Vaccine Mandates May Apply to Some of the Most Reluctant Patients

Pharmacist Heather Free administers a COVID-19 booster at the AIDS Healthcare Foundation in Columbus, Ohio.

Pharmacist Heather Free administers a COVID-19 booster at the AIDS Healthcare Foundation in Columbus, Ohio.

As an immunizer in her full-time job at the AIDS Healthcare Foundation in Columbus, Ohio, and as a part-time immunizer for The Ohio State University’s numerous vaccination initiatives, Heather Free, PharmD, has seen patients who come to COVID-19 vaccine clinics for all sorts of reasons.

Free has learned that immunizers can’t take a patient’s comfort level for granted simply because they’ve shown up for their appointment.

“People who want the vaccine can get in and out in a short period of time, but people who’ve been mandated to get the vaccine take a lot longer because you really have to talk them through it,” Free said.

At a COVID-19 vaccine clinic in Columbus, Free met a young woman who worked in sales and whose employer required that she get vaccinated against COVID-19 in order to resume business travel. In tears, the woman explained to Free how violated she felt by an employer mandate that undermined her autonomy over her own body.

Although the woman had signed the consent form and given Free permission to administer the vaccine, Free couldn’t do it in good conscience. “She was bawling. She was terribly upset,” Free recalled. “I can’t give a vaccine to someone who is in that state.”

Practice Pearl

Immunizers may need to allow extra time for patients who are required to get a COVID-19 vaccine for work or school and may be vaccine hesitant.

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The woman didn’t believe that the vaccine offered significant protection against COVID-19. She suspected the vaccine rollout was all a scientific experiment and worried about the possible long-term side effects of the vaccines. She was also uncertain about possible effects of mRNA vaccines on her body.

“I tried to assure her that the vaccine clinic was in no way part of an experiment,” Free said. The pharmacist spent an hour answering the patient’s questions and reviewing the most likely short-term side effects that could be expected from the vaccine. Free also explained mRNA technology and that it was so safe and effective that it was being used in treatments for other conditions. Finally, the pharmacist explained each of the vaccine choices—Pfizer, Moderna, and J&J/Janssen—discussing the benefits and risks of each.

“As she is a young woman, I explained the risk of blood clots and why the mRNA vaccines might be a better choice for her than the J&J,” Free said.

Eventually, the woman calmed down and told Free she was ready. She didn’t want to have to come back for a second dose and go through all the anxiety again, so she chose the J&J/Janssen vaccine. Though it wasn’t the one Free had recommended, she still considered this a win since the patient made the choice for herself.

“The most important thing to me was that [the patient] felt at least somewhat comfortable,” Free said. “I wanted her to be able to think back to her vaccine experience and remember something positive about it.”

Resources to help Discuss the Importance of COVID-19 Vaccination and Tailor Your Outreach to specific populations are available at APhA’s Vaccine Confident microsite.