Community Pharmacist Gives Nervous Teens Ample Time to Prepare for Vaccination

As soon as the Pfizer COVID-19 vaccine was approved for adolescents ages 12 to 15 years, George Zikry, PharmD, knew this group was going to have unique needs. Responsible for leading the vaccine initiative at Hendricks Pharmacy in Claremont, California—first as a Chapman University School of Pharmacy resident and then as a staff pharmacist—Zikry anticipated those needs as he planned the pharmacy’s adolescent vaccination clinics.

Zikry scheduled special COVID-19 vaccination events at the pharmacy exclusively for this age group. While adult vaccination appointments took about 5 minutes, Zikry felt it was important to allow more time for the tweens and teens.

“We didn’t know how hesitant or scared [adolescent patients] were going to be—and we never wanted anyone to feel rushed—so we scheduled longer appointments for them,” Zikry said.

The pharmacy also provided goody bags to each young patient with the promise that the contents of their goody bag after the second dose would be even better. The mastermind behind the goody bags, Zikry said, was Hendricks Pharmacy owner, Brain Garner, PharmD.

“Dr. Garner has been very hands on with COVID-19 vaccine efforts. He created the COVID-19 vaccine appointment system, scheduled specialized clinics, and kept up with the literature,” Zikry shared.

Zikry’s hunch that immunizers should take their time with younger patients was spot on. One evening, a 14-year-old girl arrived at the pharmacy with her parents to get vaccinated. But when the time came, she was terrified and didn’t want the shot.

To help the teen overcome her fear, Zikry explained that the volume of the vaccine dose was so small that it called for the thinnest needle possible. He also noted that most people were surprised when the injection was completed because they hadn’t felt much of anything. Zikry told the young patient that he was certain she would feel the same way after being vaccinated. Still, she was unmoved.

Next, the patient’s parents alternated between cajoling and pressing their daughter to get vaccinated. First, they’d listen and soothe. Then, frustrated, they’d say they were just going to hold her down. After this escalation, Zikry went in for another round of reasoning with and reassuring the patient.

“Whatever trauma she had around needles and vaccines, I didn’t want to add to that,” Zikry said.

Finally, in a light bulb moment, Zikry grabbed roll-on lidocaine from the shelf and applied the numbing solution to her upper arm. The girl’s father pressed one of his car keys into the spot on her arm to show her that she couldn’t feel it. Skeptical, the patient took the key and pressed it into her arm harder.

“I let her know that the amount of pressure she was putting on her arm with the key was far more than I would apply with the needle,” Zikry said.

Finally, the young patient relented and Zikry administered the vaccine.

All told, Zikry spent well over 2 hours with the family that night, including 45 minutes after the pharmacy had closed and everyone else had gone home for the night.

“I knew she wasn’t going to feel it and that, when she realized that, I would have contributed to helping her get past her fear, and that really motivated me,” Zikry said.

The patient did get over her fear, and she gave all the credit to Zikry and the staff at Hendricks Pharmacy. She thanked the pharmacy staff with a personal letter and a glowing Yelp review. And when she returned for her second dose, it took just 5 minutes.

Asked why he didn’t simply tell the family to come back when the young patient was ready, Zikry said, “We are trying to get everyone vaccinated. If they are taking that step to come in and get vaccinated, it’s my responsibility to help [the patient] get past her fears and make sure she does get vaccinated.”

—Sonya Collins
March 2022

Resources to Discuss the Importance of COVID-19 Vaccination and Tailor Your Outreach to help patients overcome COVID-19 vaccine concerns are available at APhA’s Vaccine Confident microsite.