THE PHILIPPINE PHARMACISTS ASSOCIATION (PPhA)

IMMUNIZING PHARMACISTS CERTIFICATION PROGRAM

TRAINING AND CERTIFICATION PROPOSAL

INTRODUCTION
For more than a decade now, the expanded role of the pharmacist on immunization has been
recognized globally, starting in the USA, which later has spread to other countries, such as, Europe,
Australia, Canada, Argentina, New Zealand, Singapore, and the Philippines (FIP, 2020 & Ciliberti, et al.,
2020).

The pharmacist is considered the first point of contact of people in the community, specifically, due to
the ease of access in terms of location and distribution in a locality, availability for prolonged operating
hours, without the need for appointments to avail of much-needed medicines for both the sick patients
and healthy individuals (Ciliberti, et al., 2020).

In the Philippines, this new role of the pharmacist as immunizer is supported by the legal mandate
articulated in Republic Act No. 10918 or the new Philippine Pharmacy Act of 2016. This is a non-
exclusive role of certified pharmacist immunizers, which allows the administration of vaccines to adults
only after they had undergone a training on the safe administration of adult vaccines including
management of adverse events following immunization (AEFI) for pharmacists (RA 10918, 2016). The
pharmacists as stipulated in the law, may administer adult vaccines, provided that the training and
certification requirements were satisfied. However, the Philippine Pharmacists Association, Inc. (PPhA),
currently the PRC-Accredited Integrated Professional Organization (AIPO) for Pharmacists recommends
that the administration of adult vaccines will be done within the premises of an FDA-Licensed
pharmaceutical outlet; EXCEPT, during public health emergency or vaccination programs initiated by the
government, where a pharmacist becomes part of the vaccination deployment team.

In this regard, the PPhA, through its Immunization Advocacy Group, developed a training program for a
Pharmacy-Based Immunization service delivery. The PPhA collaborated with the College of Pharmacy,
University of the Philippines Manila (UPM-CP), in the development of training modules and the conduct
of training of core trainers up to the regional trainers. The core trainers from UPM-CP, together with
the PPhA Immunization Advocacy Group, led by US-trained and certified immunizing pharmacists,
conducted the training of eligible faculty members from PACOP-member schools from various regions in
the country. It is envisioned that these regional trainers and assessors will serve to assist in the training
of eligible pharmacists throughout the country.

This proposal aims to describe the Immunizing Pharmacist Certification Program (IPCP) in the context
of Pharmacy-Based Immunization Service Delivery, developed by the PPhA for pharmacist immunizers,
as well as the certification process for accreditation of the PRC’s Professional Regulatory Board of
Pharmacy as the standard training program for eligible Filipino pharmacists who wish to become an
immunizing pharmacist. This is to ensure that all trained pharmacist immunizers will possess the same
skills from injection preparation to administration, and a sense of consciousness that aseptic techniques
should be observed at all times to ensure patient safety during the immunization process, as well as
equipping pharmacists with the skills to provide patient care including counseling to patients who
received the vaccine in the pharmacy. Recently, the IPCP has been adopted unanimously by the PPhA
Board of Trustees as a National Program on October 18, 2020.

This proposal also describes the important roles of the Professional Regulation Commission and PPhA
that are relevant to the implementation of the program. This proposal likewise highlights the

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PPhA Immunizing Pharmacist Certification Program
modifications in the program implementation in light of the COVID pandemic, without compromising
the expected learning outcomes of the program.

THE IMMUNIZING PHARMACIST CERTIFICATION PROGRAM (IPCP)

Legal Basis

Republic Act No. 10918 or the new Philippine Pharmacy Act of 2016 supports the expanded role of the
pharmacist on immunization. This is highlighted in Article I, sec. 4, paragraph (g), which states that
”Administration of adult vaccines as approved by the Food and Drug Administration (FDA): Provided,
That they shall undergo the training on the safe administration of adult vaccines and management of
adverse event following immunization (AEFI) for pharmacists and hold a certificate of training issued by
an institution duly accredited by the Professional Regulation Commission (PRC); Provided, Further, That
the safe administration of vaccines be part of the higher education curriculum for pharmacists;” (RA
10918, 2016).

This was reiterated in the Implementing Rules and Regulations (IRR) of RA 10918, which stipulates in
Section 16 that a pharmacist shall be allowed to administer adult vaccines provided, among others, that
he or she has undergone prior training on the safe administration of adult vaccines and management of
AEFI for pharmacists and holds a certificate of training issued by an institution duly accredited by the
PRC (IRR of RA 10918, 2017).

Further, IRR Rule I Section 6 provides the definition of adult vaccines that can be administered by a
certified pharmacist immunizer: “Adult vaccine refers to cervical cancer, flu (influenza), pneumococcal,
other pre-exposure prophylactic vaccines to be administered to patients aged 18 years and above and
such other vaccines as maybe defined by the Department of Health (DOH) in an administrative issuance
“(IRR of RA 10918, 2017).

The law likewise stipulates the following from Rule IV Section 16, that “a pharmacist shall be allowed to
administer adult vaccines: provided,

a. He/she is a pharmacist, with valid COR & current PIC.

b. The vaccine to be administered is an adult vaccine covered by a valid registration issued by FDA.
c. He /she has undergone prior training on the safe administration of adult vaccines and
management of AEFI for pharmacists and holds a certificate of training issued by an institution
duly accredited by the PRC.
d. He/she shall ensure that the vaccine to be administered shall have a doctor’s Rx, which is not
more than 7 days old.
e. He/she shall ensure that the vaccination report and AEFI report to DOH regional offices using
the prescribed form (IRR of RA 10918, 2017).
f. If vaccination is conducted in a pharmaceutical outlet:
a. It should have a valid LTO issued by the FDA;
b. Its vaccine products should have a valid Certificates of Product Registration (CPR) issued
by the FDA;
c. It should maintain Patient Medication Profile/Record;
d. It should have Standard Operating Procedures (SOPs) for vaccine storage, handling,
preparation, dispensing, administration, and disposal;
e. It should have a procedure for monitoring, handling and reporting of AEFI; and
f. It should comply with other requirements as may be prescribed by the FDA or DOH.

