School of Pharmacy, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
Res Social Adm Pharm. 2022 Oct;18(10):3782-3791. doi: 10.1016/j.sapharm.2022.04.008. Epub 2022 May 2.
The COVID-19 pandemic has highlighted the importance of coordinating policies on vaccinations at the national level. In Australia, the regulation and management of pharmacist-administered vaccination programs are the responsibility of each of the eight jurisdictions (six states and two territories), and have been developed independently of each other, leading to substantial variation. Consequently, there are variations regarding which vaccines pharmacists can administer, the minimum age, and whether these vaccines are publicly funded.
OBJECTIVE(S): To identify opportunities for a nationally consistent approach to pharmacist-administered vaccinations in Australia.
This policy analysis used the Multiple Streams Framework to identify barriers and enablers within the three "streams" of problem, policy, and politics, and how they affected the development of a national approach. Data were drawn from semi-structured interviews with 13 key policy actors and documents (pre-budget submissions and parliamentary inquiry reports). Themes were generated around actor interests, current and proposed pharmacist vaccination programs, and policymaking processes.
From the pharmacy sector, there was little clarity around the need for a nationally consistent approach. This issue was linked to their ultimate goal of expanding pharmacist vaccination programs; it was seen as a means for states/territories with smaller programs to 'catch up' to other jurisdictions. There was also no unified policy approach from this sector; additionally, decision-makers within jurisdictional health departments faced different service delivery models, policy priorities, agendas, and policy actor relationships. Lastly, there was no federal body that had the capacity to coordinate a national approach. Possible enablers include refining the problem definition and re-framing it to a patient-centric model.
Coordination of vaccination policies is an ongoing policy issue with implications for pharmacist vaccination programs and other health policy areas in which a national approach is being considered. This analysis provides insight into how this may be developed in the future.
COVID-19 大流行凸显了在国家层面协调疫苗接种政策的重要性。在澳大利亚，药剂师管理的疫苗接种计划的监管和管理由每个司法管辖区（六个州和两个地区）负责，并且彼此独立制定，导致存在大量差异。因此，药剂师可以接种哪些疫苗、最低年龄以及这些疫苗是否由公共资金资助等方面存在差异。
确定澳大利亚在药剂师管理的疫苗接种方面采取全国统一方法的机会。
本政策分析使用多流框架，在问题、政策和政治的三个“流”中确定障碍和促进因素，以及它们如何影响国家方法的发展。数据来自对 13 名关键政策行为者的半结构化访谈和文件（预算前提交和议会调查报告）。主题围绕行为者利益、当前和拟议的药剂师疫苗接种计划以及决策制定过程展开。
从药房部门来看，对于采取全国统一方法的必要性，几乎没有明确的认识。这个问题与他们扩大药剂师疫苗接种计划的最终目标有关；这被视为较小计划的州/地区“迎头赶上”其他司法管辖区的一种手段。该部门也没有统一的政策方法；此外，州/地区卫生部门的决策者面临着不同的服务交付模式、政策优先事项、议程和政策行为者关系。最后，没有联邦机构有能力协调国家方法。可能的促进因素包括完善问题定义并将其重新构建为以患者为中心的模式。
疫苗接种政策的协调是一个持续存在的政策问题，对药剂师疫苗接种计划和其他正在考虑采取全国统一方法的卫生政策领域有影响。本分析提供了对未来如何发展的深入了解。
