title: Pharmacy immunization partnerships: a rural model.
abstract: OBJECTIVE
  To describe the Pharmacy Immunization Project, a pharmacy/county health department (CHD) partnership model for immunizing infants and adults in rural areas, and to develop service procedures and disseminate lessons learned for adapting the model to different settings.
  
  
  METHODS
  Independent community pharmacies in five contiguous rural counties in West Virginia.
  
  
  METHODS
  Participating pharmacies varied markedly in space, prescription volume, and population of service areas.
  
  
  METHODS
  Childhood and adult immunization service.
  
  
  METHODS
  Pharmacists partnered with nurses from CHDs to offer year-round immunizations at times when other providers were typically closed. Working under standing orders of the CHD medical directors, nurses also conducted routine well-baby examinations in the pharmacy. Promotions involved direct mailing, posters, fliers, direct communication, and ads in newspapers, radio, and TV.
  
  
  METHODS
  Pharmacists' and CHDs' continued willingness to participate, use of the service by local citizens, and feedback from participants and other health care providers and the West Virginia Immunization Program (WVIP).
  
  
  RESULTS
  All sites except one continued their participation through the life of the project. The one exception was a pharmacy with few infant patients, which discontinued participation during year 4 of the project. Remaining sites were used and well accepted by the community. The WVIP remains a loyal supporter, and no problems arose with local health care providers.
  
  
  CONCLUSIONS
  The model appears adaptable to urban as well as rural practice and to chain as well as independent practice in states not authorizing pharmacists to administer vaccines, for pharmacists who for other reasons prefer not to administer, and for those who prefer to offer adult immunization on a seasonal basis. From the CHD perspective, the partnership model is useful in establishing "satellite" locations to target hard-to-reach patients. Recommendations regarding agreements and responsibilities are available, as are lessons learned during project development.
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26505, USA. srosenbluth@hsc.wvu.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Rosenbluth
authors.forename: S S
authors.initials: SS
authors.lastname: Madhavan
authors.forename: R D
authors.initials: RD
authors.lastname: Borker
authors.forename: L L
authors.initials: LL
authors.lastname: Maine
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D003157:Community Pharmacy Services / Q000458:organization & administration; D003159:Community-Institutional Relations; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007223:Infant; D017146:Models, Organizational; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D014903:West Virginia