Project Summary
In the past decade, the role of pharmacists and others as non-traditional vaccine providers is becoming more
common. However, as the number of providers administering vaccines increases, there is a concern of
fragmented immunization records in state and regional registries. This is a serious issue at the State level as
well as at the provider level. Complete immunization records are necessary for the State to monitor vaccination
rates and facilitate outbreak response efforts and recalls. For providers, complete records can be used to
determine gaps in vaccinations and ensure that individuals are not over-vaccinated. In order for immunization
registries to have complete records, it is critical that each provider administering vaccines, including those non-
traditional providers such as pharmacists, participate and update the registry each time a vaccine is
administered to a patient. In Alabama participation in the registry is not mandatory; as a result, less than 25%
of adults over the age of 19 have immunization data recorded in the state registry. Lack of pharmacy
participation may have contributed to this incomplete registry records (only 27% of Alabama pharmacies
enrolled). Participation of independent pharmacies is of particular concern as approximately 40% of Alabama
pharmacies are independent, but only 4% of independent pharmacies are enrolled in the registry. The
purposes of this study are to identify barriers to utilization of immunization registries within a pharmacy
context and tailor the information learned about barriers into a novel immunization registry training program
with strategies specific to individual subsets of pharmacies, independent pharmacies in rural areas. Doing so
will help achieve the long-term goal which is to increase the use of immunization registries in community
pharmacies in Alabama. The research design is a mixed methods approach to qualitatively identify contextual
barriers and facilitators to registry utilization and quantitatively assess effectiveness of the training program and
implementation guide through a randomized controlled trial. The specific aims are to 1) identify barriers and
best practices of immunization registry implementation, 2) use a participatory design approach to
develop an immunization registry training program, and 3) disseminate and assess the impact of the
immunization registry training program among community pharmacies' registry participation rates.
The impact of the training program on registry participation rates will be assessed using a randomized
controlled trial design comparing Alabama community pharmacies' registry data as well as intention to
participate. The expected outcome is to create an effective training program that is scalable and ready for
dissemination. If successful, this resource can be replicated and used to significantly impact the completeness
and accuracy of immunization registries across the U.S., providing the potential for registries to be used
consistently in assessing immunization status and recommending additional vaccines in the pharmacy setting,
thereby improving vaccination coverage and making the provision of immunizations safe and efficient.