A coordinated strategy to develop and distribute infographics addressing COVID-19 vaccine hesitancy and misinformation

BackgroundVisual communication strategies are becoming increasingly prevalent for conveying information to health professionals as well as to the general public. The potential of social media for rapid knowledge dissemination using infographics was recognized early in the coronavirus disease (COVID-19) pandemic by health professionals.ObjectiveThe purpose of this study was to describe a coalition of health professionals’ approach to developing infographics about COVID-19 vaccines and the reach and engagement of those infographics when shared through social media.MethodsInfographics were created by a core team within the coalition following a stepwise approach. Each underwent a multistep review process, readability evaluation, and translation into Spanish. Infographics were then shared through multiple social media platforms. They were grouped into 1 of 3 categories for this analysis: COVID-19 vaccine series, myth debunkers, or other.ResultsAll infographics had greater outreach, impressions, and engagement on Twitter than they did on other platforms. When comparing the 3 groups, no 1 infographic type was consistently performing higher than the others.ConclusionEach infographic reached thousands to tens of thousands of people. We do not know whether those who viewed these infographics changed their perspective on vaccination, so we are unable to draw a conclusion about their impact on vaccine hesitancy based on this study alone.     

Exploring COVID-19 vaccine hesitancy at a rural historically black college and university

ObjectivesMinorities have been disproportionately affected by the coronavirus disease 2019 (COVID-19) yet have the lowest COVID-19 vaccine rate. Vaccine hesitancy has been reported at higher rates in African Americans (AAs) and young adults. This study aimed to assess COVID-19 vaccine hesitancy, determine the rationale for receiving or declining the COVID-19 vaccine, and propose strategies to address confidence in faculty, staff, and students at a rural historically black college and university (HBCU).MethodsA study was conducted using an electronic survey administered to a convenient sample of 210 faculty, students, and staff at the University of Maryland Eastern Shore, an HBCU in a rural community.ResultsMost participants were 18 to 24 years old (69%), college students (73.89%), AA (70%), and identified as a woman (70%). Notably, 87% of participants were nonhesitant (received one dose or intended to be vaccinated). Approximately 54% had already received at least one dose of a COVID-19 vaccine. Only 13% of participants were hesitant and did not plan to receive the COVID-19 vaccine. The most common rationale for vaccine hesitancy was mistrust of the health care system or government toward AAs.ConclusionThe results show that vaccine hesitancy was low in the predominantly young-adult AA population at a rural HBCU. However, opportunities exist for pharmacists and other accessible health care professionals to contribute to efforts aimed at decreasing vaccine hesitancy and improving vaccine confidence.     

COVID-19 and influenza vaccine hesitancy among college students

BackgroundSuccessful vaccination against coronavirus disease 2019 (COVID-19) is an essential component of achieving community immunity to bring the COVID-19 pandemic to an end. Vaccine hesitancy, identified as a top threat to global health by the World Health Organization, is a significant barrier to vaccine uptake. With COVID-19 vaccination programs in effect since December 2020, it is critical that vaccination barriers are proactively identified. With limited information surrounding college students’ perspectives on COVID-19 vaccines, outreach measures will play a pivotal role in vaccine uptake in this population. Development of informative, cohort-driven vaccination campaigns requires proactive assessment of factors influencing vaccine hesitancy, access, and uptake.ObjectivesThe primary objective of this study was to investigate the spectrum of vaccine hesitancy among college students at the University of Rhode Island (URI). The secondary objective was to identify differences in COVID-19 and influenza vaccine hesitancy rates in this population.MethodsA 22-item, Institutional Review Board–approved, anonymous questionnaire was developed to survey URI students who voluntarily attended 2 joint University Health Services and College of Pharmacy influenza vaccination clinics in November 2020.ResultsA total of 237 vaccination clinic participants consented and responded to at least 1 question on the survey. Once available to their respective priority group, 92% are very/somewhat likely to receive a COVID-19 vaccine and 50% will receive a COVID-19 vaccine as soon as possible. Only 3% of the participants stated that they would never receive a COVID-19 vaccine. The top 3 reported COVID-19 vaccine–related concerns were safety (37%), effectiveness (24%), and limited information (16%). When asked if COVID-19 vaccines and influenza vaccines should be mandated, 85% and 83%, respectively, were in favor.ConclusionUnderstanding the spectrum of vaccine hesitancy is critical in achieving COVID-19 community immunity thresholds. URI students are willing to be vaccinated against COVID-19 provided that the vaccines are proven safe and efficacious.     

