What Are You Famous For?

Celebrating Non-traditional Vaccine Programs

By Dale Dauten, Syndicated Columnist

When you study success, whether it’s successful organizations or people, you are looking for that one thing that’s special. Said another way, you are seeking answers to question like these:

What are you great at?

What are you famous for?

Today we get to meet someone who has interesting answers to those questions: Tana Kaefer. (When we asked how she pronounces her name, she laughed and said, “Tana rhymes with banana and Kaefer rhymes with wafer, so just remember Tana Kaefer, banana wafer.” You can’t forget that.) Tana has a Doctorate of Pharmacy from Virginia Commonwealth University and is Director of Clinical Services at Bremo Pharmacies in Richmond, Virginia.

Here’s what caught our eye: Tana leads the clinical efforts at Bremo Long Term Care Pharmacy – that’s their operation dedicated to the needs of residents of group homes and small assisted living facilities, currently serving over 300 such accounts, many of them specializing in intellectual handicaps and mental illness.

As so often happens with an organizational specialty, Bremo’s grew out of meeting a specific customer/patient need. Tana explained the origins of their business model this way: “Some thirty years ago there was a move to get people out of state mental hospitals and into the community — the Virginia legislature decided that too many people were being kept in hospitals who were capable of living in the community with a bit of help managing medication and other basic needs. The founders of Bremo Pharmacy believed in being an active part of the community and thus the pharmacy worked on ways to better serve the new group homes and assisted living facilities sprouting up in central Virginia.”

In addition to synchronizing medications and bubble-packing prescriptions, the folks at Bremo helped develop a program to train employees of group homes and assisted living facilities on medications – this became a 32-hour course for Medication Aides. They also developed a vaccination program. Tana takes it upon herself to personally do an onsite clinic for any of the homes/facilities that have 10 or more people (residents and employees) needing vaccinations.

“This is mostly during flu shot season,” she told us, “but before I go out I assess the patients at the home and take other vaccines — Tdap, Shingrix and others.” Given that the residents are people who need assistance, many with intellectual disabilities, you can imagine how grateful group home staff people are that Bremo comes to them for immunizations. As Tana put it, “I tell students on rotation that come with me to these flu clinics that if they can handle patients we see, they’ll be able to give a shot to pretty much anyone.”

Having had patients swing at her, bite her and spit at her, Tana says she has become a master of “the creative distraction, and the really fast shot.” But she laughs about those experiences, and against that she can count all those patients who remember her and are glad to see her, including one blind girl who knows Tana’s voice and who tells her, “I’m a flu shot lover.”

While Bremo Pharmacy has retail locations, Tana and her team are in a “closed door pharmacy,” meaning that it doesn’t have retail traffic, but remains focused on training and on being a Long Term Care Pharmacy, one that figured out a better way to contribute to the community.

This is the first is a series on non-traditional vaccination programs. If you have a program you’d like us to profile, please contact our Editor, Dale Dauten —

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Vax Stats of the Month

Updated HPV Immunization Recommendations: Where Are the 11-26 Year-old Males?

by Bill Davenhall, Geomedicine Analyst, STC Health Analytics (

In 2024, over 33 million males ages 11-26 will be candidates for the HPV immunization (if the recent recommendations from the Advisory Committee on Immunization Practices committee are followed). Guessing which males will elect to receive the shot and where the demand will be the greatest is currently a work in progress. Approximately 43% of the eligible candidates will reside in only 100 counties, (less than 4% of all counties). Add an additional 361 counties and you’ll account for about 75% of all eligible males in the new target age range.

Despite the published low coverage rate of the HPV vaccine among this age group, a significant new challenge lies ahead for immunizers in both the largest counties and the smallest, but for very different reasons. Large counties will offer greater density of males in this age group while the smallest counties will suffer wide-spread distribution of males in the target age group. Extending two additional years (26 vs 24) to the present recommendation means everybody must re-calibrate their existing expected target populations and calculate new estimates for HPV coverage rates. The best estimates will be adjusted by race and ethnicity, a significant factor in most immunization coverage. Stand by!

Data Sources: US Census Bureau, Scan\US, and STC.