Vaccine on-demand service: One shot or a sustainable prevention?

Hajj season is the annual Islamic pilgrimage where about two million pilgrims gather every year in Makkah, Saudi Arabia. Hajj is mandatory for every adult Muslim to undertake at least once in their lifetime (Charrel et al., 2015). This mass gathering poses a major public health challenge to the Ministry of Health (MOH) in Saudi Arabia because it is associated with an increased risk of transmitted respiratory infections, which can spread rapidly among the pilgrims and to local population (Memish et al., 2014). This fear has been rising continuously, particularly over the last couple of years, and is still ongoing given the increase in flu outbreaks globally (Cox and Subbarao, 2000). During the Hajj, it is estimated that at least one-third of pilgrims will be affected by respiratory viruses which result in significant morbidities and mortalities along with their impact on direct healthcare spending and productivity loss (Memish et al., 2014).

Inevitably, serious attempts were put forth to mandate certain vaccinations for all pilgrims (Alzeer, 2009). Moreover, there is a great ongoing effort by various health regulatory bodies in Saudi Arabia to boost vaccination rates to meet the desired target of 90% of Healthy People 2020 for influenza vaccination (People, 2020, 2016). The current rate largely falls short of that target, which provides a clear national signal for the need to increase vaccination rate particularly for adult and older individuals (Alfelali et al., 2016). Subsequently, the MOH has adopted a new approach and collaborated with the international ride-share service Uber to launch a vaccine on‐demand campaign. During this five‐day campaign, Uber users can get a free flu shot and meningitis vaccine delivered to their homes. This innovative service aimed to overcome some of the barriers to vaccination by making it easier for people to receive vaccines. It is hoped that this service will increase the vaccination rate in the community, especially with the approach of the Hajj (Brownstein et al., 2015).

Vaccine on-demand service has already been employed in several cities around the world (Brownstein et al., 2015). Although this approach has captured our attention, there is keen interest in how the Saudi community will react and use the service because it faces a number of challenges. Among the potential challenges are the sustainability of the service given the cost and health care professionals needed specially with a significant decline in oil prices which may have a negative impact on the health care system in Saudi Arabia (Elachola and Memish, 2016).

On the other hand, one large sector of the pharmacy services in Saudi Arabia is the community pharmacy which offers convenient locations, high distribution in every neighborhood and streets, and is easily accessible with extended working hours. These factors put the community pharmacy in a unique place and appealing alternative for providing vaccination services to the community (Papastergiou et al., 2014). Moreover, community pharmacies often have a high volume of public traffic. This advantage could be used not only to provide vaccinations, but also to promote patient education about immunization, encourage individuals to receive recommended vaccines as per local and global recommendations, and monitor vaccine safety (Papastergiou et al., 2014).

Pharmacy practice has changed over recent decades, and in countries such as United States, Canada, Australia and United Kingdom the importance and benefit of community pharmacists providing vaccination services has already been recognized (Hogue et al., 2006). Pharmacists are highly trained and knowledgeable about vaccines, and they have proven their ability to immunize and positively influence the vaccination rate in their communities (Papastergiou et al., 2014, Hogue et al., 2006). Likewise, patients appreciate this service and express a high degree of satisfaction with vaccination by a community pharmacist (Steyer et al., 2004).

There is a great opportunity in Saudi Arabia to increase the overall immunization rate for adult individuals in our community with lower cost and broader accessibility model to this critical service. This is the ideal time for health regulatory bodies in Saudi Arabia and in the region to fully utilize the pharmacists’ training and expertise by expanding their role to include providing immunization services via community pharmacies.

It is hoped that the role of pharmacists will be expanded to deliver more patient‐directed services in Saudi Arabia to meet the Saudi Arabia 2030 vision. One of the aims for 2030 is to enhance the quality of health care services and increase the options available to individuals in their communities (Kingdome of Saudi Arabia’s Vision 2030, 2016). Implementation of community pharmacy vaccination service may create not only an upsurge in the number of people vaccinated and a consequent reduction in vaccine‐preventable infectious diseases, but it will also provide a safer alternative to efforts such as the Uber vaccine-on-demand campaign. Future research on the feasibility and attainability of providing vaccination service to society through community pharmacists in Saudi Arabia is warranted.