The IRR Rule I Section 6 also defines the term “Pharmaceutical outlet” as “an entity licensed by
appropriate government agencies, involved in compounding and /or dispensing and selling of

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PPhA Immunizing Pharmacist Certification Program
pharmaceutical products directly to patients or to end-users” (IRR of RA 10918, 2017). This includes
community pharmacy (drugstore / botica), and the hospital pharmacy and institutional pharmacy.

Rationale for offering the Program

The International Pharmaceutical Federation (FIP) has considered vaccination as one of the most
successful, safe and cost-effective health interventions (FIP, 2020). Improving vaccination coverage has
been a global strategy and pharmacists are called to join these efforts. Being the most accessible
healthcare professionals in small and large communities, pharmacists can significantly contribute to
public health and help bring the pandemic under control (FIP, 2021). Thus, the IPCP is envisioned to:

1. Promote access of Filipinos to vaccines, considered as a group of essential medicines;

2. Help increase vaccination rates among adults in the Philippines;
3. Ensure that control measures are in place, (i.e. proper patient screening prior to vaccination,
proper documentation and reporting of patients vaccinated, as well as improved reporting of
AEFI) which can result in the creation of an immunization registry); and
4. Provide a program that emphasizes the need for quality and patient care all throughout the
immunization process.

Description of the Immunizing Pharmacist Certification Program (IPCP)

This national program has been designed by the PPhA for the training of Filipino pharmacists on the safe
vaccination processes and practices, from proper storage, preparation, administration techniques,
documentation and clinical skills assessment, including the management of adverse events following
immunization (AEFI). It is anchored on the core values and principles of PPhA such as, excellence,
integrity, trust, collaboration, professionalism and altruism. The PPhA-IPCP has a practice-based
curriculum which reflects a fusion of clinical pharmacy and public health pharmacy. The training
program has been patterned with relevant modifications from the certification program and Pharmacy-
Based Immunization Delivery of the American Pharmacists Association (APhA), which has been
implemented and adopted by many countries worldwide since 2006.

Goals of the Program

The Immunizing Pharmacist Certification program hopes to achieve the following goals:

1. To provide eligible pharmacists training & certificate upon completion of the training, after
which PRC issues the certificate as immunizing pharmacist;
2. To provide the pharmacists the knowledge, skills and resources necessary to establish a
successful immunization service delivery in the pharmaceutical outlet;
3. To maintain a database of all certified immunizing pharmacists after the training;
4. To consolidate reports from the immunizing pharmacists on AEFIs & database of vaccinated
individuals which can be good sources of data for research & program improvement;
5. To provide technical support to pharmacies who would be offering the pharmacy-based
immunization service; and
6. To collaborate with relevant government agencies, such as, FDA, DOH & PRC in the formulation
of guidelines;

Qualifications of the Trainers

The IPCP has a pool of qualified trainers, all US-certified immunizing pharmacists and experienced
pharmacist practitioners in the USA. They have trained the core and regional trainers for the program
who were mostly interested faculty from the different schools of pharmacy in the country. These faculty
members were certified as trainers and at the same time, have satisfied the stipulation in the IRR to

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PPhA Immunizing Pharmacist Certification Program
enable them to teach courses dealing with vaccines, immunization, injection administration techniques
and handling of AEFI in their respective schools of pharmacy. Further, they are expected to join PPhA in
the training of eligible pharmacists from all over the country.

• The core trainers were the faculty members from the Department of Pharmacy, College of
Pharmacy, UP Manila, who mostly developed the training modules.
• The initial batch of regional trainers were faculty members from the different schools of
pharmacy (from the Philippine Association of Colleges of Pharmacy, PACOP), who were handling
the following subject areas:
a. Human Anatomy and Physiology
b. Microbiology
c. Public Health Pharmacy
d. Clinical Pharmacy / Pharmacotherapy
e. Dispensing
f. Hospital Pharmacy
g. Quality Assurance
• The succeeding regional trainers must be:
o Willing to undergo the trainers training, and
o Committed to cascade the training to eligible pharmacists to be immunizers
• In the future, PRC-certified immunizing pharmacists will also be trained as trainers for the
Immunizing Pharmacist Certification Program

Eligibility Requirements for the Pharmacist

The pharmacist must satisfy the following requirements to be able to register in the training program
and must have a:

• Valid Pharmacist PRC Professional ID (Professional Identification Card)

• Valid BLS ID card or certificate issued by the Department of Health, American Heart Association,
Philippine Red Cross, the Philippine Heart Association or any recognized certifying authority.
• Proof of Hepatitis B vaccination or acceptable titer value. (i.e. Certification from licensed
physician)

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PPhA Immunizing Pharmacist Certification Program
THE TRAINING PROGRAM AND THE CERTIFICATION PROCESS

Once the eligible pharmacist registers in the Immunizing Pharmacist training program of PPhA, the
certification process must be followed until its completion to finally become a certified immunizing
pharmacist in a pharmacy outlet. A certificate will be issued upon completion of the seven modules and
passing the post-test or comprehensive exam in Level 1 (General Vaccination Principles). This
certification will be the passport of the pharmacist to proceed to Level 2 (DOH Covid-19 Vaccination
Principles) passing the post-test in this level will provide the pharmacist the PPhA-DOH Certificate of
Training on COVID-19 Vaccination, which will qualify him or her to serve as a Cold Chain Management
Pharmacist and as an AEFI Management Pharmacist. By earning this certification, the pharmacist
becomes eligible to move forward to the skills certification program in Levels 3 (Basic Pre-Clinical Skills
Training) and 4 (Supervised Clinical Skills Training). Satisfactory completion of the last two levels in the
program will make the pharmacist a PRC- Certified Immunizing Pharmacist.

