WBA Magazine

Don’t hesitate

Two pharmacy leaders discuss the drivers behind vaccine hesitancy among the Black community, and the ways Walgreens is combatting it.

Vaccine administration

The pictures and videos of millions of tiny vaccine vials making their way across the country are a welcome sight for most of us, as we collectively look toward the potential end of the COVID-19 pandemic that has shaped our lives for the past year. The end, it seems, is finally within reach.

But for some Americans, the end seems a little further away. Black Americans are contracting the virus, and dying from it, at a higher rate than any other racial or ethnic group in the U.S. But according to the Kaiser Family Foundation, nearly 35 percent of Black Americans currently have no plans to get vaccinated.

Walgreens Stories spoke with Alvin Jefferson, director of pharmacy and retail operations, and Shauna Markes-Wilson, BPharm, PharmD, healthcare supervisor, both in the Georgia East area, about some of the issues facing the Black community when it comes to the COVID-19 vaccine, and some of the ways Walgreens is trying to help.

What are some of the key drivers behind vaccine hesitancy among the Black community in the U.S.?

Shauna Markes-WilsonShauna Markes-Wilson: It really has to do with history. Communities of color have reasons to be suspicious about vaccinations, including misinformation, unethical experimentation – like the Tuskegee Experiments – as well as racial and social injustice.  The way to resolve is by rebuilding the broken trust by partnering with trusted community organizations to deliver vaccine education in various formats to ensure that members of the black communities have the information they need to make informed decisions.  Polled in the top five professional groups for honesty and ethical standards, pharmacist can also play a major role in rebuilding that trust in black communities. Making sure we reach out to the community where they are, rather than having them come to us. It’s all about building trust. That’s where it starts.

Alvin JeffersonAlvin Jefferson: If I had to sum up the reason for hesitancy in one word, I would say it’s mistrust. As a member of the Black community, do I trust you to do what’s right for me and my well-being? I think that, for a large portion of the community that looks like me, there’s very little trust that providers will do what’s best for me and for people who look like me. So it’s all about re-establishing that trust, and building it through one patient, one interaction at a time. I think we’re well-positioned for it, but it’s not a battle that will be won through talking points and advertising alone. It’s won by building back that trust, one interaction at a time.

 
What are some of the historical reasons for mistrust?

SMW: The best example is the Tuskegee Experiments, which were unethical medical experiments conducted on Black men over the course of 30 years by the government and the Centers for Disease Control and Prevention. Essentially, they were injecting syphilis into Black Americans who were told they were receiving free medical treatment. There are many examples, too, of instances like this throughout history so that creates a generational distrust. So if you’re Black and you just walk into a doctor’s office, you’re already worried about what’s going to happen to you, especially if you don’t already know the doctor or pharmacist, or if they don’t look like you.

Are there people in your own lives who are nervous about getting the COVID-19 vaccine?

AJ: I have family members who have had hesitancy around getting immunized, period. Take COVID-19 vaccine off the table, and there are people in my family who refuse to get the flu vaccine. Quite honestly, I was one of them. I wasn’t fully convinced until I caught the flu 18 years ago, while taking in a warehouse truck as an EXA. I don’t normally get sick, so this was rare, but something I knew I didn’t want to experience again. I became a believer from that point on, and I haven't gotten the flu since.

My wife, I can say, is eagerly awaiting her turn to receive the COVID-19 vaccine, but when we have discussions with older relatives, who are in the 65-and-up eligible group back home in Illinois, some of them are still just thinking about getting it, but not convinced yet. So how do we move them from thinking about it to getting it? It does really help for them to know, for instance, that we plan on getting it.

SMW: My husband, for one, has a lot of mistrust that comes from how quickly the vaccine came to market, in his opinion. So not only is he dealing with historical mistrust, but also some skepticism about this vaccine specifically. So, for people like him, it’s a challenge to convince them to get vaccinated.  

What changed his mind about the vaccine was reviewing information from research and witnessing first-hand the devastation this virus can cause to friends and family members.

He now wants to get the vaccine, when it is available to him, as he now sees that the benefits of vaccination outweigh any perceived risk.

AJ: As the number of cases continues to rise, we’re getting really close to the point – if we’re not already there – where most people know someone who has had a close call, knows someone who died from COVID-19, or has had it themselves. And so people see with their own eyes that this thing is real, it’s happening and you don’t want to get it. I have people reaching out to me from church groups, on Facebook and other personal interactions saying that, yeah, they want the vaccine and don’t want to take their chances without it.

Are there factors besides vaccine hesitancy that can account for relatively low vaccination rates among Black Americans?

SMW: Absolutely. It’s not just reticence or hesitancy on the part of patients that’s coming into play here. You also have to look at access to healthcare – many doctor’s offices and hospitals are not located in or near Black communities. When you look at factors like low income and inadequate access to transportation, and even access to digital platforms and the internet… do people in these communities have access to the digital services needed to make doctor’s appointments? Are they able to take advantage of telemedicine? And then, can they afford to visit a doctor when they’re really just worried about putting food on the table? Access is a huge issue.

What are some of the ways Walgreens is addressing both vaccine hesitancy and issues like healthcare access inequality for Black communities?

AJ: I think the biggest and best resource we have to help engage with Black communities and to help protect those lives is our pharmacists. We have 85,000 healthcare service providers throughout the country, including pharmacists, pharmacy technicians, nurse practitioners and other health-related professionals. That’s critical, because our pharmacists and technicians are already in these communities, they’re trusted by their patients and they look like them. There’s a Walgreens within five miles of 78 percent of the country, so that’s huge for people that they can engage with a person they already know and trust to provide this protection.

Another thing we’re really excited about is our recently announced partnership with Uber. We’ll be able to provide free rides to a Walgreens location for individuals who need to get their vaccination. That’s a big step toward overcoming those barriers, in terms of transportation and economic access.

SMW: I would also say that it all starts with the company being aware of these disparities, and then taking steps to act on it, like the partnership with Uber. Another thing we’re doing is working with specific communities in Chicago, and across the country, to bring healthcare – and vaccinations – to them, ensuring they have all the resources they need, and that the entire team serving the community looks like them. That’s such a big deal, and it’s something that goes for the entire company, in terms of ensuring that we’re looking at diversity, equity and inclusion first and foremost in our hiring practices. In order to take care of a diverse population, it’s very important that we have cultural sensitivity, and also knowledge of those cultures so we can relate to people in these communities. That’s how we build trust, and that’s how we make sure we’re doing everything we can to protect everyone in this country.