Pharmacist Prepares Health Professions Students to Address Vaccine Confidence

Pharmacist Elizabeth Skoy (left) discusses the CDC immunization schedules with a pharmacy intern at North Dakota State University’s concept pharmacy.

Pharmacist Elizabeth Skoy (left) discusses the CDC immunization schedules with a pharmacy intern at North Dakota State University’s concept pharmacy.

In rural North Dakota, Elizabeth Skoy, PharmD, has encountered many young women who have succumbed to the influence of misinformation or disinformation about how the COVID-19 vaccine could impact their pregnancies or their fertility. A major challenge with misinformation and disinformation campaigns is that the creator can use a little scientific jargon, with words such as “protein” and “receptor,” and the message sounds believable to someone who doesn’t understand the science.

Skoy has come up with an easy-to-understand analogy that she uses to explain proteins and receptors to patients who have heard that the mRNA vaccines create spike proteins that attach to receptors on the placenta and attack it. She tells them that proteins are like keys and receptors are like locks. Each protein only fits into a certain kind of receptor. The COVID-19 spike proteins latch onto certain receptors on the surface of human cells, but not on the surface of the placenta.

“For that spike protein to latch onto receptors on the surface of the placenta would be like trying to start your boat with your car keys,” Skoy tells patients.

“I find that analogies like these really work well with patients,” said Skoy, who is an associate professor at North Dakota State University (NDSU) School of Pharmacy and a pharmacist at a community-based pharmacy in Fargo.

Since the COVID-19 vaccine rollout began in her state, Skoy has not only personally addressed misinformation, disinformation, and other vaccine concerns, she has also prepared student pharmacists and students of other health care professions to do the same. As it happens, she started this work prior to the COVID-19 pandemic in recognition that confidence in vaccines and in science has been waning for some time among certain segments of the population.

Skoy and colleagues at the NDSU Center for Immunization Research and Education received a financial grant to create a curriculum that would teach health professions students how to address vaccine concerns and instill vaccine confidence in their patients. When the pandemic hit, they were ready to prepare student clinicians across disciplines for the vaccine pushback that they would surely face. “Prior to this, they were not prepared. This is not a part of the normal curriculum. No one talks about this, so now we are talking about it,” she said.

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Additionally, Skoy has helped address the access problems that patients confront in vastly rural states such as North Dakota. She helped develop a nationally recognized training module, aligned with expanded authority in the Public Readiness and Emergency Preparedness Act (PREP Act), to certify pharmacy technicians to administer COVID-19 vaccines. Expanding the immunizer workforce was critical in North Dakota, she said.

“In some of our rural areas, there may be only one to two pharmacists,” Skoy said. “If they want to try to vaccinate at a workplace or a school with only one pharmacist, that’s debilitating. When you add a few technicians as immunizers, all of a sudden, you increase the number of vaccines you can deliver.”

Now, eight months after the first COVID-19 vaccines were authorized for emergency use in the United States, Skoy’s work is not finished. She has stepped up to assist the North Dakota Department of Health in collaboration with the Centers for Disease Control and Prevention to personally visit around 40 independent pharmacies in the state that offer COVID-19 vaccines.

North Dakota is unique in that almost all of its pharmacies are owned by pharmacists. Aside from three chain stores that were grandfathered in prior to the change in state law, the state doesn’t have any national pharmacy chains. That means the independent pharmacies don’t have a national headquarters to provide guidance on their COVID-19 vaccination programs. The site visits are intended to identify needs, such as resources and guidance, pharmacies across the state may have.

“We want to be a resource for pharmacists in North Dakota and get them the information and resources they need in order to confidently communicate with patients and address patients’ vaccine concerns,” said Skoy.

—Sonya Collins
August 2021

Learn more about how to Tailor Your Outreach to address concerns from patients who are pregnant or lactating.