Components of the Training Program

Appendix A shows the tabular components of the Immunizing Pharmacist Training program. Appendix B
shows the instructional design for the training program.

The overall training program is made up of four (4) sequential levels:

Level 1. General Vaccination Principles

This self-paced part has the following learning objectives:
a) To discuss the roles of the pharmacist in immunization and the impact to public health
b) To provide an overview of the immune system and how vaccines work and developed
c) To explain the vaccine-preventable diseases and the benefits of vaccination
d) To describe the relationship of the immunizing pharmacist and the patient
e) To discuss the importance of cold chain management including storage and handling of
vaccines
f) To explain the operational procedures in setting up and implementing a Pharmacy-Based
Immunization service delivery.
g) To describe the important blood-borne pathogens and prevention of needlestick injury

Level 1 is composed of seven (7) modules with the following topics:

• Module 1 – Pharmacists, Vaccines and Public Health
• Module 2 – Overview of Immunology and Vaccine Development
• Module 3 – Vaccine Preventable Diseases
• Module 4 – The Immunizing Pharmacist and the Patient
• Module 5 – Storage and Handling of Vaccines
• Module 6 – Preparing to Operate a Pharmacey-Based Immunization Service Delivery
• Module 7 – Blood-borne Pathogens and Needlestick Injury

These modules for reading maybe accessed through a PPhA- accredited online platform. This part
may be completed for at least 16 hours.

A post-test or comprehensive exam to assess the learning from the self-paced part will have to be
taken by the pharmacist. The post-test is composed of 70 multiple-choice type of questions, where
the participant needs to answer online in an hour and a half or less. A passing score of 75% or
better is required to proceed in the succeeding levels of the training program. PPhA issues a

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PPhA Immunizing Pharmacist Certification Program
 certificate of completion of Level 1 which can be accessed through the PPhA accredited online
platform. Should the pharmacist fail the post-test, he or she will be given another chance to take it
again on the same sitting. Failure to get a passing score during the second take of the post-test
disqualifies the participant from proceeding to the next levels of the training program. The
certificate of completion is the passport to Level 2. At some later time, the pharmacist may enroll in
the program again.

Level 2. DOH Covid-19 Vaccination Principles

This level comprises another set of modules, specific to COVID-19 vaccination, which were
developed by the Department of Health, and can be accessed through the e-webinar platform of
DOH. Learning is facilitated by DOH trainers on COVID vaccination. Through these modules, the
participant is expected to:

a) Understand and explain information about the COVID-19 Immunization Program

b) Discuss the COVID-19 Immunization Program
c) Demonstrate the proper vaccination practices
d) Identify the requirements for the implementation of the COVID-19 Immunization
Program
e) Execute plan on the nationwide capacity building on COVID-19 immunization
Level 2 has eight (8) video-based lecture modules on the following topics:

§ Module 1 – Microplanning
§ Module 2 – Profiling and Data Management
§ Module 3 – Supply and Cold Chain Management
§ Module 4 – Risk Communication and Community Engagement
§ Module 5 – Addressing the Psychological Barriers to Vaccination
§ Module 6 – COVID-19 Vaccine Administration
§ Module 7 – Managing AEFI following COVID-19 Vaccination
§ Module 8 – Immunization Waste Management

Passing the post-test (70% passing) for this second level of the program is a requirement to earn
the PPhA-DOH Certificate of Training on COVID-19 Vaccination, which will qualify him or her to
serve as a Cold Chain Management Pharmacist and as an AEFI Management Pharmacist. Those who
fail can have a retake of the post-test. This certification is an eligibility requirement for Level 3 of
the training program. This level can be completed in at least 16 hours or two days.

Level 3. Basic Pre-Clinical Skills Training

This level comprises the basic pre-clinical skills training where the eligible pharmacist will have to
attend a 6-hour virtual training plus 2 hours of face-to-face skills assessment (to be arranged by
appointment) with the following objectives:

a) To simulate the immunization process from patient screening to informed consent

reading and signing to provision of vaccine information to adverse events management
following immunization
b) To demonstrate the techniques in the proper preparation and administration of vaccines
c) To evaluate the skills on the proper preparation and administration of vaccines using two
routes, IM and SC

1. Virtual / synchronous training

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PPhA Immunizing Pharmacist Certification Program
 The topics covered in this part are as follows:
• Simulation of the immunization process in the pharmacy
• Demonstration on the Preparation and Administration of Vaccines

o Setting-up the injection preparation area

Aseptic techniques during injection preparation and administration
o Correct intramuscular and subcutaneous administration of injection
o How to provide aftercare and counseling to patients receiving the vaccine

• Skills assessment
• Feedback on the return demonstration of techniques
2. Face to face return demo (skills assessment)

Return demonstration of techniques will be done face-to-face by scheduled appointment. This will
be done in pairs, but the assessment will be made on an individual basis. The wrap up of the entire
8-hour skills-training (virtual and face-to-face) in Level 3 includes a brief discussion to correct the
improper techniques observed during the return demo assessment, a Q and A portion to answer any
queries from the class. The pharmacist must satisfy or pass the pre-clinical skills assessment before
proceeding to Level 4. The trained regional assessors will perform the skills assessment.

