title: A literature review of the impact of pharmacy students in immunization initiatives.
abstract: BACKGROUND
  Pharmacy students can help protect the public from vaccine-preventable diseases by participating in immunization initiatives, which currently exist in some Canadian and American jurisdictions. The objective of this article is to critically review evidence of student impact on public health through their participation in vaccination efforts.
  
  
  METHODS
  PubMed, CINAHL, Cochrane Database, EMBASE, International Pharmaceutical Abstracts, Scopus and Web of Science electronic databases were searched for peer-reviewed literature on pharmacy student involvement in vaccination programs and their impact on public health. Papers were included up to November 17, 2015. Two reviewers independently screened titles and abstracts and extracted data from eligible full-text articles.
  
  
  RESULTS
  Eighteen titles met all inclusion criteria. All studies were published between 2000 and 2015, with the majority conducted in the United States (n = 12). The number of vaccine doses administered by students in community-based clinics ranged from 109 to 15,000. Increases in vaccination rates in inpatient facilities ranged from 18.5% to 68%. Across studies, student-led educational interventions improved patient knowledge of vaccines and vaccine-preventable diseases. Patient satisfaction with student immunization services was consistently very high.
  
  
  CONCLUSIONS
  Methodology varied considerably across studies. The literature suggests that pharmacy students can improve public health by 1) increasing the number of vaccine doses administered, 2) increasing vaccination rates, 3) increasing capacity of existing vaccination efforts, 4) providing education about vaccines and vaccine-preventable diseases and 5) providing positive immunization experiences.
  
  
  CONCLUSIONS
  Opportunities exist across Canada to increase pharmacy student involvement in immunization efforts and to assess the impact of their participation. Greater student involvement in immunization initiatives could boost immunization rates and help protect Canadians from vaccine-preventable diseases.
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Dana
authors.initials: D
authors.lastname: Church
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Sarah
authors.initials: S
authors.lastname: Johnson
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Lalitha
authors.initials: L
authors.lastname: Raman-Wilms
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Eric
authors.initials: E
authors.lastname: Schneider
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Nancy
authors.initials: N
authors.lastname: Waite
authors.affiliation: School of Pharmacy (Church, Johnson, Waite, Pearson-Sharpe), University of Waterloo, Kitchener.
authors.forename: Jane
authors.initials: J
authors.lastname: Pearson Sharpe