The news that Pfizer, Moderna, and AstraZeneca have each developed effective COVID-19 vaccines offers an end to the pandemic. However, there are considerable moral, logistical, and financial challenges standing in the way of ensuring that the vaccine is available in significant quantities – quickly enough – and to those communities disproportionately impacted to achieve this result.
The logistical challenges of getting the necessary two injections into millions of American arms represent the next hurdle to be cleared in this public health crisis. This hurdle is made higher when combined with the need to convince a skeptical population to get the vaccine. Americans’ skepticism is not only tied to the vaccines’ efficacy or safety. The overall mistrust of government – particularly when it comes to COVID and how it has been managed – and distrust of the pharmaceutical industry are also decisive factors. Achieving vaccine confidence will be key to the uptake of the vaccine.
The general public’s skepticism is significant. The latest Axios-Ipsos survey shows that just over half of Americans (51 percent) say they’re likely to take a first-generation COVID-19 vaccination. On the plus side, that’s an improvement over last month’s finding. However, if the population is convinced the vaccine is safe, seven-in-ten (70 percent) Americans and just over half (55 percent) of Black Americans would be willing to get it. The critical challenge is to increase vaccine confidence such that those numbers increase significantly.
Recent surveys suggest that only 17 percent of Black adults would “definitely” get a free COVID-19 vaccine and nearly half said they would not get it. Another study of Black and Latinx communities offers additional proof of the challenges of achieving vaccine confidence: only 14 percent of Black Americans have trust in a vaccine’s safety and slightly more than one-in-four (28 percent) are “confident that a vaccine will be tested specifically for safety in their racial/ethnic group.”
As we’ve noted before, not only have communities of color been disparately impacted by disease and poor health status, historical factors tied to the public health and healthcare industry drive these communities’ distrust of government-pushed vaccinations. The horrors of the Tuskegee syphilis study illustrate this point. Given that Black Americans and Latinxs are three times more likely to get COVID-19 than are whites, and urban environments have virus fatality rates three to six times higher than rural areas, this is a troubling baseline to start from.
To overcome this pervasive lack of trust, local and chain pharmacies will need to build confidence in the vaccine with a public where there is significant skepticism in both the general population and communities of color.
In an effort to meet this challenge, the U.S. Department of Health and Human Services recently announced that to increase access to COVID-19 vaccinations, it had struck a deal to partner with large chain pharmacies and “networks that represent independent pharmacies and regional chains.” This is an important start, but vaccination success will require the development of a myriad of community, corporate, and governmental partnerships to promote vaccine confidence and manage the logistics of vaccine distribution.
Big chain pharmacies can service the vast majority of Americans – eight in ten Americans live within 10 miles of a CVS and nearly 20 percent live within one mile. This is significant: a Franklin Templeton-Gallup Economics of Recovery study found that 15 percent of respondents who previously said they would not get the vaccine identified availability of the vaccine at their local pharmacy as a major factor influencing whether they would ultimately get vaccinated. Given their proximity, retail pharmacies and especially those in urban environments must engage their customers and the communities they serve to promote health literacy about the vaccine and build social capital and trust. We believe these pharmacies are uniquely positioned within communities to help build vaccine confidence and ultimately ensure Americans have equitable access to it.
To start, these pharmacies must gain deeper insight into their customer base, understanding where and how they live and learning what influences their health-care decisions. It will also be important to identify and address barriers to healthcare access. These goodwill efforts will assist in managing some of the communication considerations important to tracking which community residents have received which vaccine, when, and informing them when they need to get the second dose.
This important opportunity requires a plan that is inclusive of key stakeholders and partners. A plan founded on health equity, that properly considers those disproportionately impacted by the pandemic and who have too often been an afterthought, will be critical. Demonstrating cultural competence allows for the consideration of those subtle and more evident intersections that have created health inequities. Partnerships are key to this approach: it’s not “them,” it is “us.” The virus has continued to outpace our efforts to understand and manage it. Now with the release of a vaccine on the horizon, it’s more important than ever that we work together, and the retail pharmacy industry provides an important nexus in creating important partnerships.
It is up to each of us to protect our community. Vaccination is less about our individual protection and much more about protecting our family, friends, and community. It is incumbent on the corporations and organizations that will administer the vaccines to understand all of the communities they’ll be servicing. We’re all in this together.
