Rabies Post-Exposure Prophylaxis Referral Program - Impact of Expanded Vaccine Access on Immunization Rates

Completion of rabies post-exposure prophylaxis (rPEP) remains suboptimal due to vaccine access variables and barriers during follow-up. This study evaluated whether community pharmacy referral improves rPEP series completion as compared to emergency department availability alone.

A hospital improvement plan was implemented across a 16-emergency department (ED) health system. Patients initiating rPEP in the ED with revised electronic medical record (EMR) guidance were referred to a newly formed network of community pharmacies for rPEP series completion. Completion rates before and after implementation were compared, and logistic regression identified predictors of series completion.

During the intervention period, 367 patients initiated rPEP. Patients who chose at least one vaccine dose in a community pharmacy had higher completion rates than ED-only patients (80.0% vs 49.7%) RR 1.6; 95% CI, 1.3-2.0. rPEP patients who utilized a community pharmacy were 3.036 times (aOR=3.036; 95% CI= (1.172 - 7.861)) more likely to finish the entire series compared to those who did not utilize a community pharmacy.

Community pharmacy is a viable resource to expand rPEP vaccine access and improve vaccine series completion as compared to emergency department visits alone.