Level 4. Supervised Clinical Skills Training

This level pertains to the supervised clinical skills training of the pharmacist who passed the skills
assessment in Level 3. This step is essential for the pharmacist to gain sufficient confidence in
vaccinating actual patients under the supervision of a licensed physician or a PRC-certified
immunizing pharmacist. The vaccination skills will be assessed by the physician or the PRC-certified
immunizing pharmacist, following the form provided by PPhA, who eventually will sign as proof that
the pharmacist passed this last level. The physician or assessor has the discretion of determining
the number of patients at which the pharmacist has demonstrated sufficient skills in vaccinating real
patients.
The pharmacist is expected to accomplish the following objectives:
a) To assist in the vaccination processes:
• Provide patient care before vaccine administration, including screening of patients, reading
and letting the patient sign the informed consent, registration, etc.
• Receiving, recording and storage of vaccines
• Dispensing and monitoring of administered vaccines
• Provide patient care during and after vaccine administration (patient counseling &
management of AEFIs)
• Observe actual vaccine administration

b) To administer vaccines to adult patients under the supervision of a licensed physician/ PRC-
certified immunizing pharmacist

The supervising physician or certified pharmacist immunizer will then assess the performance of the
pharmacist and will sign the assessment form as proof of satisfaction of this requirement.

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PPhA Immunizing Pharmacist Certification Program
ISSUANCE OF CERTIFICATE OF COMPLETION OF TRAINING (PPHA)
Pharmacists who have successfully completed the training program from Levels 1 to 4 will be issued a
Certificate of Completion by PPhA. Each participant is required to submit the following compiled
documentary requirements for eventual certification:

1. Certificate of achievement of Level 1 (passed the post-test/comprehensive exam)

2. PPhA-DOH Certificate of Training on COVID vaccination (Level 2)
3. PPhA Pre-Clinical Skills Assessment Form (Level 3)
4. Clinical Skills Assessment Form (Level 4)
5. Program Evaluation
6. Proof of Hepatitis B Vaccination
7. Proof of BLS training (Valid ID or certificate)

The PPhA Certificate of Completion will contain the following statement as adopted with modifications
from the American Pharmacists Association (APhA) Guidance document on Immunization Program:
https://www.pharmacist.com/sites/default/files/files/CTP%20CoAs%20IMZ%20Guidance%20Document
%20081315.pdf

“The training associated with this PPhA Certificate of Completion has been based on current
practice standards on immunization and recommendations at the time of training. The certified
trained pharmacist is responsible for engaging in Continuing Professional Development (CPD) to
be updated on current developments, recommendations, protocols related to vaccines and
vaccination and to maintain current knowledge and skills related to patient care. This
Certificate of Completion does not expire, however, in accordance to existing immunization
standards in global practice, immunizing pharmacist should maintain and have proof of
participation to mandated learning programs relevant to immunization every year, including a
valid certification on Basic Life Support (BLS). “

PPhA will then submit to PRC the list of pharmacists who have completed the training to be certified as
immunizers.

ISSUANCE OF CERTIFICATE AS IMMUNIZING PHARMACIST (PRC)

The Professional Regulation Commission will issue the Certificate as Immunizing Pharmacist based from
the submission of PPhA on the list of pharmacists who had completed the training program from Levels
1 to 4.

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PPhA Immunizing Pharmacist Certification Program
THE ROLE OF THE PRC PROFESSIONAL REGULATORY BOARD OF PHARMACY (PRC-
PRBOP)
RA 10918 requires that the immunizing pharmacist undergoes a certificate training program
administered by an institution accredited by the Professional Regulations Commission (PRC).

For the certification of the immunizing pharmacist, the envisioned roles of PRC would include the
following:

• Accredit PPhA as the national training provider for the Immunizing Pharmacist Certification
Program
• Accredit the PPhA Immunizing Pharmacist Certification Program as the standard training
program for Filipino pharmacists who wish to become pharmacist immunizers
• Issue Accreditation Card as Immunizing Pharmacist to the pharmacists who have completed the
Immunizing Pharmacists Certification Program by the PPhA.
• Renew accreditation cards whose validity would be co-terminus with their valid PRC ID.
• Monitor the practice of the immunizing pharmacist.

THE ROLE OF THE PHILIPPINE PHARMACISTS ASSOCIATION INC (PPhA)

On the other hand, PPhA’s role would include the following:

• Develop a training program for Filipino pharmacists to be certified as immunizers

• Update the existing training modules and other materials (i.e. video, slides) to be used for the
training
• Obtain an accreditation from PRC as the training provider for the certification of the Immunizing
Pharmacists.
• Obtain accreditation for the PPhA Immunizing Pharmacist Certification Program for Filipino
Pharmacists
• Provide refresher trainers’ training for the previously trained core trainers and the regional
trainers/assessors
• Provide training to interested pharmacists to become certified immunizers
• Issue a Certificate of Completion for those who will pass the training program and an
Identification Card indicating the name of the certified immunizing pharmacist
• Submit to PRC-BOP the list of pharmacists with the Certificate of Completion
• Maintain a database of all certified pharmacist immunizers including the name and address of
pharmacy they where they are employed, and the date they have completed the training
• Randomly check the performance of the Certified Pharmacist Immunizer in the first year of
offering the service
• Offer Continuing Professional Development (CPD) courses with post-test evaluation related to
vaccines and vaccination to maintain current knowledge and skills among these certified
pharmacists
• Issue Certificate of Good Standing as Immunizing Pharmacists for the renewal of the
accreditation card.

