Pharmacy Focus
S2 Ep33: Pharmacy Focus: Address Vaccine Hesitancy Through Outreach, Collaboration
Hi, I'm Ashley Gallagher from Pharmacy Times, and you're listening to Pharmacy Focus. The Pharmacy Times Pharmacy Focus Podcast provides the latest industry news and information, thought leader insight, clinical updates, patient counseling tools, and innovative solutions for the everyday practice and business of pharmacy. On this one's episode, we spoke with Olivia Kinney, National Pharmacy Practice Manager at Kroger, about the importance of getting seasonal immunizations. Approximately one in five people are vaccine resistant. In your experience, what are the most common reasons for individuals being vaccine resistant? Sure, so vaccines represent innovation and collaboration and hope, and they're really recognized as one of the most effective public health measures, but they're increasingly viewed as unsafe or unnecessary by an increasing number of people. And so vaccine hesitancy was actually identified as one of the World Health Organization's top 10 global health threats in 2019. The hesitancy itself really varies by the virus, the technology, the number of doses, and so it's a really complex mix for why a person is hesitant. I would say the most common reason is a concern of side effects, we're all guilty of deciding when we want to get our vaccine based on if we have a day off tomorrow to recover. But there's a number of other reasons, like misinformation, that you hear from a friend or you catch from social media. Sometimes people are hesitant because transportation is difficult for them to get to a provider. Other people have cost concerns, or cultural and religious beliefs. And finally, I'd say that social and political influences play a big role in vaccine hesitancy because we hear a lot of public figures making comments throughout the year that influence people to get a vaccine or not. So how can pharmacists effectively address vaccine concerns and misinformation from patients in a way that kind of facilitates trust and encourages informed decision making? I think pharmacy teams are already well regarded as trusted sources of information. We provide expert, credible, convenient care every day. And hesitancy is still very normal if a person is getting a cavity filled, you have a question, and so it's totally normal to ask a question about getting a vaccine too. Pharmacy teams can build trust by listening, staying relevant to the question that's asked, and by being consistent. We want to listen to our patients' concerns and experiences as the first thing anytime you're talking to someone about a vaccine. Silence is a part of that conversation because it allows you to hear your patients' concerns and then because you heard them, you can address it relevantly in the context for that situation. At Kroger Health, we believe healthcare is personalized, not generalized, and vaccines are a really excellent example of that because each person has their own individual questions and concerns around getting a vaccine. So being consistent and constant is the last part of this. We need to keep renewing the relationship with our patients. It's kind of like gardening where you have to keep pulling weeds to make way for a flower to bloom. We've got to keep educating our patients each chance we get so they feel confident to make that decision to get a vaccine when they're ready. So what resources are available to pharmacists that want to stay up to date on vaccine information, vaccine recommendations, and also best practices for communicating with hesitant patients? There is no shortage of vaccine resources available to pharmacy teams. We have webinars and continuing education classes, newsletter articles, so many different ways to hear about changes in vaccines. And so I think it's less the question of which resources are available and more of a question of which resources do I want to use to stay up to date on vaccine changes. It's important that pharmacy teams understand the regulatory process for how a vaccine comes to be available to the public because when the media catches that a change is being made in vaccine guidance and it gets reported, patients often call in and ask about when they can get that vaccine. So it's important for pharmacy teams to point out that no, the FDA is just looking at the data right now, it will need to be reviewed and approved by the CDC before it gets to us in the pharmacy for us to start administering the vaccine. So I think the most important part is for each individual pharmacist and technician to decide how they're going to stay up to date on vaccine guidance, which changes roughly three times a year depending on how the ACIP votes. So with the rise of online misinformation, how can pharmacists kind of position themselves as a more trusted source of vaccine information for patients when compared to online information? I think that relationships are king in this opportunity we have. The worst thing we could say to a vaccine hesitant person is to accuse them of being ignorant. We know that their questions come from a good place as they're trying to make confident decisions about which vaccines that they are willing to get. And misinformation is rampant, the FDA commissioner has actually said before that it's the leading cause of death in the United States. So coming back to that relationship, I think a very simple approach that is powerful is when a pharmacist or a technician leverages the relationship with their team and with those around them. So you can say, hey, I got this flu vaccine, my kids got this flu vaccine and I think you should too. Something simple like that to make it personal and a strong, clear recommendation will go a long way to making patients feel confident in their decision. Do you see a growing role for pharmacists in administering vaccines beyond traditional settings like pharmacies and how could this kind of impact vaccine hesitancy? Sure. I think that pharmacy teams have proved throughout the COVID-19 pandemic that we will go where our patients need us to be. We do vaccine clinics in parking lots in nursing homes. We go on site, we get creative in office buildings. And so that's definitely the beauty of we have vaccines, we will safely store and travel with them to reach our patients where they need us to be. We think that this is a great opportunity to impact vaccine hesitancy because if we're willing to get outside of the pharmacy and come to you, then that hopefully makes receiving a vaccine convenient enough that you're willing to proceed with it, which not only protects you but helps us care for the communities around us. So vaccine hesitancy can sometimes stem from lack of access or awareness and in some cases even health literacy. How can pharmacists kind of collaborate with other healthcare providers as well as organizations in the community that are respected to improve vaccine access and education? At Kroger Health, we believe that the future of healthcare is interprofessional, not siloed. And it is more