CPESN Missouri: Leading Vaccine Gap Closure Efforts Through Health Equity


Carson Von Alst, PharmD, Executive Fellow, Missouri Pharmacy Association


Annie Eisenbeis, PharmD, MBA, Director, Practice Development, Missouri Pharmacy Association, Managing Network Facilitator, CPESN Missouri Jake Galdo, PharmD, MBA, BCPS, BCGP, CEO, Seguridad, Inc., Managing Network Facilitator, CPESN Health Equity Mark Patterson, PhD, MPH, Associate Professor, UMKC School of Pharmacy


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harmacies traditionally think about vaccines during ‘fl u season’ – that time from September to January when patients are asking to get their annual infl uenza vaccine.


But, in reality, there isn’t a ‘fl u season’. A 6-month-old can start their infl uenza series in May – and complete by June. T ere are signifi cant gaps in preventive care that could be addressed year-round, starting with vaccinations. T is growing awareness that vaccine season should be all seasons also faces signifi cant challenges in Missouri (and nationally) due to vaccine hesitancy. T e Missouri Pharmacy Association


(MPA), Community Pharmacy Enhanced Services Network (CPESN) Missouri, and CPESN Health Equity joined together to launch the Pharmacy Vaccine Gap Closure Program. T is initiative, supported by the Missouri Department of Health and Senior Services Bureau of Immunizations with funding from the Centers for Disease Control and Prevention (CDC), aims to show the feasibility of pharmacy teams – pharmacists, pharmacy technicians, and community health workers – to provide vaccine hesitancy services and ultimately, increase vaccination rates.


In the fi rst six months of the program, the


focus is on pharmacy patients and a single education intervention. T is intervention is built around a medical billing code that is a 5–15-minute education session with one patient at a time. CPESN MO pharmacies already have focused monthly touchpoints centered around the pharmacy’s Med Sync workfl ow process as part of the minimum standard for participating in CPESN MO. T e vaccine hesitancy service is part of the pharmacy’s Med Sync process, building on this to add longitudinal education and follow-up. Pharmacy technicians, certifi ed as Community Health Workers (CHWs) and Social Determinant of Health (SDoH) specialists, deliver the vaccine hesitancy counseling aſt er a pharmacist conducts a holistic immunization eligibility screening. To date, over 20,000 interventions have


occurred representing over $500,000 paid to pharmacies for patient care services – not dispensing medications – in the fi rst fi ve months. Some have focused on a specifi c vaccine the patient may be eligible for and others have broadened the session to address broader issues of vaccine hesitancy and supporting access to vaccinations. T e focus on education and hesitancy is built on an already established and trusted relationship


between patients and the pharmacy team. Preliminary data from University


of Missouri - Kansas City and Purdue University show an approximately 10% gap closure rate. And not all vaccines are the same – gap closure for infl uenza is less than 10% – showing this service can help improve immunization rates in other routine vaccines, also considering that the typical fl u shot “season” has not started yet. What can this success be credited to?


T e program’s design is


foundational. T e design of this program prioritizes


training the entire pharmacy team from the start, incorporates services into the existing technology and workfl ow of a pharmacy already, and provides extensive resources on building up that workfl ow process. T is program builds the foundation for future services and programs, making sure that each participating pharmacy will be successful at implementing quality services addressing gaps in care, and do so effi ciently so that the more opportunities that come to fruition, the more services the pharmacy team can provide without becoming overwhelmed or maxing out their capacity.


46 Missouri PHARMACIST | Volume 98, Issue II | Summer 2024


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