Perceptions and barriers to the annual influenza vaccine compared with the coronavirus disease 2019 vaccine in an urban underserved population

BackgroundFor a vaccine to be successful, communities must perceive it as important, safe, effective, and necessary. However, there are many barriers and hesitancies to vaccination. Underserved patient populations may face additional challenges related to access and cost. Because community pharmacists improve vaccine access and increase vaccination rates, it is beneficial for pharmacists to understand perceptions and barriers to vaccinations in their community to increase vaccine confidence.ObjectivesThis study aims to assess and compare barriers and perceptions of the annual influenza to the coronavirus disease 2019 (COVID-19) vaccine for underserved patients of a charitable pharmacy.MethodsPatients who qualified to receive medications from an outpatient charitable pharmacy took an electronic survey when receiving medications. The survey incorporated questions developed by the World Health Organization’s Strategic Advisory Group of Experts on Vaccine Hesitancy on a 5-point Likert scale. Questions about the influenza and COVID-19 vaccines mirrored one another. Demographic data such as age, race, sex, and education level were also collected.ResultsOf the 189 patients surveyed at the charitable pharmacy, 71.7% were 55 years old and older and 58.9% were female. Of note, 78% and 77% of participants agreed or strongly agreed that the influenza and COVID-19 vaccines, respectively, were important for the health of others in their community. Adverse effects and the cost of the COVID-19 vaccine were noted to be statistically significantly more of a concern with the COVID-19 vaccine than that of the influenza vaccine (P < 0.001).ConclusionEnsuring equitable vaccine access, promoting the COVID-19 vaccine as free, and eliciting and addressing individual persons’ concerns related to vaccine safety and adverse effects are all important ways pharmacists and other health care providers and community stakeholders can help promote vaccine confidence within the populations they serve.     

Community pharmacists' exposure to COVID-19

IntroductionSince the beginning of the 2020 Sars-CoV-2 Italian outbreak, healthcare workers have been among the most exposed categories. There is little information about community pharmacists’ on occupational exposure, symptoms development, and testing practices in the community pharmacist cohort.MethodsBetween April 30th and May 10th, a questionnaire was administered through social media to Italian community pharmacists. From 67000 pharmacists currently working in community pharmacies, 1632 answered the survey.ResultsThe survey population reflected the general Italian community pharmacists population in terms of age, gender, and number of co-workers. Protective measures were adopted in up to 99.9% of pharmacies. 624 pharmacists (38.2%) developed at least one COVID-19 related symptom in the period between February 28th and May 10th. Also, 102 pharmacists (6.2%) were tested for COVID-19 and 15, the 15% of the tested population and 0.92% of the whole survey population, resulted positive on nasopharyngeal swab. However, while the number of symptomatic pharmacists decreased, a higher number of tests were performed, thus COVID-19 prevalence among community pharmacists could have been underestimated and is probably intermediate between other healthcare workers and the general population (0.31%).ConclusionCommunity pharmacists have probably been one of the first categories to experience increased contact risk to SARS-CoV-2. COVID-19 prevalence among pharmacists could have been underestimated. In addition, the rates of protection measures adoption might have helped to reduce the spread of COVID-19 among co-workers and the community.     

