Objectives: To describe pharmacy stages of involvement in outsourced and inhouse immunization services and to explore the variability of stages of involvement across the sampled states.
Design: Cross-sectional study.
Setting: Community pharmacies in 17 states, between July 2005 and February 2006.
Participants: Key informants of 2,558 community pharmacies.
Intervention: Computer-assisted telephone interviews regarding pharmacy involvement in immunization services.
Main outcome measure: Pharmacies' stage of involvement in immunization services, based on the following categories: no interest; interested, no plan; planning; implemented; discontinued; and no response.
Results: Of 2,558 community pharmacies, 1,707 (69.1%) completed the interview. For outsourced immunization services, about one-half of participating pharmacies (50.6%) implemented and planned to implement the services while only 20.7% had no interest in offering the services. These percentages contrast sharply with inhouse immunization services: 24.7% of pharmacies in this category implemented and planned to implement the services and 38.1% indicated no interest in offering the services. Involvement in immunization services varied widely across the 17 states. For outsourced services, implementation ranged from 17.5% to 68.8% of pharmacies, while 13.5% to 39.3% had no interest in the services. For in-house services, implementation ranged from 0% to 42.1% of pharmacies; 19.6% to 49.5% had no interest.
Conclusion: Understanding stages of pharmacy involvement in immunization services should allow design and implementation of more effective strategies for increasing involvement and decreasing abandonment of immunization practices.