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PPhA Immunizing Pharmacist Certification Program
REFERENCES:

Ciliberti, R., Bragazzi, N. L., & Bonsignore, A. (2020). The implementation of the professional role of the
community pharmacist in the immunization practices in Italy to counteract vaccine hesitancy. Pharmacy,
8(155), 1–12. https://doi.org/10.3390/pharmacy8030155

FIP. (2020, June 25). FIP releases resource for pharmacists to expand their roles in immunization.
https://www.fip.org/news?news=newsitem&newsitem=321

FIP develops tool to support regulators in implementing pharmacy-based vaccination programmes to

combat pandemic. (2021, February 4). FIP. https://www.fip.org/press-releases?press=item&press-
item=98

Implementing Rules and Regulations (IRR) of Philippine Pharmacy Act (Republic Act 10918). (2017, May).
PRC. https://www.prc.gov.ph/uploaded/documents/Draft%20IRR%20of%20RA10918%20(090916)_e.pdf

Republic Act 10918. An Act regulating and modernizing the practice of pharmacy in the Philippines,
repealing for the purpose RA 5921, otherwise known as the Pharmacy Law. (2016, July 21). Official
Gazette. https://www.officialgazette.gov.ph/2016/07/21/republic-act-no-10918/

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PPhA Immunizing Pharmacist Certification Program
 APPENDIX A

Components of the Training Program*

(Immunizing Pharmacist Certification Program)

* Pharmacist must submit proof of Hepatitis B vaccination and valid BLS Certificate to become a fully
PRC-Certified Immunizing Pharmacist

* PRC-certified immunizing pharmacist must participate yearly to accredited CPD programs relevant
to immunization with 3-CPD credits and must ensure validity of BLS certification.

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PPhA Immunizing Pharmacist Certification Program
 APPENDIX B

Instructional Design for the Training Program

(Immunizing Pharmacist Certification Program)

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PPhA Immunizing Pharmacist Certification Program
 LEVEL 1. General Principles on Vaccination &
Immunizing Pharmacist Certification Program (PPhA)
(Self-Paced Learning Modules)

Title of the Module: Module 1. Pharmacists, Vaccines and Public Health

Description of the Module: This module provides the pharmacist with the rationale for participating
in immunization advocacy through the establishment or participation in
pharmacy-based or collaborative immunization programs. The Philippine
Health Situation is briefly explained and the benefits of immunization to
public health is emphasized.

General Objectives:
1. Describe the Philippine health situation and public health issues.
2. Explain the importance of immunization to public health.
3. Discuss the role of the pharmacist in preventive health through
immunization advocacy.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

After finishing the module, 30 minutes Online At the end of

the pharmacist will be able reading this module,
to: module for there will be
self-paced online review
1. Describe the current health A Look at the Health Situation in the questions
learning
situation in the Philippines Philippines (3 items, not
• Health indicators graded)
• Factors contributing to infectious
diseases in the Philippines

Immunization Program Benefits and

2. Explain the importance of
immunization, its evidence- Impact on Public Health
based benefits, and impact to
public health. Main Targets of Immunization Programs
• Disease eradication
• Disease elimination

Misconceptions and the Rise of the Anti-

Vaccination Movement

3. Discuss how pharmacists can Pharmacists in Immunization Programs

contribute to preventive health
Considerations in Establishing a Pharmacy-
through participation in
Based Immunization Service
immunization advocacy.
• Education and training
• Legislative framework
• Existing immunization programs in the
Philippines
• Economic factors and sustainability

Resource for Filipino Pharmacists

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PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 2. Overview of Immunology and Vaccine Development

Description of the Module: This module provides the pharmacist with a basic understanding of
the immune system and how it works, immunobiologicals and their uses,
vaccine development and their mechanism of action, and the concept of
herd immunity.

General Objectives:
1. Explain the basic principles of immunology.
2. Discuss how vaccines are developed and how they work to provide
protection.
3. Describe herd immunity.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

After finishing the module, Two Online At the end of

the pharmacist will be able hours for reading this module,
to: the whole module for there will be
module self-paced online review
1. Explain basic principles Basic Principles of Immunology learning questions
of immunology. • Anatomy and physiology of the (3 items, not
immune system graded)
• Major types of immune responses
• Types of immunity

2. Differentiate Immunobiologicals and their Functions

immunobiologicals in • For active immunization
terms of functions and • For passive immunization
examples.

3. Discuss how vaccines Mechanism of Action of Vaccines

work and provide
protection against
diseases.

4. Discuss how vaccines Product Development of Vaccines

are developed or • Formulation/components
formulated.

5. Describe the principles Rationale for Administration of

and applications of herd Vaccines
immunity
Principles and Application of Herd
Immunity

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PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 3. Vaccine-Preventable Diseases

Description of the Module: This module provides the pharmacist with basic information
regarding vaccine-preventable diseases that are a concern for Filipino
adults, their recommended vaccines, doses, schedules, as well as
precautions, contraindications, and possible adverse reactions to
these vaccines.

General Objectives:
1. Describe the epidemiology, clinical features, and potential complications of
the indicated vaccine-preventable disease.
2. Identify pharmacy patients who will benefit from vaccines using the
recommendations from professional society guidelines.
3. List the vaccines for each vaccine-preventable disease that are available in
the Philippine market, the precautions and contraindications for its use, as
well as potential adverse reactions after vaccine administration.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

After finishing the module, The topics are arranged per vaccine- Two hours Online At the end of this
preventable disease and include the for the module, there
the pharmacist will be able reading
following: whole will be online
to: module for
• Etiologic agent module
self-paced
review questions
1. Describe the • Mode of transmission (3 items, not
learning
epidemiology, clinical • Risk factors graded)
features, and potential • Spectrum of clinical illness
complications of certain • Global and national disease
vaccine-preventable distribution
diseases. • Vaccines
o List of vaccines
2. Identify vaccines available o Contraindications and
in the Philippine market, precautions
describe their features and o Potential adverse reactions
also identify precautions and after vaccination
contraindications related to Influenza
their use. • All the above topics
• Antigenic changes
3. Use recommendations • Pandemics
from professional society
guidelines to identify target Pneumococcal Disease
groups for receipt of each Tetanus, Diphtheria, Pertussis
vaccine, particularly Measles, Mumps, Rubella
influenza and pneumococcal Varicella
vaccines. Herpes Zoster
Hepatitis A
4. Counsel patients Hepatitis B
regarding the benefits of Human Papilloma Virus Infections
vaccination and possible • All the above topics
adverse reactions associated • HPV-associated cancers
with the vaccines.
Invasive Meningococcal Disease
Typhoid Fever
Rabies
• All the above topics
• Post-exposure treatment

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PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 4. The Immunizing Pharmacist and the Patient

Description of the Module: This module provides the pharmacist with an understanding of their
role in immunization service delivery in the pharmacy, including patient
care – from assessment of vaccination needs, patient screening, vaccine
administration, counseling post vaccination, until monitoring,
management and reporting of AEFI.

