Mugambi, Melissa M.MToye, Timilehin Eyitayo2024-09-092024-09-092024-09-092024Toye_washington_0250O_27256.pdfhttps://hdl.handle.net/1773/51667Thesis (Master's)--University of Washington, 2024BACKGROUND: While Typhoid conjugate vaccines (TCVs) offer significant advantages, they are only available to children up to 2 years of age in Nigeria's routine immunization program. To address immunization gaps among individuals who are missed by this strategy, innovative approaches such as pharmacy-based immunization (PBI) are being explored. This study explored the perspectives of global experts on a PBI strategy for TCV, including the potential barriers and facilitators to its implementation. METHOD: From February 2024 to May 2024, we conducted 12 semi-structured interviews with global experts. We purposively sampled the experts to include individuals working within nonprofit and academic research agencies and with experience developing and implementing vaccines or working with pharmacy-based programs. Interviews were conducted via Zoom, audio recorded, and transcribed. We applied in-vivo codes and analyzed the transcripts to capture key thematic barriers and facilitators to the implementation of a PBI strategy categorized by the domains of the Capability Opportunity Motivation and Behavior (COM-B) model. FINDINGS: Experts showed great enthusiasm regarding the prospects of PBI in increasing vaccine coverage. They referred to it as an untapped resource that could significantly increase vaccine coverage in Nigeria. However, experts highlighted the need for pharmacists to be trained and certified in vaccine administration and reported that leaving unskilled or untrained persons to carry out pharmacist duties could hinder this strategy. Additionally, experts pointed out that pharmacies may lack space and cold storage and face resistance from some healthcare professionals. Clear policies are needed to address these issues. Experts discussed the need to adopt strategic approaches to incentivize pharmacists, for example, by offering business development opportunities. CONCLUSION: While experts see significant potential in using pharmacies to deliver TCV vaccines in Nigeria, addressing key challenges like pharmacist training and certification, pharmacy space constraints, cold chain storage, and potential resistance from healthcare professionals will be important for successful implementation. Further research should explore optimal policy frameworks, effective incentive programs to motivate pharmacist participation, and the resource requirements for pharmacies to deliver TCVs.application/pdfen-USnoneGlobal health expertsPharmacy based immunizationTyphoid conjugate vaccinesPharmaceutical sciencesImmunologyPublic healthGlobal HealthThesis