Vaccine Hesitant Patients Just Want to Be Heard

Renee Robinson, PharmD, knows there’s more to vaccinating than drawing up syringes and injecting vaccines into arms. Her efforts to get the COVID-19 vaccine out to as many Alaskans as possible have also included teaching, researching, and information sharing. Robinson is an associate professor of pharmacy at the University of Alaska Anchorage/Idaho State University (UAA/ISU) Doctor of Pharmacy Program.

In an effort to reach some of Alaska’s most vulnerable residents, Robinson led members of the American Pharmacists Association–Academy of Student Pharmacists (APhA-ASP) Operation Immunization patient care project in bringing COVID-19 vaccines to assisted living facilities (ALF). In Alaska, the typical ALF has only three to ten residents and one caregiver. That meant it would take visits to many homes to make a significant impact on vaccination rates in this population. But Robinson was undaunted.

“We established processes to ensure that we could safely give the vaccine within these homes,” Robinson said. “We were able to vaccinate 766 residents.”

Knowing this was no small feat, Robinson shared best practices for vaccinating ALF residents with other pharmacists in an APhA virtual town hall.

Still, Robinson knew her corps of students could make an even greater impact if they took roles beyond just administering vaccines. She found opportunities for the students to provide administrative support at pharmacies that had vaccines and vaccinators but lacked the infrastructure to get those vaccines to patients. Her resourcefulness provided additional education for the student pharmacists and expanded their reach far beyond simply vaccinating patients.

“The students helped plan and manage [vaccinations] so they could understand the processes that go into making sure individuals are vaccinated,” Robinson said.

UAA/ISU pharmacy students helped older adults overcome a major barrier to vaccination: online appointment scheduling. Robinson placed students at an independent pharmacy in Anchorage, where they sat down with patients who had just received a first dose of the Pfizer or Moderna vaccine to schedule second doses online using iPads. That way, the patients didn’t need to navigate online scheduling later on their own. This system was convenient for patients and had a collateral benefit, too.

“That made a huge difference in building trust. It gave us the opportunity to address concerns and continue to help [older adults] through the vaccination process so they could go home and share that information with family and friends,” Robinson said.

Throughout these vaccination efforts, Robinson and her students have encountered vaccine hesitancy in many different forms. Community members have expressed fears that the vaccine will render them sterile; that it will alter their DNA; that you cannot tolerate alcohol once vaccinated; that mRNA technology is too new; and that vaccine clinical trials took shortcuts on the path to approval.

While individual reasons for vaccine hesitancy vary widely, most apprehensive people who voice their concerns have one thing in common. “They want to be heard, and as soon as you listen and share your own story, people are a lot more comfortable,” Robinson said.

Robinson explains that mRNA technology is not new but that the COVID-19 vaccine is a new application of the established technology. She assures patients that vaccine trials didn’t skip any scientific steps. Rather, they bypassed cost feasibility studies, which were less important because federal subsidies made the vaccine free for everyone.

Regardless of patients’ individual concerns, Robinson also shares her personal story. She emphasizes that she wouldn’t encourage patients to do anything that she wouldn’t want her own family to do and that she and her family have been vaccinated.

Knowing that vaccine hesitancy isn’t limited to her own community, Robinson has conducted research on hesitancy and developed educational modules so other health care providers can prepare themselves to face this problem.

Robinson’s practice has confirmed that giving patients a platform to ask questions and letting them be heard goes a long way to counter hesitancy. She said, “The conversations with patients may take as long as 20 to 30 minutes, but once you address all their concerns…they are much more apt to get the vaccine.”

—Sonya Collins
April 2021