Community Pharmacist Eliminates Barriers to Increase Vaccine Uptake

Before a recent house call to administer a COVID-19 vaccine to a homebound patient with multiple comorbidities, the patient asked Alex Rothey, PharmD, to bring an extra COVID-19 shot for her son just in case they could convince him to get vaccinated.

For Rothey, a pharmacist at Hilltop Pharmacy in Pittsburgh, Pennsylvania, house calls often provide these kinds of opportunities. The pharmacist may have the chance to get the patient up to date on other vaccines in addition to the one ordered. She may also get to vaccinate other household members, so she always goes prepared.

When Rothey entered the patient’s home, she saw a life in chaos. The house was in disarray, with piles of clutter everywhere. “It seemed that the woman was living on her own and that her son had his own challenges,” Rothey said. “The woman kept apologizing for the state of the house and saying that her son was just not at his best.”

When the patient’s son entered the room and saw Rothey preparing the vaccine for his mother, he took a few steps back and told the pharmacist not to come near him. Rothey assured him that she wouldn’t go near him without his permission and invited him to watch his mother get vaccinated.

As Rothey prepared and administered the shot, she asked the young man why he didn’t want the vaccine.

“It was the same spiel we hear from a lot of people—mainly that he didn’t like needles,” Rothey said.

While the mother pleaded with her son to get vaccinated, Rothey explained to the man why the COVID-19 vaccine was so important to his mother. Homebound with multiple comorbidities, the woman faced the risk of COVID-19 exposure every time her son came into the house. Not only was he unvaccinated, but he continued to ride the subway and go out almost every night.

Eventually, the young man acquiesced.

“I’ve dealt with people with various challenges in the pharmacy, and I know that when you convince some patients to do something, the window is small. You have to move quickly before they change their mind,” explained Rothey.

Rothey completed the necessary paperwork, administered the shot, and sat with him for 15 minutes afterward.

“He would never have done this on his own—gone somewhere, completed the paperwork, and sat through a clinic,” Rothey said. “What allowed me to do it was being in his home and eliminating anything he saw as a barrier.”

Over the course of the COVID-19 vaccine rollout, Rothey’s mission has been to combat vaccine concerns by eliminating any perceived barriers to vaccination that she could.

Located in a low-income neighborhood where few people have their own car, Hilltop Pharmacy partnered with a local business alliance to coordinate buses to take community members to COVID-19 vaccine clinics. When both paper forms and online registration platforms proved to be barriers to vaccination for many of her community’s elderly and low-income residents, Rothey recruited volunteers to do all this legwork for patients in advance. When distrust of the vaccine appeared to be on the rise in the local Asian community—a reaction to the rampant COVID-19–related Asian hate incidents at the time—Rothey enlisted a local Asian restaurant to serve as a safe site for a vaccine clinic for the Asian community.

“Once you start eliminating all the barriers to access—computers, transportation, paperwork, misunderstanding—you start to see people’s negativity about the vaccine disappear,” Rothey shared.

—Sonya Collins
August 2022

COVID-19 vaccine resources to Reach Diverse Communities, Know What Drives Vaccine Confidence, and Community Outreach Tools are available at APhA’s Vaccine Confident microsite.