Honors Theses

Date of Award

12-2025

Document Type

Undergraduate Thesis

Degree Name

BS

Department

Biology

Faculty Mentor

Casey Daniel, Ph. D.

Advisor(s)

Nancy Rice, Ph. D., Jeremiah Henning, Ph.D.

Abstract

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska Native. However, fewer than seven community pharmacies have enrolled as VFC providers in Alabama, with some later discontinuing participation. This study seeks to understand VFC pharmacies' experiences with the program, reasons for unenrollment (when applicable), potential barriers that might deter other pharmacies from enrolling in the future, and strategies for improvement and increasing community pharmacy VFC enrollment. Nine one-on-one qualitative, semi-structured virtual interviews were conducted from June 2024-August 2024 with relevant stakeholders, including four current VFC pharmacists, one former VFC pharmacist, and four employees from the Alabama Department of Public Health (ADPH). Verbal interviews were transcribed and analyzed using NVivo qualitative data analysis software. Most pharmacists described their communities as medically underserved, with few or no local providers and limited access to preventive health resources such as vaccines. They viewed offering VFC vaccines as a vital community service, often driven by a strong sense of responsibility to fill gaps in care. Pharmacists were motivated by their roles as trusted, accessible healthcare professionals in areas where options are otherwise scarce. However, participation in the VFC program was hindered by logistical challenges, such as cold chain management, hnmPRINT (hnmunization Patient Registry with Integrated Technology) integration, and administrative burden, with low reimbursement cited as a major barrier to long-term sustainability. These findings underscore both the potential and the current limitations of leveraging pharmacies to increase vaccine access in underserved areas. Community pharmacies offer opportunities for increased and equitable access to preventive services like vaccination, increasing potential for positive, long-term health impacts for the rural areas they serve. However, strategies must be developed to ensure the sustainability of pharmacies as VFC providers over time, ensuring access to underprivileged and underserved children in medically underserved areas of Alabama and beyond.

Comments

© 2025 Myra Bajwa ALL RIGHTS RESERVED

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