Pharmacist Removes Vaccination Barriers by Bringing Vaccines to the Public

Pharmacist Christina Madison (seated) and 2021 PharmD graduates at a COVID-19 vaccination event in a Las Vegas–area high school.

When Christina Madison, PharmD, meets a potential patient who declines the COVID-19 vaccine, she doesn’t simply assume they are hesitant to the vaccine overall.

“There are so many different reasons why people choose to get vaccinated or not. You have to listen to their why and focus on the person right in front of you,” she said.

Madison, who is founder and CEO of a consulting firm called The Public Health Pharmacist and associate professor of pharmacy practice at Roseman University of Health Sciences in Las Vegas, Nevada, spearheaded a massive undertaking that led to administration of more than 10,000 doses of COVID-19 vaccines from January through June 2021.

The effort included high-volume vaccination events in multiple sites across Roseman University’s campuses, including clinics at Huntridge Family Clinic, which serves LGBTQ+ patients, and Volunteers in Medicine, which serves low-income patients. There were also individual events at community centers dedicated to transgender youth, LGBTQ+ adults, and African Americans. Additionally, the volunteer immunizing team worked to meet people where they were, organizing clinics at senior centers and pop-ups at major music and sporting events.

Madison has been a vaccine advocate, with a focus on public health and infectious diseases, throughout her pharmacy career. She previously practiced at Southern Nevada Health District, which is the county health department, and her first order of business at Huntridge Family Clinic was to add vaccination services to the facility’s offerings. She continues to pitch in at the health department for back-to-school clinics and flu-shot drives. It was this track record that helped her garner the volunteer workforce necessary to staff the COVID-19 vaccine clinics.

Together, the volunteers Madison helped recruit provided more than 5,000 hours vaccinating or running clinics. The workforce included Roseman University faculty and students; faculty spouses and children; the Medical Reserve Corps; emergency medical technicians and local ambulance companies; veterinarians from the U.S. Department of Agriculture; retired police officers who served as security; and Team Rubicon, a veteran-operated disaster response organization.

“I contacted every person I possibly could, and luckily about 95 percent of them showed up,” Madison said.

Sometimes, Madison says, what looks like vaccine hesitancy is actually a barrier to access. Madison has made it her mission to remove those barriers by, for example, taking vaccines directly to neighborhoods and locations that people in the community trust and streamlining the appointment-making process for those who struggle to navigate online registration.

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When Madison and a team of PharmD students set up a booth to offer vaccines at the Las Vegas Jazz Festival, students circulated in the crowd to get the word out that vaccines were available. But many spectators didn’t want to lose their great spot on the lawn. So, Madison gave her students the green light to push a cart across the huge field and administer vaccines at patients’ individual picnic blankets.

“I told the students, ‘As long as you sit there with them for 15 minutes after, you can do it,’” Madison said.

At this point in the vaccination timeline, Madison said, immunizers are facing the “movable middle.” These patients are not the early adopters who lined up for hours to receive the vaccine earlier this year, nor are they people outright opposed to vaccines. Members of the movable middle will come into the clinic, the pharmacy, or even a vaccine event to get answers to their questions.

“If they’re there and they still have questions, that’s where we as trusted health care professionals are able to answer their questions and convert them,” Madison says. “You just have to make sure they feel comfortable, dispel the myths and misinformation, and answer their questions.”