The MCW School of Pharmacy’s COVID-19 Immunization Program

 From the 4/23/2021 newsletter

Some questions for …

 

 George E. MacKinnon III, PhD, MS, RPh - MCW School of Pharmacy

 

 

The MCW School of Pharmacy’s COVID-19 Immunization Program

 

 

In what ways was the MCW School of Pharmacy well-positioned to quickly ramp up a response to the call for COVID-19 immunizers? 

Dr. MacKinnon: The School of Pharmacy ran several influenza clinics on the MCW Milwaukee Campus that well prepared faculty and student pharmacists to respond to the call for immunizers, albeit these were very small operations. In the fall of 2020, under the leadership of Professor Karen, MacKinnon, Director of Outreach in the School of Pharmacy, we expanded the influenza clinics and opened them to more individuals of MCW (all students, staff, and faculty). The intention was that these clinics would serve as the prototype for the COVID-19 Immunization Clinic for MCW. The MCW School of Pharmacy joined with the MCW Office or Research (led by Ann Nattinger, MD, MPH, Associate Provost for Research, Senior Associate Dean for Research, School of Medicine) to jointly lead the creation of a COVID-19 Vaccination Clinic on our Milwaukee Campus to administer the COVID-19 vaccine beginning December 22, 2020.

All eligible MCW student pharmacists are trained early in their education to administer vaccines, including the COVID-19 vaccine. They also receive training in the Doctor of Pharmacy (PharmD) program in point-of-care testing such as nasopharyngeal testing for coronavirus and strep throat testing, and thus were an asset to our clinical partners for COVID testing these past 12 months. Additionally, many of our pharmacy faculty have been trained in immunization administration over the years. Thus, we had a cadre of internal pharmacists and student pharmacist that were able and willing to participate in COVID-19 vaccine administration.

Pharmacists have expertise in planning for vaccine procurement, storage, distribution, preparation, administration, post immunization monitoring, and record keeping. Fortunately, the School of Pharmacy had just jointly hired Kristin Busse, PharmD, BCPS with the Office of Research when the pandemic emerged in early 2020. She came to us with years of experiences in investigational drug services at Froedtert and was an ideal pharmacist to lead the vaccine procurement and preparations (complying with all regulatory issues at federal and state levels for the emergency use authorization (EUA) vaccines that were to be released).

 

How quickly did you decide that you needed to be proactive with the Wisconsin state legislature to change the rules for oversight and delivery of vaccine? What was that process like?

Dr. MacKinnon: When we began to develop our PharmD curriculum in 2015, we identified that we would be unable to include immunization training early on in the program and had to wait until the second year of the program. We did meet with MCW Office of Government Relations but realized that this was a statutory change needing intervention from the state legislature. Over the past four years, we also met with the Pharmacy Society of Wisconsin (PSW) expressing our desire to gather support as we believe that having a state statue dictate the timing of curriculum delivery in a PharmD Program is overly prescriptive, limiting, and antiquated.

As it became apparent that in late 2020 a COVID-19 vaccine would likely be available, we again brought up this topic with PSW and brought the other two schools of pharmacy in the state into the discussion. Our position was simple, during a pandemic, when all appropriately credentialed providers are needed, such arbitrary distinctions would hinder our full deployment of life-saving vaccines now and into the future.

During this process we also requested an additional language change that would allow student pharmacists to be supervised by any health care provider authorized to administer vaccines (e.g., nurses, physicians). As was previously written in statute, a student pharmacist must have been overseen by only a pharmacist in the administration of an immunization. In fact, we used LCME accreditation language to help support our position and draw an analogy to medical education. With the Legislature’s bipartisan bill and the Governors approval, our suggested changes were enacted in late February 2021. Thus, we have been able to support a team-based approach to healthcare in concert at the regulatory and professional levels, at least with respect to immunizations.

 

When the next pandemic arrives (as it likely will!), what will we do differently?

Dr. MacKinnon: Certainly, there were identified process improvements along the way. The clinic, while conceptually the same in December, has grown and matured to an efficient operation. This sentiment was echoed by the many individuals that came to staff the clinic or be immunized. The credit to this goes to the blended teams from the MCW Office of Research (led by Dr. Nattinger) and the School of Pharmacy (led by Dr. MacKinnon) via the MCW COVID-19 Vaccine Program Team Leads as follows:

Vaccine and program logistics:

Leads: Kristin Busse and Lisa Henk

Clinic Supervision and orientation:

Leads:  Karen MacKinnon and Susan Mauermann

Scheduling and planning:

Leads: Jayne Jungmann and AshLeigh Sanchez

Reporting and maintenance of records:

Leads:  Jen Brown and Theresa Dobrowski

Personnel Eligibility and Invitations:

Leads: Katie Kassulke and Ann Nattinger

MCW COVID Administrative Response Team:

Leads: Dan Wickeham and Adrienne Mitchell

As the vaccine goes through the phases of roll-out into our communities, the role of a pharmacist is critical, as pharmacists have specific knowledge about immunization and pharmacists’ accessibility can help address issues surrounding vaccine hesitancy in the public. We need to continue the public health discussion surrounding the value of all immunizations to preventing diseases, disability and death.

 

What reactions did you get from the SOP students, faculty, and staff to the process? 

Dr. MacKinnon: The School of Pharmacy mission is to: Advance the health of our communities through innovative pharmacy education, continuous public and professional service, and diverse scholarly collaborations. So, our desire to contribute to abating the pandemic was right in line with our mission all along.  We were able to get 100% participation from our faculty and staff. With respect to engagement, overall, there were 95 individuals (faculty, staff and students) from the School of Pharmacy that contributed over 4,500 hours in clinic over the 45 days of clinic operations.

 

 

What surprised you most in all of this?

Dr. MacKinnon: Two things in particular stand out, though none as real surprises but rather gratitude.  

First was the initial influx of staffing for the first phase of the COVID-19 Clinic from School of Pharmacy faculty, staff and student pharmacists and staff from the Office of Research over the typical holiday break. Many individuals changed their personal plans to staff the clinic. As time went on many individuals were putting in 12-hour days at the clinic and catching up on their regular responsibilities on weekends, it became apparent that more assistance would be needed. Student pharmacists needed to return to classes and faculty had responsibilities to attend to as well. This is when the entire MCW campus rallied to support the clinic with medical students, having been trained in immunization, joining forces with physicians, nurses, physician assistants, and medical assistants as immunizers. There too was an outpouring of support from the basic sciences as individuals with the requisite technical skillset and experiences were able to prepare the syringes filled with vaccines.  

Next was the outpouring of support that came from all members of the extended MCW Community including Board members and the significant others and family of faculty and staff. Frankly people had been isolated for so long because of the pandemic and they just wanted to do their part to assist in the clinic. We welcomed them with open arms. Everyone’s contributions were essential to so many tasks that needed to be accomplished including the planning, delivery and ongoing operation of the Clinic. 

As the saying goes, culture eats strategic planning every day for lunch. Thus, we can plan and strategize all that we want, but the culture of collegiality and respect that we initiated through the COVID-19 Immunization Clinic is what emerged that allowed us to be successful. This developing culture will have a long-standing impact to MCW in years ahead as it emerges into a health science university. I am certain that the COVID-19 Immunization Clinic will be a defining moment in this transformation internally and externally as others in the community recognize what a resource and gem that MCW is to all.

 

George E. MacKinnon III, PhD, MS, RPh, FASHP, FNAP is the Founding Dean of the School of Pharmacy and Professor of Pharmacy at MCW.