Gudzak Victoria, Logeman Charlotte, Crown Natalie, Ilersich Anthony N T, Folinas Mike, McMurtry C Meghan, Bucci Lucie M, Shea Christine, Shah Vibhuti, Boon Heather, Katz Joel, Dolovich Lisa, Taddio Anna
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
The Hospital for Sick Children, Toronto, Canada.
Hum Vaccin Immunother. 2025 Dec;21(1):2509484. doi: 10.1080/21645515.2025.2509484. Epub 2025 Aug 7.
Mass vaccination clinics efficiently vaccinate large numbers of people. The CARD system (Comfort, Ask, Relax, Distract) is a vaccination delivery framework that can improve the experiences of vaccine recipients and providers. This two-stage hybrid effectiveness-implementation study implemented and sustained CARD in university-based vaccination clinics involving pharmacy student vaccinators. Stage 1 was a before-and-after study conducted across four COVID-19 vaccination clinics in November-December, 2022. Stage 2 was a single cohort study whereby CARD was sustained across four COVID-19/influenza vaccination clinics in November, 2023. In both stages, vaccine recipients rated experiences relative to last vaccination () and symptoms (pain, fear, dizziness) using surveys. Pharmacy student vaccinators completed attitudes and behaviors surveys; a subsample participated in focus groups. In Stage 1, more vaccine recipients in the after period (vs. before) reported a better vaccination experience relative to their last vaccination (64.0% vs 33.6%; < .001; = 181). Fear and pain were lower (1.1 vs. 1.7, = .03; and 1.6 vs. 2.1, = .02, respectively). In Stage 2, 57.4% (95% CI: 53.1%-61.6%; = 542) of vaccine recipients reported a better experience. Across stages, pharmacy students had positive attitudes about acceptability, feasibility, and sustainability of CARD and reported high fidelity with CARD-recommended interventions. CARD is recommended for university-based vaccination clinics to improve vaccine recipient and provider experiences.
大规模疫苗接种诊所能够高效地为大量人群接种疫苗。CARD系统（舒适、询问、放松、分散注意力）是一种疫苗接种实施框架，可改善疫苗接种者和提供者的体验。这项两阶段的混合效果-实施研究在以大学为基础的疫苗接种诊所中实施并维持了CARD系统，这些诊所的疫苗接种人员为药学专业学生。第一阶段是一项前后对照研究，于2022年11月至12月在四个新冠疫苗接种诊所开展。第二阶段是一项单队列研究，于2023年11月在四个新冠/流感疫苗接种诊所维持实施CARD系统。在两个阶段中，疫苗接种者均通过调查问卷对相对于上次接种的体验以及症状（疼痛、恐惧、头晕）进行评分。药学专业学生疫苗接种人员完成态度和行为调查问卷；一个子样本参与了焦点小组。在第一阶段，后期（与前期相比）更多的疫苗接种者报告称相对于上次接种有更好的接种体验（64.0%对33.6%；P<0.001；n = 181）。恐惧和疼痛程度较低（分别为1.1对1.7，P = 0.03；以及1.6对2.1，P = 0.02）。在第二阶段，57.4%（95%置信区间：53.1%-61.6%；n = 542）的疫苗接种者报告有更好的体验。在两个阶段中，药学专业学生对CARD系统的可接受性、可行性和可持续性持积极态度，并报告对CARD系统推荐的干预措施有较高的依从性。建议以大学为基础的疫苗接种诊所采用CARD系统，以改善疫苗接种者和提供者的体验。