General Objectives:
1. Assess patient immunization needs and recommend appropriate vaccines.
4. Address patient concerns about vaccines and vaccination.
5. Describe possible adverse reactions to vaccines, how to minimize and
address these.
6. Explain the different techniques on vaccine administration.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

Three and a At the end of this

After finishing the module, Online reading
half hours for module, there will
the pharmacist will be able module for
the whole be online review
to: self-paced
module questions
learning;
1. Evaluate patient Assessment of Patient Vaccination (3 items, not
includes case
vaccination needs based on Needs discussions and graded)
age, health condition, other self-
occupation and previous paced activities
vaccines received.

2. Explain the Vaccination Schedule Case Discussion

recommended – Patient
immunization schedule for Assessment
pediatric and adult
vaccination, and
recommend appropriate
vaccines given the
recommended schedule.

3. Discuss the rationale for Timing of Vaccine Administration Case Discussion

timing and administration • Antibody-vaccine interaction –
of vaccines. • Vaccine-vaccine interaction 1. Vaccine-
vaccine
interaction
2. Timing of
vaccina
administrati
on

4. Develop screening Screening Patients Prior to Vaccine Activity 1.

questionnaire and screen Administration Develop a
patients for • Permanent contraindications to screening
contraindications and vaccines questionnaire
precautions to the • Temporary precautions to to be used in
requested vaccines. vaccines the pharmacy
• Temporary precautions to Demonstrate
receiving live vaccines patient
• Other concerns that may come screening
up during patient screening during the live
• Screening for precautions and session.
contraindications
Potential Adverse Reactions to
5. Identify potential Activity 2.

16
PPhA Immunizing Pharmacist Certification Program
 adverse reactions after Vaccines Develop an
administration of a vaccine • Managing vaccine reactions in emergency
based on signs and Adults medical
symptoms and know how • Required document: Medical protocol for
to manage these reactions. management of vaccine the pharmacy.
reactions in adults

6. Document and report • Reporting of vaccine adverse Case Discussion

adverse events following events – Adverse
immunization. Reactions to
Vaccines

Vaccine Safety Concerns

7. Educate patients Case Discussion
regarding the benefits of – Vaccine
vaccines and address Safety
concerns regarding safety Concerns
of vaccines.

8. Address common myths • Other Myths About Vaccines

by providing patients with
accurate information
regarding vaccines.

Administration of Vaccines
9. Explain the appropriate Case Discussion
techniques for the different • Staff training and education – Patient Care
routes of vaccine • Patient care prior to, during, and by the
administration. after vaccine administration Immunizing
• Infection Control Pharmacist
• Preparation of the Vaccine

How vaccines are administered

Documentation

17
PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 5. Storage and handling of Vaccines

Description of the Module: This module will provide the pharmacist with information about proper
storage and handling of vaccines, the importance of cold chain
maintenance and what to do in case of a breach, how to transport vaccines
for offsite immunization, and procedures for vaccine preparation and
disposal.

General Objectives:
1. Define cold chain and discuss its importance when handling vaccines.
2. Store vaccines properly in the pharmacy following the manufacturer’s
recommendations.
3. Develop vaccine management protocol for the pharmacy.
4. Demonstrate proper procedures for receiving, unpacking, storing, and
transporting vaccines.
5. Demonstrate proper procedures for vaccine preparation and disposal.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

After finishing the module, Three hours Online reading At the end of
the pharmacist will be able for the module for self- this module,
whole there will be
to: paced learning
module online review
1. Discuss the cold chain Vaccine Storage and Handling questions
process and its importance • Vaccines and the cold chain (3 items, not
in preserving vaccine quality. • Cold chain maintenance graded)
• Effective vaccine storage
management
• Cold chain management
requirements in the Philippines

Elements for the cold chain to be

effective
• Staff training and education
• Vaccine coordinator

Reliable Vaccine Storage Equipment

Temperature Monitoring Equipment

2. Develop a vaccine Effective Vaccine Storage Management

management protocol to be • Vaccine management protocol
used in the pharmacy. • Outreach immunization sessions
• Caring for vaccines during
immunization sessions

3. Develop procedures to be • Management of power failure

used in the pharmacy in
cases of power failure.

4. Demonstrate proper Vaccine Inventory Management

procedures regarding
receiving, unpacking, and Vaccine Deliveries
storing of vaccine deliveries.

5. Explain and demonstrate

18
PPhA Immunizing Pharmacist Certification Program
 what to do in cases of cold
chain breach.

6. Demonstrate proper Vaccine Transport

procedures for transporting
vaccines for off-site
immunization services.

7. Demonstrate proper Vaccine Preparation

procedures regarding Vaccine Disposal
vaccine preparation and
vaccine disposal.

19
PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 6. Preparing to Operate a Pharmacy-Based Immunization Service
Delivery

Description of the Module: This module will provide the pharmacist with information on the why and
how of initiating a pharmacy-based immunization service delivery including
the technical and regulatory requirements relevant to the provision of the
service, pharmacy workflow options, and marketing strategies to promote
immunization services in the pharmacy.

