Expanding Vaccination Access in Underserved Communities Across Maryland Through a Collaborative Approach.

Abstract

Background: From April 2023 through April 2024, Maryland Living Well Center of Excellence (LWCE) in collaboration with The Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy and community partners, Meals on Wheels of Central Maryland, and Maryland Primary Care Program (MDPCP) provided vaccination services and education for older persons including those with disabilities who have been historically underserved.

Objectives: To expand equitable access to all applicable adult vaccines with a focus on influenza and COVID-19 in adults 60 years of age and older.

Practice description: A collaborative team of pharmacists, pharmacy students, pharmacy technicians, community and public health workers, as well as primary care physician practices were assembled. Through a series of bi-weekly meetings, a model of outreach to low-income, urban, rural and remote underserved and senior housing communities was established to provide education and referral services directed toward improving vaccine access and administering vaccines. To bridge access barriers, vaccines were offered, in community centers, pharmacies, physician practices, low-income senior housing units, and individual patient homes in an effort to enable equitable access to influenza and COVID-19 vaccines principally, but other vaccines were available. Development of an age-friendly vaccine brochure and interest form was disseminated to Meals-on-Wheels recipients and through housing and pharmacy partners. Biweekly public health emails were distributed to over 1,100 primary care practices calling for providers to promote vaccines and engage in this initiative.

Practice innovation: This community-based collaborative model of vaccination programs featured a multi-pronged innovative approach of: a) outreach through a school of pharmacy, community wellness hub, Meals-on-Wheels, community pharmacies, and primary care practices; b) referral services for vaccine scheduling assistance and transportation; c) vaccine services provided in the communities including in: low-income senior housing buildings, community centers, primary care practices, and in patient's homes; and d) widely disseminated services to urban, suburban, rural, and remote areas of the state with a concentration to individuals with socioeconomic challenges.

Evaluation methods: Goal attainment was measured by the number of all vaccines administered with a focus on influenza and COVID-19 vaccines to adults 60 and older including those with disabilities.

Results: Community outreach to 115,785 people through Meals-on-Wheels, primary care offices, wellness and cultural events resulted in 23,521 administered vaccines (COVID-19 (48%), influenza (36%), hepatitis B (13%), and other (3%)). Over 11,400 individuals received scheduling assistance (63%), transportation (<1%), and referrals for other services (36.9%). The program was sustained through 2025 with additional funding by USAging.

Conclusions: Engagement between community pharmacies, pharmacists, pharmacy faculty and students, low-income senior housing communities, primary care practices, and community health workers led to a significant uptake of vaccination services among adults 60-years of age and older including those living with mental and physical disabilities. The collaborative overcame access issues by working with trusted partners and meeting people where they live by bringing services to them.