Leading vaccine gap closure with community health workers: The CPESN Missouri health equity approach

Backbround

The Missouri Pharmacy Association (MPA), Community Pharmacy Enhanced Services Network (CPESN) of Missouri, and CPESN Health Equity launched the Missouri Pharmacy Vaccine Gap Closure Program aimed to improve vaccine coverage by integrating community health workers (CHWs) into pharmacy settings. Preliminary findings indicate 6.6% gap closure rate, $700,000 in increased revenue, and $2.5 million in reduced costs.

Objective

To assess the feasibility and effectiveness of integrating CHW-trained pharmacy technicians into existing workflows for immunization services, evaluate staff perceptions and acceptance, and identify facilitators and barriers to implementation.

Methods

Pharmacy technicians trained as CHWs or Social Determinants of Health (SDOH) specialists worked with pharmacists to conduct immunization and SDOH screenings, tailored educational sessions, and patient follow-ups aligned with medication synchronization workflows. Data on vaccine eligibility, patient demographics, and health status were collected prospectively and surveys administered to staff assessed barriers and facilitators.

Results

Staff from pharmacies participating rated the program highly in value for both the pharmacy and patients, feeling comfortable addressing vaccine hesitancy. Integration with Med Sync workflows received moderate scores, while the Basecamp support portal was highly valued, along with positively rated but less utilized regional facilitators (RF). Key facilitators included cross-training, integration with Med Sync, and robust resources and training. Barriers included staff shortages, low patient engagement, and difficulties in stores lacking a dedicated workflow champion.

Conclusion

The Missouri Pharmacy Vaccine Gap Closure Program has demonstrated positive impact and initial success in the first 6 months, integrating well into pharmacy workflows and receiving strong support and value recognition from pharmacies' staff. Key success factors include the cross-training of technicians as CHW/SDoH specialists and robust technical support from MPA and CPESN. Growth opportunities include enhancing awareness of RFs' value among pharmacy sites and further analyzing medication synchronization workflow variations to establish best practices to optimize program implementation and delivery.