Pharmacists at FQHC Make House Calls to Address Vaccine Concerns

When Heeya Ju, PharmD, administered a second dose of COVID-19 vaccine to 90-year-old “Juan” during a routine diabetes visit at a Federally Qualified Health Center (FQHC), the pharmacist learned that the patient’s wife hadn’t yet received a first dose of COVID-19 vaccine. Ju asked the man why his wife hadn’t been vaccinated more than a year after older adults became eligible. He implied that she was afraid.

On a modest fixed income and no longer able to drive, Juan goes to Mariposa Community Health Center in Nogales, Arizona, every week for diabetes management using free transportation that Ju arranged for him.

“Some patients really do have to choose between food and health care,” Ju said. The FQHC, located near Arizona’s border with Mexico, serves a predominantly Hispanic patient population, the vast majority of whom rely on Medicaid.

To have a conversation with Juan’s wife about COVID-19 vaccination concerns, Ju knew she would have to meet with the woman in person. Ju visited the couple at their home during the evening after she had administered Juan’s second dose.

“She was afraid the vaccine would make her sick and unable to take care of her husband,’” Ju said. The woman chose instead to avoid both the vaccine and the virus by never leaving the house.

Ju explained to the woman that she wasn’t entirely avoiding potential exposure to the virus because her husband continued to go out into the community for doctors’ appointments. But the woman was still afraid.

Careful not to pressure the patient, instead Ju offered to reach out the next day to see how Juan was feeling after his second dose of vaccine. Juan was feeling fine when Ju called, but his wife still wasn’t ready to get the vaccine herself. Ju told Juan’s wife to let her know when she was ready.

The following week, when Ju called to remind Juan of his weekly diabetes appointment, she asked his wife if Juan had continued to do well after his vaccination and whether she was ready to get vaccinated as well.

“She finally agreed, so we went back to give her the vaccine,” Ju said.

Ju and her pharmacist colleagues, Jabbar Mendivil, PharmD, and Jeanna Szablicki, PharmD, have personally delivered COVID-19 vaccines to numerous homes in the area after their regular workday. They started with senior living facilities and then expanded their reach to individual households where a patient might be bed-bound or lacking transportation. When needed as language interpreters, a pharmacy technician would join a pharmacist for a home visit.

Pharmacy technicians can play a critical role in addressing the fears and reservations of patients with vaccine concerns. “Educate your staff to answer questions,” Ju said. “Technicians can have friendly conversations with patients and say, ‘I got the vaccine, too, and I’m doing fine.’”

Many of Ju’s home visits come at the end of workdays that started at 4:30 AM. For 5 months, Mariposa Community Health Center hosted daily COVID-19 vaccine clinics at a local recreation center. Ju would get up before dawn to pick up the vaccines from the clinic and get them to the recreation center prior to set up for the event. During peak demand, the mass vaccination event provided 800 to 900 immunizations per day. The effort required participation from every department at the FQHC, including nursing and dentistry.

In addition to vaccinating U.S. residents from the Nogales area, the FQHC enabled equitable access to COVID-19 vaccine for residents from communities in Mexico near the border town. Ju and her pharmacist colleagues at Mariposa have also organized drive-through vaccine clinics for first responders, customs officers, and border patrol officers as well as school-based clinics for adolescents and their parents.

“It’s just about extending as many opportunities as possible to the entire community,” Ju said.

—Sonya Collins
April 2022

Resources to Know What Drives COVID-19 Vaccine Confidence, Tailor Your Outreach to address COVID-19 vaccine concerns of specific populations, and tools to Educate Your Health Care Team about COVID-19 vaccine are available at APhA’s Vaccine Confident microsite.