Poster presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). Copenhagen, Denmark, 25–28 April 201

Cavaco-Silva, P.

Costa, F. Alves da

Matias, B.

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1. Batista I, Conde P, Falcão I, Falcão J, Gonçalves P, Guiomar R, et al. Efetividade da vacina antigripal na época 2010-2011 em Portugal: resultados do projeto EuroEVA. Rev Port Med Geral Fam. 2012;2:271–84. !2. Branco M, Nunes B. Vacinação antigripal da população portuguesa, em 2010-2011: cobertura e algumas características do acto vacinal. 2011. !3. Nunes B, Uva MS, Roquette R, Contreiras T, Dias CM, Nacional I, et al. Vacinação antigripal da população portuguesa na época 2013-2014: Estudo na amostra ECOS. 2014. !Alves da Costa F., Matias B., Cavaco-Silva P.!Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz (ISCSEM), Monte de Caparica, Portugal	"Evaluation of influenza vaccination services and users’ perception about its utility: a study in a community pharmacy in Lisbon, Portugal"	Flu is an acute infectious respiratory tract disease responsible for outbreaks and annually affecting 5-20% of the population. 1!Vaccine administration is the most important preventive measure to avoid complications in susceptible individuals, such as the elderly, diabetic and asthmatic patients, to name a few. The recognition of the pharmacist‘s role in this context led to the inclusion of this service in the Portuguese law (2007) classified as an advanced service possible to provide by Portuguese pharmacies. 2!Introduction!To evaluate flu vaccination services in a community pharmacy  in the Lisbon area. To estimate the seasonal flu vaccine coverage in the population served by the pharmacy in the study; to estimate the proportion of the population served by this pharmacy resorting to pharmacy based vaccination services; to demographically characterize the population vaccinated at the pharmacy; to assess potential determinants for choosing the vaccination site; to assess the practical storage of the flu vaccine and to evaluate the health beliefs of those who do not resort to vaccination.!Objectives!In an attempt to evaluate the service of flu vaccination in a community pharmacy in the Lisbon area, two studies were performed. One retrospective study, using existing records (paper and computer) in the pharmacy from 2008 till 2013 and, a descriptive cross-sectional study, using the information gathered from a face-to-face questionnaire developed for the study, and conducted during the 2013 flu season.!The technical director of the pharmacy signed a consent form authorizing the data collection by the research team and all information was treated anonymously.  !Statistical analysis was done using IBM SPSS version 21.0, resorting to univariate and bivariate analysis, with a 95% confidence interval.!Methods!!Influenza vaccine administration!The retrospective data included 1741 cases . Considering the theoretical population covered by the pharmacy (24500 inhabitants), one can estimate that, depending on the year, the flu vaccine coverage ranged between 5,17% (2013) and 11,06% (2009) (Table 1).  !The majority of patients who had their vaccine administrated in the pharmacy were female (n=1017; 58,4%) and the mean age was 66,6 years old (SD=17,9.)!The pharmacy vaccinated more than 50% of the sold vaccines, however there was a sharp decline in vaccination over the years (5,89%), particularly since 2010 (Fig. 1).!!!!!!!!!!!!!!A substantial decrease in influenza vaccine sales and demand for flu vaccine administration was observed in this pharmacy, from the season of 2011/2012 to 2012/2013. This may be due to governmental measures implemented in 2012/2013, administering free flu vaccines (and without prescription) in Health Centers, to individuals belonging to risk groups (e.g. elderly, patients with chronic conditions such as asthma, etc.) 3  !Vaccination services and users’ perception!A total of 260 questionnaires were collected. It was found that the main determinant for vaccination was the inclusion in a risk group (p=0,001) (Table 2). Users opting for vaccination at the pharmacy, instead of any other location, reported waiting time and trust as key reasons. !!!!!!!!Noteworthy is the fact that, most people who bought the flu vaccine at the pharmacy, and didn’t immediately vaccinate, did not know how to store it correctly. !The main reasons given by people for not wanting to be vaccinated were: 1. the fact that they had never considered this hypothesis (41,6%), 2. believing they never had a cold (17,4%), and 3. that the vaccine itself causes the flu (14,8%) .!Results!228	  384	   387	   328	  233	   181	  0	  200	  400	  600	  2007	   2008	   2009	   2010	   2011	   2012	   2013	   2014	  Number	  of	  vaccines	  Year	  Evolu3on	  of	  the	  administra3on	  of	  inﬂuenza	  vaccines	  Fig. 1 - Evolution of the administration of influenza vaccine (2008-2013) - absolute data.!2008! 2009! 2010! 2011! 2012! 2013!Nº	  of	  vaccines	  ! 228! 384! 387! 328! 233! 181!	  %	  of	  vaccina7on	  in	  rela7on	  to	  popula7on!	  6,51!	  10,97!	  11,06!	  9,37!	  6,66!	  5,17!Table 1 – Flu vaccine coverage provided by the pharmacy administering the flu vaccine, from 2008 to 2013!Risk group! Total! Significance!Yes! %! No! %!Did	  you	  get	  the	  ﬂu	  shot	  this	  year?	  Yes! 97! 51,9! 14! 19,2! 111! !0,001!No! 90! 48,1! 59! 80,8! 149!Total! 187! 100! 73! 100! 260!Table 2 – Chi-square test between variables vaccination and risk group.!The community pharmacy is a convenient and safe place for the administration of the flu vacc ine to the genera l population.	  !The present study warns that, since its legalization in 2007, administration of influenza vaccine in pharmacies has been declining over the flu seasons, and an intervention to revert the situation could be relevant. !People belonging to risk groups, essentially elderly, constitute the majority who use this service, however with the new measures adopted by the Portuguese government, there will be a tendency to change vaccination sites and the risk of pharmacies losing this service is substantial.!In the future, vaccination s t r a t e g i e s s h o u l d b e implemented among the least v a c c i n a t e d i n d i v i d u a l s , t h r o u g h e n c o u r a g i n g vaccination programmes, name ly i n pha rmac ies . Pharmacists should also alert u s e r s f o r t h e e x t r e m e importance of the correct storage of vaccines.!!Finally, a better disclosure of i n f o r m a t i o n  o n  t h e impor tance , sa fe ty and efficacy of the flu vaccine may well change the perception of the unvaccinated population. !Discussion/Conclusions	

Evaluation of influenza vaccination services and users’ perception about its utility: a study in a community pharmacy in Lisbon, Portugal

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Evaluation of influenza vaccination services and users’ perception about its utility: a study in a community pharmacy in Lisbon, Portugal

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