Pharmacies Are Critical to Pandemic Planning, Not Just Response

September 22, 2021 | Joanne Roth

Mortar and pestle in the foreground, out-of-focus pharmacist visible in the backgroundPharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.

“The once segregated druggist with limited public health engagement in times of epidemics or national initiatives has morphed into a medication evaluator, health educator, immunizer, and health-care partner.”1

The Pennsylvania Department of Health has partnered extensively with pharmacies for quite some time. Since 2016, the state has worked in concert with the University of Pittsburgh, local health departments, retail drug stores, and pharmacy organizations to expand capacity for delivering vaccines statewide through community pharmacies.

A key component to the agency’s successful collaboration was learning how to quickly implement memoranda of understanding and agreement (i.e., MOUs and MOAs). That success was due in no small part to ASTHO’s Guidance and Templates Toolkit, which helps state and territorial health officials review, customize, and implement emergency MOUs and MOAs. More specifically, Pennsylvania was able to have statewide discussions with the pharmacy community to better understand their roles, responsibilities, and desires to support communities on a larger scale during a public health emergency.

As Pennsylvania responded to COVID-19 and stood up its vaccine campaign, coordinating with and supporting public health agencies and pharmacies was nothing less than critical. The department of health revisited the Pharmacy MOAs, Pennsylvania’s Immunization Information System (PIIS), and the development of the state’s COVID-19 vaccination plan. It also helped community partners reinforce identified financial burdens, including the costs to interface with PIIS and purchase supplies for cold chain management for vaccines.

As a result, Pennsylvania quickly able to increase the number of signed MOAs to 251 by November 2020, covering 1,158 pharmacies statewide. This jump was partially due to the department’s partnerships and connections with representatives of the National Association of Chain Drug Stores and the PA Association of Chain Drug Stores. Thanks to their support and pledge to involve large chain drug stores, the Pennsylvania Department of Health received signed MOAs from Costco, The Giant Company, Wegmans, Weis, and Rite Aid.

“The adoption of the MOA served as the foundation for our pandemic vaccine response and informed us further on the role of DOH and their partnership with community pharmacies,” said Chiara Gessler, Senior Manager of Pharmacy Training, Education, and Research at Giant Eagle Pharmacy. “A greater understanding of the concepts of pandemic vaccine procurement, documentation, and reporting helped us establish an electronic immunization information system in advance of the COVID-19 pandemic.

“The research around pandemic planning that was conducted in partnership with the Pennsylvania Department of Health and the University of Pittsburgh School of Pharmacy was instrumental in preparing us to respond to the COVID-19 emergency,” Gessler concluded.

In order to expand pandemic vaccination capacity, Pennsylvania recommends that state and territorial health officials:

  • Review and revise jurisdictional MOU/MOA templates as part of after-action reports.
  • Inform county and municipal health departments about state planning with pharmacy partners.
  • Collaborate with and plan roles for retail pharmacy chains and independent pharmacies during a public health emergency.
  • Engage student pharmacists in public health preparedness and response efforts, including training and exercises.

1Meyerson BE, Ryder PT, Richey-Smith C. Achieving pharmacy-based public health: a call for public health engagement. Public Health Rep. 2013;128(3):140-143. doi:10.1177/003335491312800303.