Brent I. Fox, Pharm.D., Ph.D and Joshua C. Hollingsworth, Pharm.D., Ph.D.

We are more than halfway through 2021, and the COVID-19 pandemic is still dominating the news, unfortunately. Primary talking points include the impact and potential impact of new variants; vaccination rates and boosting vaccination rates by addressing vaccine hesitancy; and regulation regarding proof of vaccination. Recently, the United States set a goal of getting 70% of Americans vaccinated by July 4. Although efforts have been truly impressive, we have fallen short of this goal. There is still significant work to be done in terms of vaccinating our population. As vaccination efforts continue, major barriers must be addressed in order for these efforts to be effective. Here we will discuss vaccine hesitancy — a barrier for many in terms of getting vaccinated — as well as technology you can use when creating messaging campaigns to promote incentives, assistance programs, and pertinent information to prompt patients to get vaccinated.

VACCINE INCENTIVE RESOURCES
www.nga.org/center/publications/ covid-19-vaccine-incentives/
www.vaccines.gov/incentives.html

Vaccine hesitancy is defined by the World Health Organization (WHO) as a “delay in acceptance or refusal of vaccination despite availability of vaccine services.” Further, the WHO states that vaccine hesitancy is “complex and context specific, varying across time, place and vaccines,” and that it is “influenced by factors such as complacency, convenience and confidence.” Studies assessing hesitancy regarding COVID-19 vaccines have found lack of confidence to be the biggest driver of vaccination hesitation. If you think about it, this makes sense. Given the negative impact that the pandemic has had thus far (and continues to have), combined with the positive impact that widespread vaccine adoption will have, and the extensive media coverage that the pandemic and vaccination efforts have garnished, complacency is relatively low. People generally want to do their part to protect themselves and others (as long as they are confident that the vaccine is safe and effective). And with nearly every healthcare institution, including most retail pharmacies, offering free vaccinations, getting vaccinated is pretty convenient, all things considered. (In fact, a quick search at www.vaccines.gov reveals there are 24 COVID-19 vaccine providers within 5 miles of Auburn, Ala., 22 of which are pharmacies). That said, efforts should still focus on decreasing complacency and increasing convenience in order to maximize vaccination rates, and addressing vaccine confidence should be included in the process.

Vaccine confidence refers to an individual’s trust in 1) the vaccine development, testing, authorization, and manufacturing processes, 2) the safety and effectiveness of the resulting vaccine, and 3) the providers administering the vaccine. Vaccine confidence varies widely across communities and populations. One major factor that leads to low confidence in the COVID-19 vaccines is concern regarding adverse effects, both in the short and long term, known and unknown. But this is only one of many potential factors that can lead to low vaccine confidence, and it is pertinent that the concerns of the individual patient are addressed. Thus, pharmacists and other healthcare providers should take a patient-centered approach when providing evidence-based information to boost vaccine confidence. To maximally boost vaccination rates, efforts should simultaneously strive to make getting vaccinated as convenient as possible, provide incentives to diminish complacency, and address concerns to boost confidence in the vaccines. Such synergistic efforts will no doubt translate into more people getting vaccinated. Given this, let us consider some specific approaches that could be used to address vaccine hesitancy by decreasing complacency and increasing convenience and confidence.

Financial incentives, such as gift cards, discounts, freebies, and lotteries, can increase motivation and thus decrease complacency. Such financial incentives are being offered from individual businesses up to the state level, and we know that they are effective at decreasing complacency, especially with one- or two-time behaviors such as vaccination. What financial incentive(s) can you offer to boost your patients’ motivation for vaccination? Discounts on front-of-store merchandise? In addition to your offering, you can also increase awareness of incentives that others are offering. For example, the National Football League (NFL) is offering to vaccinated persons a 25% discount on merchandise and a drawing for a chance to win 50 tickets to Super Bowl LVI. And city leaders in Memphis, Tenn., began a sweepstakes for a free car to any resident who was vaccinated. For more incentives, visit the sites in the box.

Then there are assistance programs designed to make getting vaccinated more convenient. These programs make getting vaccinated easier by decreasing the time, money, and/or effort involved. For instance, both Lyft and Uber are offering free rides to vaccine appointments. And the YMCA and Bright Horizons are offering free childcare during vaccine appointments. If these services are available in your area, consider mentioning them in your messaging campaign regarding COVID-19 vaccination. Further, be sure to check with your state and county departments of health to see if there are additional programs in your area to which you could direct patients.

Increasing vaccine confidence can be more challenging. Generally, you want to address the individual’s thoughts and concerns regarding the impact of getting vaccinated versus not getting vaccinated. And you want to take a balanced and evidence-based approach without pressuring patients. You must acknowledge that it is their right to choose whether or not to get vaccinated. Given that you have the requisite training, motivational interviewing is a powerful approach that can be utilized when discussing vaccination with a patient. But what about general messaging to increase vaccine confidence? The CDC has six ways that you can help build COVID-19 vaccine confidence. These include encouraging community and organizational leaders to be vaccine champions, sharing key messages regarding safety and effectiveness, and providing education regarding vaccine development and safety monitoring, among other strategies. These are all things that you can include in your messaging meant to prompt patients to get vaccinated.

So, we have discussed general approaches to address complacency, convenience, and confidence regarding COVID-19 vaccines. But how do you systematically alert patients to the incentives, assistance programs, and information available that will facilitate their getting vaccinated? This is where your pharmacy technology comes in. There are many approaches that you can use. Here are a few. Post information regarding the incentives and assistance programs available to your patients on your website, along with key information regarding the safety and effectiveness of the vaccines. Create a QR code that links to this information on your website and that you can print and attach to prescriptions for patients to scan upon pickup. If you are on social media (e.g., Facebook, Instagram), consider posting incentives, assistance programs, and information there too. You can also use these platforms to publicly engage with and promote community leaders who are serving as advocates for vaccination. Set up your interactive voice response (IVR) system to mention promotions and assistance programs regarding vaccination when patients call your pharmacy. If your IVR supports outbound calls, create a campaign that reaches out to your patients. Create an email and/or text messaging campaign that covers the incentives, assistance programs, and information pertinent to prompting your patients to get vaccinated.

There you have it. A few technology-based strategies that you can use to provide information, alert your patients to the incentives and assistance programs available to them and, ultimately, prompt more of your patients to get vaccinated. As always, we want to hear from you. What strategies have you found to be effective for facilitating COVID-19 vaccination? And what other approaches do you plan to try? Let us know. We welcome your comments. CT

Joshua C. Hollingsworth, Pharm.D., Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, and Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University.
The authors can be reached at jhollingsworth@auburn.vcom.edu and at foxbren@auburn.edu.

Advertisement