Covid vaccinations: pharmacists on the frontline

Practice

Covid vaccinations: pharmacists on the frontline

In Practice

Community pharmacies are playing their part on the frontline of the Covid vaccination rollout. Here, five pharmacists talk about why they were determined to get involved in the national effort, how they make the process work, and what it means to them and their patients

Pharmacy Complete’s Michael Holden has been supporting the vaccination service led by fellow pharmacist David Parker, owner of Church Crookham Pharmacy in Fleet, Hampshire.

“David has a fairly small pharmacy, so he decided to use Church Crookham Memorial Hall for the vaccinations. We launched on January 20 with around 50 people – vaccinators, helpers and volunteers. The team now has around 20 vaccinators (nurses and pharmacists) and over 100 helpers of all ages.

“The hall has 16 workstations, all screened off, with four teams of four people. When a patient arrives, a chaperone brings them to an empty workstation. We go to the patients waiting to be vaccinated, rather than them come to us.

An administrator confirms their details and checks for potential clinical issues (e.g. vaccination history). Then once the patient has given consent, the vaccinator arrives at the workstation to take over. We are using the AstraZeneca vaccine, so also have an observer watching each patient for three minutes afterwards. We then clean down each workstation between patients.

“In the first six days over a two-week period, we did over 2,000 vaccinations. We are fully booked but continue to be limited by vaccine supplies.
We are currently doing three days a week, with the capacity to do 12-hour days, seven days a week. It is frustrating as we could have been doing 5,000 vaccinations a week from the start.

“This is the most professionally satisfying role I’ve ever had. The patients are delighted at having the vaccination in such a safe and efficient set-up, with many bringing in cards and boxes of cake to thank us. It is so rewarding to know we are starting people on the pathway to some immunity against Covid-19.”

This is the most professionally satisfying role I’ve ever had

Overwhelmed

Nishil Shah, superintendent pharmacist at Cheeseman Pharmacy, is vaccinating patients at the Rufus Centre in Flitwick, Bedfordshire. The vaccination centre has been set up by two pharmacies – Cheeseman Pharmacy and C&H Barton Pharmacy.

“Alex Hill [from C&H Barton Pharmacy] and I joined forces so we could still keep our pharmacies running smoothly. We had a good relationship with the local PCN, and this then turned into something much bigger. The vaccination centre now involves two PCNs and six GP surgeries but we, the pharmacists, are taking the overall lead.

“We set up a website for volunteers to express their interest and were overwhelmed when 850 people signed up in one week. At any one time
we have 18 to 20 volunteers on site. It is fantastic that they are dedicating their time and braving the winter weather. We also have nurses, pharmacists, paramedics and doctors doing the vaccinations. Each surgery has a dedicated GP present on vaccination days in case there are any clinical issues, and we have a paramedic as the dedicated first aider.

“We went live on January 21. Within 10 days, we had vaccinated 4,000 patients. We could do 600 to 700 vaccinations every day if we had the supplies. We have also been into local care homes to vaccinate residents and any staff present that day. From the beginning of February, we have been vaccinating housebound patients as well.

“Setting up the service has been a huge challenge, but it’s all been flowing perfectly. We have been getting so many messages and phone calls from grateful patients. Some are crying with happiness when we vaccinate them. Right now, we’re dealing mainly with the over-80s, with many not having left their homes for eight to 10 months.”

Less daunting

Reshma Malde is the superintendent pharmacist at John Bell & Croyden pharmacy in London, which began vaccinating patients on January 30.

“I was elated when the email arrived to say we had been selected as one of the Covid vaccination sites. Our whole team was on board and we looked at how we could make it work. We realised we weren’t going to manage with just our consultation room to do the minimum 1,000 vaccinations a week. We needed a check-in area, vaccination area and post-vaccination area. This takes up a lot of floor space so we reduced some of our pharmacy lines and put the vaccination centre at the back of the shop with three booths.

