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Pharmacists Should Expect Challenges in Increasing COVID-19 Vaccine Uptake

Getting people to agree to an annual influenza vaccine is difficult enough, but pharmacists should expect different – and maybe more – barriers with the COVID-19 vaccine, when it is FDA-approved. Find out what a recent survey revealed about factors that would cause or prevent respondents from receiving a vaccine once it becomes available.

COLUMBUS, OHIO – While most respondents to a recent survey say they would be open to receiving a COVID-19 vaccine, once available, some groups were much less likely to say they will get one.

Pharmacists who will be providing the vaccine might be surprised at how political the decision to be vaccinated against the novel coronavirus has become, according to authors of an article in the journal Vaccine.

The report points out that several prophylactic vaccines against COVID-19 are currently in development but that relatively little had been known about acceptability of a COVID-19 vaccine to adults in the United States.

Researchers from The Ohio State University conducted an online survey of 2,006 adults in May 2020 to gauge their willingness to get a COVID-19 vaccine, i.e., vaccine acceptability.

Results indicate that, overall, 69% of participants expressed willingness to get a COVID-19 vaccine. .”The interest here is higher than what we typically see for flu vaccine and other vaccines where there is a strong public health need for widespread protection,” explained lead researcher Paul Reiter, PhD, MPH, an associate professor of health behavior and health promotion.

Participants were more likely to be willing to get vaccinated if they thought their healthcare provider would recommend vaccination (RR = 1.73, 95% CI: 1.49–2.02) or if they were moderate (RR = 1.09, 95% CI: 1.02–1.16) or liberal (RR = 1.14, 95% CI: 1.07–1.22) in their political leaning.

The study team also note that respondents said they were more likely to be willing to get vaccinated:

• if they reported higher levels of perceived likelihood getting a COVID-19 infection in the future (RR = 1.05, 95% CI: 1.01–1.09),
• perceived severity of COVID-19 infection (RR = 1.08, 95% CI: 1.04–1.11), or
• perceived effectiveness of a COVID-19 vaccine (RR = 1.46, 95% CI: 1.40–1.52).

"That aligns with what we see in public health in a variety of areas -- if someone perceives themselves to be at a higher risk of a health issue, that's going to make them more likely to engage in the health behavior, in this case vaccination," Reiter said.

On the other hand, he added, “COVID-19 has turned into a political issue in many cases, and I think that some people just pick their side based on that, without much research. We've seen that with mask wearing. It's a promising public health intervention, but it's turned into a political powder keg."

While it was expected that adults who reported a higher level of perceived potential vaccine harms (RR = 0.95, 95% CI: 0.92–0.98) would be vaccine hesitant, researchers say they were concerned that participants were less likely to be willing to get vaccinated if they were non-Latino Black (RR = 0.81, 95% CI: 0.74–0.90)

"Given the disproportionate burden of COVID-19 infection and death among Black Americans, it's concerning to see that Black survey participants had less interest in a vaccine," Reiter said, referring to results that only 55% said they were likely to be vaccinated. "I think there are likely several factors at play, including access to care and trust in health care and potential socioeconomic barriers."

Such barriers are key since only 35% of participants in the study said they would agree to pay $50 or more out-of-pocket for a COVID-19 vaccine, he added.

“Many adults are willing to get a COVID-19 vaccine, though acceptability should be monitored as vaccine development continues. Our findings can help guide future efforts to increase COVID-19 vaccine acceptability (and uptake if a vaccine becomes available),” study authors conclude.