers. All our videos provided sources so 245 that viewers could navigate away to trustworthy resources. 246

We believe that disseminating our model where a DPH partnered with pharmacists to tackle a major 247 health crisis can allow creative thinking of how these natural partners could further work together. 248

Departments of public health could leverage the pharmacist's accessibility and standing in the 249 community, to address many pressing health crises. 250

A partnership between the Connecticut DPH and the UConn School of Pharmacy allowed the 252

State of Connecticut to rapidly scale up its capacity to administer the COVID-19 vaccine to its citizens. receptive to accessing the health information they create on social media. This is another way in which a 258 pharmacist can impact public health and together suggest that pharmacists should be more directly and 259 indirectly involved in enhancing public health initiatives. 260 J o u r n a l P r e -p r o o f J o u r n a l P r e -p r o o f 

Health professionals identified in the Commissioners Executive Order

Investigations/PLIS/Approved-COVID-19-Vaccination-Training-Programs

Recommended Adult Immunization Schedule for ages 19 years or older

University Support in the Feasibility of Public Health 268 Programs: CT WISEWOMAN Medication Therapy Management (MTM) Program. Oral 269 presentation at: American Pharmacist Association Annual Meeting & Exposition

Creating Community-Clinical Linkages to Reduce Disparities in Hypertension Identification and 273

Poster presented at: Bringing Public Health and Primary Care Together: The Practical 274

Playbook National Meeting

Medication Therapy Management Services on the

Self-Care and Clinical Outcomes of Patients with Diabetes and/or Hypertension. Poster presented 278 at: ASHP Midyear Clinical Meeting

Cessation Outcomes in an underserved community with and without diabetes and health 281 disparities

Identifying the Scope of Drug Therapy Problems in 283

American Pharmacists Association Annual Meeting

Advancing Pharmacist Medication Management through 286

Poster presented at: American Association of Colleges of 287 Pharmacy Annual Meeting

Connecticut Coronavirus Vaccination Progress

States ranked by percentage of population fully vaccinated

School of Pharmacy YouTube Page

Pharmacy Students Create COVID-19 Vaccine Information Series in 5 299 languages

McCook A. Pharmacists Get Green Light for COVID-19 Testing. Pharmacy Times

When fear and misinformation go viral: Pharmacists' role 305 in deterring medication misinformation during the 'infodemic' surrounding COVID-19

Measuring the impact of COVID-308 19 vaccine misinformation on vaccination intent in the UK and USA

Online social endorsement and COVID-19 vaccine 311 hesitancy in the United Kingdom

What Social Media is Saying about the COVID-19 Vaccine Rollout