Wisconsin’s not seeing a problem with “pharmacy deserts” harming its COVID-19 vaccination efforts. In fact, pharmacies are a big help.
Pharmacy deserts refer to areas with limited or no access to community pharmacy services. The federal government sponsors systems to identify and define areas with shortages of health professionals or facilities, such as Health Professional Shortage Areas. But no such designation exists for community pharmacies.
“Community pharmacies are a key component of the COVID-19 vaccination plan, and are also key to expanding access to other vaccinations as well,” said UW-Madison School of Pharmacy Professor Kevin Look. “However, those individuals living in pharmacy deserts will definitely be disadvantaged when it comes to access to the vaccine.”
Look is the lead author on a paper currently under review by the Journal of the American Pharmacists Association. It found 99 percent of the Wisconsin population lives within 20 minutes of a pharmacy and 89 percent live within 10 minutes of a pharmacy.
In fact, pharmacies are proving to be a strength of Wisconsin’s vaccination efforts.
As of Monday, Wisconsin had 698 pharmacies enrolled as COVID-19 vaccinators, making up about half of the state’s total vaccinators. DHS Deputy Secretary Julie Willems Van Dijk said pharmacies’ wide networks, walk-in style appointments, flexible hours and relationships with their customers and patients make pharmacies strong partners.
“Wisconsin is far ahead with pharmacies than many other states and part of that is we have worked with pharmacies for quite some time to be active vaccinators,” she said, adding that a great percentage of flu shots are administered in pharmacies annually.
Most of Wisconsin’s pharmacies have gotten doses of the COVID-19 vaccines but not necessarily every week. Last month, the department limited vaccine distribution for those that requested fewer than 50 doses for the week. The smallest amount of Moderna vaccine that the state can ship is 100 doses, Willems Van Dijk explained. DHS does not want extra doses sitting on shelves for vaccinators that have smaller demand. While the state can ship smaller amounts of Pfizer vaccine, it’s too difficult for the state to make so many deliveries for such small quantities for a vaccine with stringent storage and handling requirements.
Willems Van Dijk said as the state gets more vaccine doses, it would become possible to get smaller amounts of vaccine to smaller providers. For example, 100 doses of the Moderna vaccine could be sent every three or four weeks to a vaccinator who can put 30 shots in arms every week.
“We recognize the value particularly that small pharmacies in small towns bring to us, but again, they’re not going to have the kind of foot traffic that a CVS or a Walgreens in a downtown urban area is going to have,” she said. “And so we have to make some adaptations to make sure that we can get vaccine to those smaller, great pharmacies in little towns in Wisconsin.”
Pharmacy deserts most commonly refer to urban areas with limited or no pharmacy access, Look said. For example, in Chicago, pharmacy deserts within the city exist because of lack of profitability of locating a pharmacy there, perceived safety concerns or lack of fit with the local community — like not having Spanish-speaking staff in a primarily Latino area, Look explained.
Transportation is a huge barrier in urban areas where many people rely on public transportation. It could take a significant amount of time — or time off of work — to travel to the location.
“If you had to travel an hour by bus during work hours to get to a pharmacy located miles away, that would definitely result in disproportionate access and lower vaccination rates,” Look said.
Urban pharmacy deserts are much less of an issue in Wisconsin due to the smaller nature of its cities. But Look said the state’s largest city, Milwaukee, has some areas with higher populations of low-income individuals and those with limited English proficiency that would likely qualify as pharmacy deserts.
According to the census, Milwaukee County has a 27.2 percent Black and 15.6 percent Latino and Hispanic population. But vaccination data from the Department of Health Services show only 11.8 percent of those who have gotten at least one dose are Black and 6.2 percent are Latino or Hispanic.
“However, pharmacy deserts can exist anywhere, including in rural areas,” said Look, who works with the Wisconsin Office of Rural Health to better understand pharmacy access in Wisconsin. This is part of the School of Pharmacy’s new rural health program that focuses on preparing pharmacy students to practice in underserved areas, such as rural, inner-city urban or tribal health.
Large areas and sometimes even entire counties that don’t have community pharmacies in the U.S. could very easily be classified as pharmacy deserts, Look said.
Nationwide, 111 rural counties have no pharmacy capable of administering COVID-19 vaccines, according to a recent report by Kaiser Health News. Only northern Florence County in Wisconsin is without at least one pharmacy, but it’s doing above average, having fully vaccinated 15 percent of its population. In many other places, pharmacies exist but residents need to travel long distances to reach them.
“We know that many rural individuals have to travel long distances to receive health care, with some people traveling hours to receive specialty care in larger cities,” Look said. “Community pharmacies are often the only formal health care facility located in rural areas.”
-By Stephanie Hoff