“That first weekend, we had 139 patients to vaccinate on the Saturday and 148 on the Sunday. Patients said coming here was less daunting than going to a mass vaccination centre, with our frontline concierge controlling the flow of people. Four pharmacists and five store staff are involved in the vaccination service, with the rest of the pharmacy team still operating across the store. But it is not just the pharmacy team making this process easier for the patients. Taxi drivers, for example, are supporting our patients to and from the door, as many of this age group have walkers and walking sticks.

“I am so glad and humbled to have this opportunity. This pandemic has put everything into perspective, as Covid-19 has touched the lives of so many people. Our members of staff are not necessarily local and some have family in different countries. Many haven’t been home for months, and this vaccine provides an opportunity for them – and our customers, especially the older generation – to meet with loved ones again.”

Patients said coming here was less daunting than going to a mass vaccination centre

Weekend visits

Louise Lydon, a pharmacist in Jarrow, South Tyneside, is involved in a Covid-19 vaccination service for housebound patients in three PCNs.

“We are a group of 22 community pharmacists, each buddying up with a healthcare assistant or technician to visit around 25 to 35 patients in one day. We’re doing this on Saturdays and Sundays as everyone has a community pharmacy to run in the week. The central vaccination hubs rely on patients being mobile or their families being able to bring them, and a lot of people can’t get there easily.

We are also vaccinating house-tied carers who can’t leave patients to get to the hub.

“Patients receive a phone call a week before their appointment and are told to expect a visit between 8am and 8pm on a specific day. The pharmacy team calls them half an hour beforehand so the patient can get ready for them (e.g. opening the door). When we arrive, we put on fresh PPE.

Our kit bag contains everything we need, including patient information leaflets and a refrigerated medical-grade cool bag with the vaccines. After the vaccine, we wait to make sure there is no reaction and give advice on taking paracetamol and elevating their arm if it is a bit sore.

“Between us, we vaccinated 409 people on the first day; on the second weekend we vaccinated over 800 people. Sometimes we are getting 11 or 12 doses out of the AstraZeneca vaccine vials, so we keep working until these are finished.

“This is one of the most rewarding things I’ve done in 20 years as a pharmacist. I feel privileged to visit patients in their own homes, and they are always welcoming. For the patients, it is the biggest relief to get vaccinated as they feel very vulnerable – one woman aged 102 said she wished she could give us a kiss to thank us.”

On a high

James Tibbs at AR Pharmacy in Southampton decided to set up a marquee outside his pharmacy to accommodate his vaccinations service.

“We are a large pharmacy with five full-time pharmacists and eight consultation rooms, so have a big capacity and skill set, but there was a risk of damaging our core business by focusing on the Covid vaccines in the pharmacy. To do a minimum of 1,000 vaccinations a week, I created a Covid-compliant set-up in a marquee outside instead. This way, we still have a robust team in the pharmacy as well. On a day-to-day basis, we have between one and four vaccinators, all pharmacists, depending on demand. We also have many volunteers – on computers, on the door checking patients in, some outside and others inside to help.

“We managed 1,200 vaccinations in the first week, and 800 in the second week. Vaccine supply is a limiting factor – we could do 5,000 a week. With the AstraZeneca vaccine, we’re supposed to get 10 doses out of each vial, but we are sometimes getting 11 or even 12 doses. We didn’t receive enough syringes for the vials, so that’s a minor teething problem we have needed to sort out.

“Because appointments are spread out from 8am to 8pm, we’re working at a lower intensity at times. I added in some extra features, such as artificial turf outside to give patients a more pleasant experience while they wait. Some patients were saying it was cold in the marquee because it is open since we need to maintain the air flow, so we added more heaters.

“This vaccination service is so rewarding for all of us, with many patients in tears of gratitude. One patient brought in a box of chocolates as a thank you because we managed to squeeze her husband in for a vaccination. And another pharmacist vaccinated a patient in their car – the patient had bad oedema so was struggling to get out – and the patient brought in more chocolates. It has been incredible – we are all on a high!”

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