Mobile Health Clinic Reduces Barriers to Vaccinating People in Rural Areas

When the first COVID-19 vaccines became available, Ohio Governor Mike DeWine had a special mission for Ohio Northern University (ONU) College of Pharmacy: Vaccinate the residents of six counties in 60 days. Long before the pandemic, ONU College of Pharmacy had begun laying the groundwork to support vaccine confidence at a time like this.

“Vaccine hesitancy comes down to complacency, confidence, and convenience,” said Michael Rush, PharmD, Assistant Clinical Professor of Pharmacy Practice and Director of ONU HealthWise and Pharmacy Residency Programs, who spearheaded the college’s vaccination efforts. “It is either having some level of complacency towards the disease, lack of confidence in the health care system, or lack of convenience or access to care.”

ONU College of Pharmacy started working in 2017 to ensure convenience would never be a barrier to receiving health care, including vaccines, in rural Ohio. A 38-foot recreational vehicle was customized to include two patient care rooms, a waiting room, Wi-Fi, and cold storage. The mobile clinic brings health care to some of the hardest-to-reach, most underserved areas in the state, including some rural areas adjacent to Amish communities.

The county where ONU is located—a federally designated Health Professional Shortage Area—has one Critical Access Hospital. Within the county, only one city and one village have pharmacies and physicians’ offices. “The rest of the county is devoid of any real access to care, including pharmacies. There’s no pediatrician in our county at all, so folks are driving out of the county for most specialties. We also have a high poverty rate,” Rush noted.

When ONU College of Pharmacy began receiving shipments of COVID-19 vaccine, it already had the infrastructure in place to bring the vaccines to the rural counties it served.

“Through our mobile clinic, we leverage the rapport we had already established with patients within those areas,” Rush said.

Well beyond vaccinating residents in the originally proposed six counties in 60 days, the clinic-on-wheels brought the vaccine to more than 30 sites in 10 counties for as many days as needed to vaccinate everyone who wanted the immunization.

Rush and his team of student pharmacists, pharmacy residents, and faculty colleagues took advantage of a range of pop-up clinical sites. In one rural county, they used a large metal carport, intended for the storage of farm equipment on a fairground, as a drive-through clinic. The team of immunizers vaccinated eight cars with up to four passengers every 5 minutes. After the patients received their vaccine, the cars would pull out of the metal shelter and wait on the grounds for the 15-minute monitoring period.

“Taking a clinic-on-wheels into rural areas certainly increases the convenience of receiving the vaccine,” Rush said.

ONU College of Pharmacy addressed complacency and confidence in a number of ways, including through a weekly column on COVID-19 that Rush wrote for placement in a couple of rural newspapers. The column attempted to stay a step ahead of myths and misinformation about COVID-19 and eventually about the vaccines for it.

“We received frequent emails from readers thanking us for the articles and for being a source of reliable information,” Rush said.

To tackle the barriers surrounding complacency, confidence, and convenience—and to educate people in the community to move from vaccine contemplation to vaccine acceptance—Rush said, “Every pharmacist has a role in addressing these areas. They can provide good information and make the patient feel more comfortable with the science. After all, if the patient is coming to the pharmacist, chances are they trust that pharmacist.”

—Sonya Collins
April 2022

Resources to Know What Drives Vaccine Confidence, Answer Common Questions about COVID-19 vaccine, and Community Outreach Tools are available at APhA’s Vaccine Confident microsite.