Patient perceptions of acute infectious disease point-of-care tests and treatment within community pharmacy settings

BackgroundCommunity pharmacies are well-positioned to help patients overcome many health care barriers they experience when trying to receive care. Community pharmacists are ready and equipped to provide patient care interventions like the test-and-treat model for acute infectious diseases.ObjectivesThe objective of this study was to determine patients’ experiences with rapid strep and influenza tests administered at community pharmacies, focusing on what impacted patients’ decisions to receive care, their perception of the care received, and if offering these tests in community pharmacies expanded their access to care.MethodsSeven independently owned pharmacies in Tennessee and Kentucky from November 2020 to April 2021 recruited study participants. Qualitative semi-structured key informant interviews were conducted using the theory of planned behavior as a theoretical framework. Participant interviews were audio recorded, transcribed, and independently coded by 2 investigators and reviewed by a third investigator. A qualitative analysis was completed, with a selection of supporting quotations for each theme. Qualitative analysis identified participant perceptions of rapid strep and flu POCT and treatments provided in community pharmacies, consistency and quality of patient care, and if these interventions expanded their access to care.ResultsA total of 11 patients participated in the interviews; of which, 9 (81.8%) participants were female, and participants ages ranged from 22 to 64 years (median, 40 years). Of 11, 7 participants received a strep test, 3 participants received a flu test, and 1 participant received both the tests. The analysis uncovered 10 major themes within the following 4 different categories: (1) convenience to patients, (2) quality of care received, (3) improved access to care, and (4) additional interventions for which patients want expanded access to care.ConclusionPharmacies offering services like rapid strep and flu tests provide convenience and quality care that can help expand patient access to health care and could help provide expanded access for underserved populations.     

The [underutilized] power of independent pharmacies to promote public health in rural communities: A call to action

Independent community pharmacies are in a unique and powerful position to promote public and individual health in their communities. Independent pharmacies are particularly important in rural communities where there are few chain pharmacies and accessible health clinics. West Virginia received national attention recently when they opted out of the Federal Pharmacy Program collaborating with CVS and Walgreens and developed their own plan for COVID-19 vaccine distribution and administration, heavily relying on independent pharmacies and the infrastructure they already have in local communities. However, in other areas of public health with urgent, unmet need, such as pregnancy prevention, there is considerable room for independent pharmacies to improve. The pandemic has allowed independent pharmacies to shine during the vaccination effort and has demonstrated what can be accomplished when policymakers, providers, and pharmacists work together for the benefit of community health. Expanding such collaboration to include contraceptive provision and counseling in a timely, nonjudgmental manner could play a pivotal role in preventing unintended and unwanted pregnancies.     

Virtual town halls addressing vaccine hesitancy among racial and ethnic minorities: Preliminary findings

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic remains a public health priority, and vaccination is important for ending the pandemic. Racial and ethnic minorities are disproportionally affected by COVID-19 yet report high levels of vaccination hesitancy.ObjectiveWe conducted virtual town halls to address vaccine hesitancy among racial and ethnic minorities in South Florida.MethodsOur approach used social influence and persuasion models. In a formative phase, we gathered meeting preferences from our communities and developed and tested our approach. In an implementation phase, we conducted 6 virtual town halls in partnership with 6 different minority-focused community-based organizations.ResultsThe town halls reached 379 participants (mean age 36.6 years; 63.9% female, 33.5% male, 0.3% nonbinary; 55.8% racial or ethnic minority). Of these 379 participants, 69 completed both polls who were unvaccinated at the time. Among these nonvaccinated participants, at the prepoll, 58% reported a high likelihood of seeking vaccination, rising to 72.5% at the exit poll, which was a statistically significant change. Unvaccinated non-hesitant and hesitant groups were compared on trusted information sources and reasons and barriers for vaccination. Nonhesitant participants reported greater trust in the COVID-19 Task Force (97.3% vs. 83.3%) as a source of vaccine information than did hesitant participants. Nonhesitant participants were statistically significant more likely to endorse family safety (82.5% vs. 63.2%), community safety (72.5% vs. 26.3%), personal safety (85% vs. 36.8%), and wanting to return to a normal life (70% vs. 31.6%) as reasons for vaccination than were hesitant participants. Hesitant participants were statistically significant more likely to endorse concerns about vaccine safety (63.2% vs. 17.5%) as barrier to vaccination than were nonhesitant participants. Qualitative data revealed high consumer satisfaction with the town halls.ConclusionThis study supports the feasibility, acceptability, and potential impact of virtual town halls for addressing vaccine hesitancy among racial or ethnic minorities; however, our approach was resource intensive, required an extensive community-university collaborative infrastructure, and yielded a small effect.     

