Vaccine Confident mark
An initiative to help pharmacists strengthen vaccine confidence in their patients and communities
How to talk to people about COVID-19 vaccines Addressing concerns that the COVID-19 vaccines were “rushed” Addressing concerns about COVID-19 vaccine side effects Addressing concerns related to pregnancy, breastfeeding, and fertility Addressing the belief that COVID-19 vaccination is “not needed” Addressing concerns about COVID-19 breakthrough infections Addressing concerns related to religious beliefs Understanding the “COVID skeptics” Addressing concerns about staying up to date with COVID-19 vaccines How to restart the vaccine conversation Understanding the “system distrusters” Addressing concerns about SARS-CoV-2 variants Identifying credible information about COVID-19 Vaccines Addressing COVID-19 vaccine myths Understanding the “cost anxious” Addressing concerns about vaccinating children and teens Addressing COVID-19 vaccine misinformation and disinformation Addressing COVID-19 vaccine misunderstandings Addressing concerns about administering COVID-19 vaccines with other vaccines Addressing concerns of people who are immunocompromised Effectiveness of COVID-19 vaccines during pregnancy and after delivery Using numbers to communicate COVID-19 risk to patients Managing pandemic-related exhaustion

Understanding the “cost anxious”

Note: While this section was written with COVID-19 vaccines in mind, many of the general principles apply to other vaccines as well. Individual vaccines may vary in their antigenic components or dosage forms, but the principles of human behavior and good communication skills transcend most differences between vaccines.

The Issue

When COVID-19 vaccination efforts began in the United States, it became clear that vaccine hesitancy could not be explained reliably by traditional demographic categories (e.g., political affiliation, race, age, gender, economic status). Instead, some distinct personas emerged based on shared beliefs and barriers to getting the vaccine. These personas transcend traditional demographic categories, and each persona includes at least some members of every demographic group.

According to the nonprofit organization Surgo Ventures, one of these personas is the “cost anxious.” Hesitancy among the cost anxious is related to possible financial costs and time costs of getting vaccinated.

What You Need to Know About the Cost Anxious

Based on polling and psychobehavioral analysis conducted by Surgo Ventures in 2021, approximately 9% of Americans are cost anxious.1 They likely have delayed seeking care for their health in the past due to the expense; some may have delayed seeking health care because of work and time.2

Many cost-anxious people fear that a COVID-19 vaccination will cost them money out of pocket. Concern about costs associated with the COVID-19 vaccine appears to be especially prevalent in Hispanic communities. Some cost-anxious people fear they cannot get time off work to get the vaccine or recover from side effects.

Cost-anxious people may be accustomed to a health system where the bills are frequent, significant, and perhaps unexpected. This creates a feeling of mistrust that must be acknowledged.

What Might Work

Perhaps the most important information to impart to the cost anxious is this: the federal government is providing vaccines free of charge to all people living in the United States, regardless of their health insurance status or immigration status.

When appropriate, share that the CDC does not require U.S. citizenship for individuals to receive a COVID-19 vaccine. Jurisdictions (state, tribal, local, and territorial) cannot add U.S. citizenship requirements or require U.S. citizenship verification as a requirement for vaccination.

Encourage the cost anxious to check with their employer to find out if they can have paid time off to get the vaccine and recover from the expected physical response. An added value of pharmacy-based vaccination is a broader range of hours for individuals to get vaccinated without having to take off from work. The pharmacy may also be closer in distance than other sites offering vaccination.

In areas with many cost-anxious people, a fruitful approach is to bring the vaccines to the people. Consider holding vaccination clinics in community locations people frequent, such as workplaces, religious venues, daycare centers, and supermarkets.

References

  1. Sgaier SK. Meet the four kinds of people holding us back from full vaccination. The New York Times. May 18, 2021. Accessed February 28, 2022. https://www.nytimes.com/interactive/2021/05/18/opinion/covid-19-vaccine-hesitancy.html
  2. Surgo Ventures. A large-scale Facebook survey of U.S. adults: leveraging precision health to increase COVID-19 vaccine uptake. May 2021. Accessed February 28, 2022. https://surgoventures.squarespace.com/resource-library/a-large-scale-facebook-survey-of-us-adults-leveraging-precision-health-to-increase-covid-19-vaccine-uptake

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