Exploring perspectives on vaccinations delivered in complementary nonclinical settings and by nonphysician health professionals: A qualitative interview study

Abstract

Background

Although vaccines are an effective solution for preventing infectious disease, some vaccination rates remain below national targets, creating a need to increase vaccination access and uptake. A potential solution to improve vaccination rates is the implementation of policies that allow for more convenient vaccination access, such as the expansion of vaccination delivery by nonphysician healthcare providers (NPHPs) outside of traditional clinical settings.

Objective

To understand perspectives on vaccine administration at complementary sites (such as pharmacies, mobile clinics, and pop-up clinics) by NPHPs, and the barriers surrounding administration.

Methods

We performed interviews with healthcare providers and vaccination policy experts to elicit perspectives on including vaccination program scope, facilitators and barriers to NPHPs administering vaccines, and recommendations for improvement of vaccine administration. Eligible participants were required to either work directly in vaccination administration or work in vaccination policy.

Results

Thirty-eight participants completed interviews. Participants reported that U.S. individuals have a positive view of vaccination at complementary sites and by NPHPs, especially since the COVID-19 pandemic, where vaccination was often performed by NPHPs at complementary sites. Concerns expressed by participants included language barriers, out-of-pocket costs, and mistrust among marginalized communities. Participants described the complexity of state and local regulations, particularly scope of practice laws, as a barrier to implementation of NPHP vaccination programs at complementary sites.

Conclusion

NPHPs and vaccination advocates report that complementary sites represent a potentially important step to ensuring broader, more equitable vaccination service in the United States.