General Objectives:
1. Describe how to implement a Pharmacy-based immunization service
delivery.
2. List the technical and regulatory requirements relevant to the provision of
immunization in the pharmacy.
3. List the different workflow options for implementing a Pharmacy-based
immunization service delivery.
4. Use marketing strategies to promote immunization services in the
pharmacy.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

One and a At the end of this

After finishing the module, Online
half hours for module, there
the pharmacist will be able reading
Engagement of Filipino Pharmacists in the whole module for will be online
to:
Pharmacy-Based Vaccination Service module review questions
self-paced
1. Describe important (3 items, not
learning
considerations when graded)
deciding to start pharmacy-
based vaccination services.
Regulatory and Technical Requirements
2. Discuss the different
regulatory and technical • Pharmacy
requirements for a • Immunizing health professional
vaccination service.
Record Keeping and Documentation

Occupational Hazards of Vaccination

Services and Appropriate Interventions

Strategies for Pharmacy-Based

Immunization Service Delivery.

3. Differentiate workflow Workflow Models for Immunization

options for implementing Services
Pharmacy-Based
Immunization Service
delivery.

4. Prevent and manage Prevention and Management of

adverse events and Adverse Events and Emergencies
emergencies.

5. Use marketing strategies Marketing Strategies to Promote

for promoting pharmacy- Immunization Services
based immunization service
delivery to the public.

20
PPhA Immunizing Pharmacist Certification Program
 Title of the Module: Module 7. Bloodborne Pathogens and Needlestick Injury

Description of the Module: This module will provide the pharmacist with an understanding of
what bloodborne pathogens and needlestick injuries are, why they
are relevant to the immunizing pharmacist, how to minimize
exposure and occurrence, what to do in case of exposure, and
documenting the incident.

General Objectives:
1. Define bloodborne pathogens.
2. Define needlestick injury.
3. Describe how exposure occurs and how to control it.
4. Demonstrate proper handling and disposal of sharps to minimize
needlestick injury.
5. Develop an exposure control plan for the pharmacy.

Time Teaching
Learning Outcomes per Topic Topics to Be Discussed Evaluation
Allotment Methods

After finishing the module, the pharmacist will Three hours for Online At the end
the whole of this
be able to: reading
Bloodborne Pathogen module module for module,
1. Define bloodborne pathogens and discuss Standard there will
self-paced
why this is a concern for immunizing be online
learning
pharmacists. review
questions
Bloodborne Pathogens (3 items,
2. Identify bloodborne pathogens of primary
concern and discuss what to do in case of • Hepatitis B not
exposure. • Hepatitis C graded)
• HIV

3. Define needlestick injury and list ways to Needlestick Prevention

prevent it. • What to do in case of
needlestick injury
4. Demonstrate proper sharps disposal. Post exposure follow-up

5. Describe what to do in case of needlestick

injury.

6. Develop a sharps injury log for the • Sharps Injury Log

pharmacy.

7. Define universal precaution and explain how Universal Precaution

bloodborne pathogens enter the body. How Exposure Occurs

Exposure Control Plan

8. Define exposure control plan.
• Exposure controls
9. Demonstrate proper handwashing. • Engineering controls

10. Demonstrate proper donning and doffing of Work practice controls

gloves.

11. Demonstrate one-handed needle-scoop

technique.

12. Develop an exposure control plan for the

pharmacy.

Level 1 Assessment:

21
PPhA Immunizing Pharmacist Certification Program
 This is a post-test or comprehensive exam composed of a 70-item multiple choice questions. The pharmacist
trainee would need a score of 75% to pass the post-test. Should the trainee fail on the first take, he or she is given
another chance to take the post-test on the same sitting.

A PPhA Certificate of Completion for Level 1 will be issued to the trainee, and this will allow the trainee to proceed
to Level 2.

LEVEL 2. DOH COVID-19 Vaccination Deployment

(DOH Facilitated Learning Modules for COVID-19 Vaccination Training)
(Source: DOH COVID-19 Immunization Training Design)

Description of the Program:

This training course is developed to give guidance to health workers and partner implementing agencies on
the efficient nationwide implementation of the COVID-19 Immunization Program. Content experts on COVID-
19, vaccination, human resource training, data management, logistics, health communication and counseling,
surveillance and waste management were consulted for development of this training course. This training
course encompasses the whole spectrum of the delivery of services from pre- to post-implementation.

This training course shall update the skills and knowledge of our program coordinators and implementers,
surveillance teams, community health educators and workers and partner agencies on vaccination in
consideration to dealing with a communicable/ infectious disease and managing and administration of a new
vaccine.

Course Objectives:
The training aims to:
1. Discuss the basic principles about COVID-19 Immunization Program and COVID-19 vaccine
2. Identify the knowledge and skills needed for the implementation of the COVID-9 Immunization Program.
3. Capacitate the trainers on blended teaching and learning modalities.
4. Develop a plan on the nationwide capacity building on COVID-19 immunization.

Time Teaching
Learning Outcomes Content Evaluation
Allotment Methods

After the learning Module 1 – Microplanning This is a 2-day Different Pre- and Post-test
sessions, the participant facilitated teaching • This is a virtual pre-
should be able to: learning strategies will and post-test
Module 2 – Profiling and Data session administered through
Management be employed.
Google Forms
1. Understand and
• Virtual
explain information Module 3 – Supply and Cold • Passing rate is 70% ,
lecture
about the COVID-19 Chain Management those who fail may
presentati
Immunization Program retake post test
ons
Module 4 – Risk
2. Discuss the COVID-19 Communication and • Discussion Post training
Immunization Program Community Engagement Supervision
• Question
• Post training
Module 5 – Addressing the and
supervision and
3. Demonstrate the Psychological Barriers to answer
mentoring will be
proper vaccination Vaccination session
scheduled to
practices
• Self- monitor activities
Module 6 – COVID-19 Vaccine directed and issues and
4. Identify the Administration learning concerns of the
requirements for the via DOH trained teams.
implementation of the Academy
Module 7 – Managing
COVID-19 E-Learning Training Evaluation
Adverse Events Following
Immunization Program Platform • Administered
COVID-19 Vaccination
virtually via Google