Social distancing and the use of PPE by community pharmacy personnel: Does evidence support these measures?

Community pharmacists are one of the most accessible healthcare professionals and are often served as the first point of contact when it comes to minor ailments and health advice. As such, community pharmacists can play a vital role in a country's response to various preventative and public health measures amid the COVID-19 pandemic. Given the essential nature of community pharmacy as a health service, community pharmacies are unlikely to shut down in any foreseeable lockdown scenario. It is therefore important to assess the preventative measure directives for community pharmacies that are in place to safeguard community pharmacy personnel from SARS-CoV-2 in the various parts of the world. Upon reviewing the recommendations of 15 selected countries across five continents (Asia, Europe, Oceania, North America, and Africa) on social distancing and the use of personal protective equipment (PPE) in community pharmacies, we found inconsistencies in the recommended social distance to be practiced within the community pharmacies. There were also varying recommendations on the use of PPE by the pharmacy personnel. Despite the differences in the recommendations, maintaining recommended social distance and the wearing of appropriate PPE is of utmost importance for healthcare workers, including community pharmacy personnel dealing with day-to-day patient care activities, though full PPE should be worn when dealing with suspected COVID-19 patients.     

Pharmacy provision of influenza vaccinations in medically underserved communities

ObjectivesTo demonstrate the extent to which a community pharmacy can provide influenza immunizations in communities designated as medically underserved.MethodsThis retrospective study examined the number of influenza immunizations administered and populations served in areas with limited access to health care by Walgreens pharmacies during the 2009–10 influenza season.ResultsMore than 43% of the U.S. population resides in medically underserved areas (MUAs), and our results show that Walgreens pharmacies served nearly one-half of this population. Nationwide, more than one-third of influenza immunizations were administered by pharmacies located in MUAs. In states with the highest proportion of their population in MUAs, the percentage of influenza vaccines provided in MUAs was much greater (up to 77.1%).ConclusionCommunity pharmacies are convenient and accessible venues at which patients can obtain seasonal influenza vaccines and other immunizations. They are well-positioned throughout the country, including in areas that are otherwise medically underserved. These factors help community pharmacists eliminate one of the most important barriers to vaccination: accessibility.     

An observational survey assessing the extent of PrEP and PEP furnishing in San Francisco Bay Area pharmacies

BackgroundHuman immunodeficiency virus (HIV) remains prevalent in the United States despite medications that reduce the risk of infection, primarily pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP). In 2019, California authorized pharmacists to furnish PrEP and PEP under Senate Bill 159 (SB-159).ObjectiveAssess implementation of SB159 in San Francisco Bay Area community and mail-order pharmacies.MethodsWe conducted an observational, cross-sectional survey of independent community and mail-order pharmacies in the 9-county San Francisco Bay Area to identify those that were in the process of furnishing, actively furnished, or furnished under a collaborative practice agreement (CPA). We conducted interviews with furnishing pharmacies in April 2021, focusing on the barriers to and successes of implementation, as well as the impact of coronavirus disease 2019 (COVID-19), and qualitatively analyzed them.ResultsOf the 209 pharmacies contacted, 6 furnished under SB-159 (2.9%), 2 were in the process of furnishing under SB-159, and 1 furnished under a CPA. Six pharmacies and 7 pharmacists were interviewed. Barriers to implementation and furnishing included COVID-19, laboratory tests, lack of time and staff, cost to pharmacy, refill limitation, lack of patient awareness, difficulty arranging follow-up care, and vague wording of the policy. Facilitators to implementation included collaborations with clinics and health centers, privacy, increased accessibility, increased need in the patient population, and the pharmacy culture.ConclusionBarriers and facilitators to PrEP and PEP furnishing were consistent across pharmacies, suggesting strategies that could be replicated and potential improvements to SB-159.