important than ever to be the kind of provider who collaborates with others. We know that outcomes are best when we take a holistic view of our patients. And so we need to start by getting to know the other healthcare providers in our area, which is difficult to do if you're spending your day working behind the counter, for example, at a community pharmacy or in a hospital. But we do talk to a number of providers over the phone and it's a small healthcare community. So making an effort to learn not only the other providers in your community but also the resources is key. It's important, especially for a pharmacy team to know where the health department is, to know where the food bank is, where all of these resources in the community. Could you build a list, could you compile the different options? What if someone comes in and can't afford a vaccine for their child? Do you know if there's a vaccine for children program in your area that you could refer them to? So making sure to work together to collaborate with other providers will definitely improve access and education. Many patients might have concerns about vaccines safety, especially for children. What advice can you give to pharmacists on effectively addressing these concerns while also keeping in mind the patient's feelings about the concerns? I think that vaccine safety is a hot topic that is arguably one of the top reasons why people are hesitant because they're nervous about the safety of receiving a vaccine. And so to me, I believe that the messaging is key. I think that many problems originate with how we communicate and there's a real opportunity here for pharmacists to translate all this fancy scientific talk into something that is meaningful to a patient. A really great example that always sticks with me is when vaccine safety data indicated during the pandemic that we should stop providing the Johnson and Johnson COVID-19 vaccine due to some safety signals. There was an opportunity there to say, "Great news, the safety surveillance work is expected, and so we are going to pause this for now," and instead the message felt very scary. So when parents or caregivers or even adult patients are asking questions, it's important to frame up what you're talking about and to know your talking points. The CDC has a number of excellent safety resources that I reference myself. And so if you don't have your talking points memorized when someone asks a specific question and around autism or Guillain-Barre syndrome, know where to go to find that resource and don't let that patient leave with more uncertainty than when they arrived. So how can patients counter misinformation that is surrounding the development and testing process for new vaccines? Yes, our job as pharmacy teams is really not to convince people to get a vaccine but more to educate them. The development and testing processes we know are rigorous and extensive. The CDC has a very well written out description of what that process looks like, but patients may or may not want to hear that full description of it. And so just providing the education or the resource and not allowing it to just slip away is your first opportunity here. We just want to chip away at hesitancy by saying, "I understand it feels fast. Would you mind if I share with you how the vaccine is regulated and tested all the way before it gets to the public?" So when people have questions like this, if they kind of push back around it, you don't really want to play fact tennis. I think you only want to go for a couple of volleys back and forth and really it's more about jumping over that fence and playing doubles with the person against the disease and being able to share with them what you know about testing and development and instilling that confidence in getting the vaccine. In your opinion, what are some of the most promising strategies for helping pharmacists educate patients on vaccine hesitancy and improve overall vaccination rates? There are a lot of different strategies to overcoming vaccine hesitancy and there's not one-size-fits-all because it depends on the patient, it depends on the generation. One of the things I'm really interested in is social media. I think that it's a very polarizing topic and the idea of reaching people by quantity versus quality is not always an enticing one, but at the same time, we all spend a lot of time on social media on our phones each day. So if we're staring at our screams, what kind of opportunity do we have to put trusted health professionals or influencers who are able to be equipped with the facts to get a hold of people, to debunk some myths, to answer some questions? I think that we should not discount social media and instead be able to endorse social media influencers who are doing a great job at sharing vaccine information and combating disinformation. I would say the other promising strategy that's interesting to me is being able to leverage artificial intelligence and large language models, trying to use behavioral science techniques to be able to personalize the messaging that our patients receive from a pharmacy. If I message every person out there with the exact same call to action that it's time to go get your COVID vaccine, we may or may not react the same way. But if we have different data points about our patients that helps inform if this patient reacts better in the morning or in the afternoon and when they are more likely to agree to come and get a vaccine, that personalization leveraging technology is going to be a game changer for meeting patients where they're at, which often boils down to something taken for granted like a text message. So all of these opportunities we have are going to help chip away a hesitancy over time. And lastly, as we're sort of just wrapping up, is there anything else that you would like to add that we might not have touched on or something you want to reiterate? I think I would just like to encourage people that vaccines are extremely exciting. They are innovative. They are something we are thrilled to be able to provide to our communities because they represent hope and technology and innovation. And the act of getting a vaccine is really selfless. It is not a selfish act. And so I commend all of you who get vaccinated and who encourage others to do the same. But vaccine impact is really about use. You have to prove it. We have to use it. And if we aren't using it, if we're not getting people vaccinated or unable to get data to continue to monitor the safety and to improve the technology that will help make vaccines more effective in the future. So if you're still listening at this point and you're thinking of someone or yourself who is not up to date on a vaccine, I would challenge you to ask, stop by your local pharmacy and have a chat with them to see which vaccines you need and if they can close that gap and care for you today. Thanks for listening to Pharmacy Focus. Stay tuned for our next episode where we will be joined by another key opinion leader in the pharmacy space. [MUSIC] [BLANK_AUDIO]