22
PPhA Immunizing Pharmacist Certification Program
 5. Execute plan on the (AEFI) Forms, where link
nationwide capacity or QR code is
building on COVID-19 Module 8 – Immunization posted to access
immunization Waste Management the form

23
PPhA Immunizing Pharmacist Certification Program
 LEVEL 3. Skills Training and Skills Assessment Session
(Pre-Clinical Training Skills Assessment)

Title of the Session: PPhA Immunizing Pharmacist Certification Program Skills Training and Skills
Assessment Session

Description of the Session: This skills training session will provide the pharmacist with a simulation of
the immunization process in the pharmacy. This covers demonstration on
proper injection preparation and administration techniques, as well as a
discussion and demonstration of the immunization process as it occurs in
the pharmacy setting.

The skills assessment part of the session will help determine the
preparedness of the pharmacist in injection preparation and
administration.

General Objectives:

1. Demonstrate proper injection preparation and administration techniques.

2. Administer intramuscular and subcutaneous injection.
3. Provide patient care before, during, and after administration of vaccines.
4. Identify symptoms, manage, report, and document any adverse effects
after immunization (AEFI).
5. Evaluate techniques in the immunization process.

Learning Outcomes per Time Teaching

Topics to Be Discussed Evaluation
Topic Allotment Methods

After finishing the 6 hours Injection

module, the discussion for Preparation and
pharmacist will be able the Administration
demonstration Techniques
to:
Demonstration of screening the of the Individual
patient before vaccine immunization Assessment:
1. Demonstrate proper administration. process in the Virtual
patient care before, pharmacy Discussion and Demonstration of
during and after the demonstration skills on:
immunization process.
2. Screen patients prior 1.Screening the
to vaccine patient
administration. 2. Injection
3. Describe the different Preparation and Administration of preparation
routes of vaccine Vaccines 3.Injection
administration. • Routes of Administration administration
4. Documentation
of vaccination
process
4. Demonstrate proper • Setting up workspace for vaccine Virtual
injection preparation, preparation and administration Discussion and
while always observing
Demonstration
aseptic techniques. • Injection preparation And will be
evaluated by
5. Demonstrate how to • Injection site preparation Virtual Pharmacist
prepare and disinfect Discussion and immunization
injection site. trainers based on
Demonstration the criteria

24
PPhA Immunizing Pharmacist Certification Program
 6. Demonstrate proper • Intramuscular (IM) and 2 hours for Face to face indicated on the
injection subcutaneous (SC) injection return return Injection
administration, while administration demonstration Demonstration Preparation and
always observing face-to-face by pairs Administration
aseptic techniques. with evaluation Techniques
feedback Assessment Form
7. Provide after care After the Shot
Face to face
instructions to patients • After care instructions
return
after vaccine • AEFI monitoring Demonstration
administration. by pairs

Level 3 Pre-clinical Skills assessment:

Pharmacist trainee works with a partner and demonstrates the immunization process from patient
screening to injection preparation and administration of one (1) IM injection and one (1)
subcutaneous injection to a partner using the appropriate syringe size, needle length and needle
gauge and injection site. The product to be administered is sterile normal saline.

Pharmacist trainee is given about about 2 hours (by appointment with an assessor – core and
regional trainers) to complete the skills assessment following the criteria in the assessment form.

This will be followed by a feedback discussion on the techniques observed especially those that
need further improvement.

25
PPhA Immunizing Pharmacist Certification Program
 LEVEL 4. Supervised Clinical Skills Development
(Clinical Training Skills Assessment)

Title of the Program: PPhA Immunizing Pharmacist Certification Program Supervised

Clinical Skills Development

Description of the Program: In the supervised clinical skills development, the pharmacist trainee
will be under the supervision of an assessor (either a licensed
physician or a PRC-certified pharmacist immunizer) where he or she
will initially observe and assist in various steps in the immunization
process, including vaccine preparation and actual vaccine
administration to a patient.

The clinical training skills assessment will enhance the

pharmacist trainee’s confidence in administering vaccines
based on the evaluation and recommendation of the assessor.

General Objectives:
1. Assist in the vaccination processes.
2. Demonstrate proper injection preparation and administration
while observing aseptic techniques.
3. Administer intramuscular and subcutaneous injections.
4. Document the vaccination process in the form provided.

Learning Outcomes per Topics to Be Time Teaching

Evaluation
Topic Discussed Allotment Method

After finishing this level, 8 hours Supervised- Assessment of Skills in

the pharmacist should be (depending the Vaccination
able to: on the demonstratio Process as supervised
assessor) n of the by assessing clinician,
No discussion vaccination or certified pharmacist
a. Demonstrate proper process immunizer:
patient care before, during
and after the immunization 1.Screening the
process. patient
2. Injection
b. Demonstrate proper No discussion preparation
preparation and 3.Injection
administration of vaccines as administration
supervised by a licensed 4. Documentation of
physician or certified vaccination process
immunizing pharmacist
 27

Level 4 Clinical Skills assessment:

The pharmacist trainee will perform assisting roles in the vaccination process under the
supervision of an assessor (i.e. licensed physician or certified immunizing pharmacist). They
can initially observe, assist, and eventually administer the vaccine to individual patients.

The pharmacist trainee will be evaluated by the supervising assessor based on the criteria
provided on the PPhA-IPCP Injection Preparation and Administration Techniques Assessment
Form.

The assessor will indicate whether the pharmacist trainee is ready and has sufficient
confidence and skill to administer vaccines or would recommend the need for further training.
The assessment form is signed by the assessor to signify that the injection preparation and
administration were satisfactorily done under his or her supervision.

27
PPhA Immunizing Pharmacist Certification Program