Automated prompts to efficiently screen for HPV and shingles vaccination status
By Dr. Sherilyn Houle
Do you know for sure if your vaccinations are up to date? Most people don’t. A survey of Canadian adults prior to the COVID-19 pandemic found that while 88% of respondents believed they received all recommended vaccines for their age or risk group, only 3% had reported actually receiving them all. This discrepancy has likely worsened since, with 13% of Canadian adults and 23% of children reporting missing or delaying a routine immunization within the first 18 months of the pandemic. The addition of new vaccines to the market (e.g., for respiratory syncytial virus, RSV) or updated eligibility criteria (e.g., shingles vaccination for immunocompromised younger adults) makes staying on top of our vaccinations even harder.
While an individualized recommendation for vaccination from a health professional is well recognized as the most influential driver of vaccination uptake, heavy clinical and administrative workloads and shortages of primary care health professionals may contribute to preventive care opportunities being missed to accommodate acute concerns within limited resources.
Technology and automation have contributed to efficiencies in many sectors, and healthcare is no exception. For example, the need to rapidly vaccinate millions of people against COVID-19 has led to the development and widespread adoption of online booking platforms for scheduling vaccination appointments. Our team was interested in testing the coupling of a brief vaccination screening to an online scheduling platform.
Users of the MedEssist platform who scheduled an appointment at a participating community pharmacy in Canada from October 2021 through March 2022 for a COVID-19 or influenza vaccination were invited to answer optional screening questions on their vaccination status against human papillomavirus (HPV, for those aged 9-45 years) or shingles (for those aged ≥50 years). Those who indicated that they were unvaccinated against these diseases or were unsure if they had been vaccinated were further asked if they would be willing to discuss the vaccine with a pharmacist. If interest in this discussion was expressed, the pharmacist would be alerted to this so that a conversation could be initiated during their appointment.
Over the study period, >92,000 users answered the automated screening questions, with 70.1% of those eligible for HPV vaccination based on their age reporting being either unvaccinated or unsure, and 55.5% of those eligible for shingles vaccination based on age being unvaccinated or unsure. Overall, over 10,000 individuals expressed interest in discussing these vaccines with a pharmacist. Those interested in discussing HPV vaccination were more likely to be aged 18-29 years vs. ≥40 and identify as female or another gender orientation vs. male. Those interested in discussing shingles vaccination were more likely to be aged 60-69 vs. ≥70 with no difference by gender. For both, willingness to have this discussion was significantly lower if the user was using the platform to book an appointment for a COVID-19 vaccine vs. an influenza vaccine.
With no effort required from the pharmacist and only minimal effort from the user, over 10,000 individuals with a potential need for vaccination and interest in exploring it further were identified. While initially tested among users of a platform targeting community pharmacies and for two specific vaccines, a similar approach can be applied to other vaccines and the scheduling of health services in other care settings for even greater reach and repeated consistent messaging on vaccination from multiple care providers.
Further research will examine the effectiveness of the prompt at initiating conversations and subsequent vaccination recommendations and uptake. While technology cannot replace the impact of human interaction to establish trust between patients and care providers – an important component of vaccination decision-making – it can ensure that these opportunities to prevent potentially severe complications from a vaccine-preventable disease aren’t missed.
Whether you are a health professional or a patient, you have many things on your mind. Using technology to perform quick and automated vaccination screening has the opportunity to provide us with peace of mind, without having to be at top of mind.
Article Details
Herpes zoster and human papillomavirus vaccination opportunities identified using electronic prompts at the time of scheduling influenza or COVID-19 vaccines
Sherilyn K.D. Houle, Mhd. Wasem Alsabbagh, Nancy M. Waite
First Published July 30, 2023 Research article
DOI: 10.1177/17151635231188343
Canadian Pharmacists Journal / Revue des Pharmaciens du Canada
About the Author
