Community Pharmacy Leads First Town in Puerto Rico to Achieve 90% Vaccination Rate

In rural Villalba, Puerto Rico, a town still recovering from the infrastructural damage of Hurricane Maria, road closures and power outages are not uncommon. Under these conditions, supplies and information don’t always travel fast. When COVID-19 vaccines became available on the island, Idalia Bonilla, BSPharm, owner of Farmacias Aliadas Villalba, made it her mission to get the vaccine, along with accurate information about it, out to the people of Villalba as quickly as possible.

In addition to the more than 100 public vaccination events and clinics at long-term care facilities that she spearheaded, Bonilla and her team brought vaccines to the homes of local residents who did not or could not attend the public events.

“I was born and raised in Villalba, and I know my people, so I knew exactly where to take the vaccine after we closed the clinic each day,” Bonilla said.

Early in the town’s vaccine rollout, Bonilla realized that hesitancy and misinformation were already spreading. Like people in rural and urban areas all over the United States, some in the small Puerto Rican town worried that the vaccine came out too fast. Others, among Villalba’s most devout Catholics, believed the vaccine contained human cells from aborted fetuses.

Bonilla and her team diligently addressed these concerns with scientific facts and won over many townspeople. It was when she was able to incorporate a much more personal example and appeal to the members of her community that her vaccine advocacy made a greater impact.

“I have been immunizing for 9 years now, and I’m the voice of immunization in my community, but my own son didn’t believe in the COVID-19 vaccine,” Bonilla said.

Despite her urging, Bonilla’s adult son, who is married and has three children, had refused the vaccine. Then, he became so sick with COVID-19 that he was hospitalized for several days. After her son’s lengthy recovery, Bonilla managed to convince him to get the vaccine to protect himself from getting sick again.

From then on, Bonilla shared her son’s story with anyone who had reservations about the vaccine. “When you share your own situation and your own suffering, people identify with that,” she said.

Through a combined approach of physically bringing the vaccine to as many people as possible, educating community members, and sharing personal stories, Bonilla and her team led the charge to make Villalba the first town in Puerto Rico to vaccinate 90% of its population against COVID-19.

Demand for COVID-19 vaccines in Villalba continues today. Community members regularly call Bonilla’s pharmacy to request the bivalent vaccine. “A lot of them don’t even know the correct name for it, but they know that we have it, so they call to ask for it,” she said.

Farmacias Aliadas has become a go-to for people seeking vaccines because Bonilla has cultivated what she calls a “vaccine culture” in her pharmacy. Everyone—from the cashiers and retail staff to pharmacy technicians and pharmacists—promotes vaccine confidence and understands how vaccines fit into the workflow.

“We can’t have people waiting in long lines to get the vaccine. And when patients are waiting for prescriptions to be filled, they should be offered the vaccine every time,” Bonilla explained.

Bonilla and her team seize every opportunity to keep the community protected against COVID-19 and all vaccine-preventable diseases. They are willing to put in the time that they know it may take.

“Every encounter with a patient brings an opportunity to build confidence in vaccines,” Bonilla said. “If a patient is not ready on the first visit, you can continue the conversation on the second and even third visit. They need to see empathy, honesty, and feel they are being heard.”

—Sonya Collins
March 2023

Resources to Tailor Your Outreach to specific populations and help Answer Common Questions about COVID-19 vaccines are available at APhA’s Vaccine Confident microsite.