Helping Local Community Pharmacies Implement Immunization Services

Pharmacist Francisco Javier Jiménez Ramírez interacting with a patient in front of his parent’s pharmacy on a rainy day in Lares, Puerto Rico.

“I realized that there was a huge community need for pharmacy immunization services because adults didn’t typically go to vaccination clinics—only children. The vaccination rate in the adult population was, and is still, very low, although community pharmacies have helped increase rates,” said Francisco Javier Jiménez Ramírez, PharmD, professor and pharmacy residency program director at the University of Puerto Rico (UPR) School of Pharmacy.

Jiménez said, “I also realized that some pharmacists did not have the confidence and needed support and training in addition to the APhA immunization course to provide this service.” The Association of Community Pharmacies of Puerto Rico also became integrated into promoting immunization services around Puerto Rico, which was key.

While the majority of pharmacists in the United States have regularly provided immunization services at community pharmacies for almost 30 years, pharmacists in Puerto Rico have been administering vaccines only since 2009. One major retail pharmacy brought the APhA pharmacy-based immunization training program to Puerto Rico at that time. “My mom and aunt, both pharmacists, and other pharmacists took the course to become trained, but, as far as I know, nobody started immunization services at that time,” said Jiménez.

“In 2012, we decided to introduce immunization services at my parents’ community pharmacy in Lares, Puerto Rico,” Jiménez said. “We started the UPR School of Pharmacy Community Pharmacy Residency Program in Puerto Rico in the same year under my direction, administration, and preceptorship in collaboration with four pharmacies and some faculty as advisors and mentors.”

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Jiménez worked to expand the provision of immunization services in Puerto Rico through independent community pharmacies. “We have grown from 5 pharmacies between 2012 and 2013 to over 200 community pharmacies providing immunization services, not including chain pharmacies,” he said. “I support these pharmacies to develop their services and provide clinical support to enhance confidence and competence.” His parents’ dedication and service in pharmacy have been an inspiration to him.

As part of his efforts to train pharmacists to vaccinate patients, Jiménez brought APhA’s immunization course to Puerto Rico. In 2016, he trained pharmacist colleagues to become trainers, support community pharmacies, and educate student pharmacists. With immunization services in place at independent community pharmacies, the Puerto Rico Department of Health has allowed these pharmacies to provide COVID-19 vaccinations since March 2021. He said, “I am sure that 5 years ago, it would have been a different story, and the community pharmacies would have not been considered to administer the vaccines.”

Additionally, Jiménez started the process of getting pharmacies credentialed. Since some pharmacists were still not confident in providing the services, he created a chat in WhatsApp to support the pharmacy credentialing and reimbursement processes as well as the clinical services. The chat includes over 200 pharmacists looking for support in the process to further pharmacy services. “I believe that the community pharmacy is a health services place, not just a medication distribution place,” he said.

Jiménez’s efforts have since made it possible for local pharmacies to play an active role in the fight against COVID-19.To date, his efforts directly affiliated with the UPR Medical Sciences Campus have led to more than 11,000 doses of COVID-19 vaccine administered to more than 5,000 people.