Leveraging Community Drug Outlets for Vaccination Delivery in Tanzania: A Qualitative Study to Inform Future Implementation

Objective A prior pre-implementation survey in Tanzania identified moderate feasibility and low acceptability of integrating vaccination services into community drug outlets (CDOs). The qualitative review was conducted to gain deeper insight into the factors influencing the feasibility and acceptability of integrating vaccination services into CDOs, such as community pharmacies and Accredited Drug Dispensing Outlets (ADDOs). Methods A descriptive qualitative design was employed as part of an explanatory sequential mixed-methods approach. Interviews were conducted with purposively sampled stakeholders, guided by findings from the prior survey. Interviews were audio-recorded and transcribed verbatim, then thematically analyzed using implementation science frameworks, with coding supported by Nvivo software. Results Six themes emerged: feasibility, acceptability, training, policy, infrastructure, and economics. Community pharmacies were viewed as more feasible and better equipped than ADDOs, which face more severe challenges related to limited space, inadequate cold chain capacity, and insufficient staffing. Acceptability was higher for pharmacies, though both settings (pharmacy and ADDO) require policy, training, and infrastructure improvements. Conclusion Community pharmacies show greater readiness than ADDOs for vaccine delivery due to better infrastructure, professional staffing, and regulatory alignment. However, both face challenges requiring policy reform, training, and support systems. Future studies should assess operational readiness and develop national standards to guide safe, equitable, and sustainable pharmacy-based immunization services.