Reaching Communities From Within

Victoria Hennessey, PharmD (second from right) pictured with pharmacy technicians prepare for the pharmacy’s mobile clinic in Springdale, Arkansas.

Community Pharmacy in Springdale, Arkansas, was one of just 12 sites in Washington County to offer COVID-19 vaccines at the beginning of the rollout. Victoria Hennessey, PharmD, the owner, was prepared for high demand.

Knowing that her busy pharmacy wasn’t the right venue to meet the demand, she rented a nearby conference space to use as a vaccine clinic location. But, after running the clinic from the rented space, Hennessey realized it wasn’t ideal.

“We were only able to vaccinate about 50 people a day in that space, and we just weren’t reaching the numbers that we needed to reach,” Hennessey said. So, she enlisted the help of nearby First Church Springdale, which generously offered her use of their gym, parking lot, and a corps of volunteers.

“It was a well-oiled machine,” Hennessey said. “We had repeat volunteers who just showed up and knew what to do. At our peak, we vaccinated 930 people in a day.”

The church-based vaccine clinic quickly and efficiently reached those who were eager to be vaccinated, but Hennessey knew she’d have to use a different approach to reach those who were less enthusiastic.

Community leaders combat medical mistrust

Springdale is home to the largest population of Marshall Islanders outside of the Republic of the Marshall Islands. Because of a history of abuses against the Marshallese in their home country by U.S. interests, including internment to study the effects of radiation exposure without their informed consent, Marshall Islanders in the United States harbor a deep distrust of the U.S. health care system.

“Even when our Marshallese staff members in the pharmacy have encouraged Marshallese patients to get the vaccine, we have seen hesitancy,” Hennessey said.

Hennessey leveraged trusted Marshallese community leaders to help her rise to this challenge. She partnered with the Marshallese Consulate and Sheldon Riklon, MD, one of only two Marshallese physicians in the United States and an associate professor at the University of Arkansas for Medical Sciences, to offer a vaccine clinic.

Hennessey disseminated information about the vaccine clinic in Marshallese on Facebook. “For many Marshall Islanders, Facebook is their primary means of communication,” she said.

Together, Hennessey and Riklon, with the help of additional interpreters provided by the consulate and University of Arkansas for Medical Sciences, vaccinated Marshallese elders in the consulate’s offices.

When misinformation takes hold

Many Marshall Islanders in Springdale work at a local poultry plant, which is headquartered there. But when Hennessey administered vaccines on-site at the plant, she was surprised to see that not many Marshallese people were among the hundreds of employees who rolled up their sleeves that day.

Again, she leaned on respected community members to help her close this gap. Tyson’s staff nursing assistant, who is Marshallese, was on-site assisting Hennessey with vaccines. When Hennessey asked why they weren’t seeing more Marshallese people, the nurse went inside to find out. She learned that a rumor was circulating among the Marshallese staffers that if they took the vaccine, they would die.

The nurse approached the group, listened to their concerns, and respectfully explained that they had already vaccinated hundreds of people that day and no one had died. She also explained that while there was no evidence you could die from the vaccine, there was a serious risk of death from COVID-19, which had already hit the Marshallese community very hard.

“Before I knew it, there were 40 Marshallese people lined up outside to get vaccinated,” Hennessey said. “Without [the nursing assistant], I know we would not have been able to vaccinate them.”

While fear of death from the vaccine might seem outlandish to clinicians, Hennessey stresses the importance of hearing people’s fears and addressing them directly. This is the same approach she’s taken with people who have expressed concerns that the vaccine causes infertility.

To patients, vaccine fears are very real

“These concerns are very real to the patient,” Hennessey said. “It takes time to look that patient in the eye and say, ‘I recognize and understand your concerns.’ Acknowledgment of the concern is number one. You’re never going to get anywhere with the vaccine hesitant if you don’t acknowledge their concerns.”

Now, more than six months into the U.S. vaccination effort, large vaccine events, like those at First Church Springdale, the Marshallese Consulate, and the poultry plant, are far less common amid flagging demand.

“Those clinics were hard work, but now comes the really hard work,” Hennessey said. “We have to dig our heels in, reach the patients who are hesitant, and figure out why. Every single patient that comes to the pharmacy, we have to ask ‘Have you had your COVID-19 vaccine? If not, can we give it to you today?’”