To compare earlier (sustainers) and later (new) adopters in terms of pharmacy characteristics and characteristics of in-house vaccination services and to identify how sustainers modified their in-house vaccination services over time.
Nonexperimental multistage study.
Washington State during 2003, 2004, and 2006–2007.
Community pharmacies included in this study's analyses must have participated in all data collection stages and provided in-house vaccination services during the third stage. Based on key informants' self-reports, those who had provided in-house services before or since 2003 were sustainers and those who started their services after 2004 were new adopters.
Main outcome measures
Pharmacy characteristics and characteristics of in-house vaccination services offered in 2003 and 2006 were measured in terms of service accessibility, scope, and supportive personnel.
A total of 37 sustainers and 27 new adopters met the inclusion criteria. The majority of independent and supermarket pharmacies were sustainers, whereas the majority of chain and mass merchant pharmacies were new adopters. In-house services offered by sustainers were broader in service accessibility and scope and involved a greater number of pharmacists trained in immunization delivery than services offered by new adopters in the same year. Further, when comparing sustainers' in-house services offered in 2003 and 2006, the 2006 services were expanded to provide year-round services, involved a greater number of settings, included services to adolescents, and involved a greater number of trained pharmacists.
Community pharmacies started their in-house vaccination services on a small scale and later expanded to a larger scale. Pharmacies with expanded in-house services can make greater contributions to their business, their patients, and the profession by bringing in additional revenues, improving vaccination rates among high-risk patients, and facilitating the growth of pharmacy-based services.