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vaccine administration: ASSURING SAFETY
impetus necessary to encourage someone to be vaccinated. Pharmacy technicians should also encourage all colleagues to receive their vaccinations. The facility manager, the human resources personnel, and everyone who is a part of the facil- ity should be vaccinated to protect each other and the sick patients who are served in the facility. Many facilities offer but- tons or stickers to recognize those on the staff who have been vaccinated. These team-building and positive recognitions are important in helping the vaccination team promote this service. Walking the talk also means working to stop misinformation. Every member of the vaccination team must understand that jokes about vaccines, forwarding memes that inaccurately depict vaccinations or anything else that may undermine public trust and understanding of vaccines is unacceptable and unpro- fessional. No one expects that every member of the health care team will actively try to refute bad information, but refusal to continue the distribution of bad information is expected. Vaccine Hesitancy While pharmacies are making an impact in improving vacci- nation rates, there are several diseases where the American population is perilously close to falling below the needed vaccination rates to assure herd immunity. This protective herd immunity against historically deadly diseases such as measles and mumps is waning because children are not up to date on their vaccines. This is due, in part, to a concept termed vaccine hesitancy. Vaccine hesitancy is a complex combination of factors that ultimately leads to patients or par- ents refusing vaccinations. While vaccine advocates can be frustrated by these refusals, it is imperative that all mem- bers of the health care team remember that patients do not make decisions they believe will be dangerous to them. When someone refuses a vaccine, there is a reason for making that decision. It is up to the health care team to be respectful and empathetic when addressing these concerns. Vaccine hesitancy is not an “all or nothing” refusal in most cases. Patients may refuse one vaccine and be willing to accept another. Patients who are not able to receive a vaccine because of safety are not vaccine-hesitant, they are ineligible to be vaccinated. While herd immunity, if achieved, will pro- tect the hesitant and the ineligible, it is the patient who cannot receive a vaccine that is the focus of community health efforts to increase vaccination rates. Patients with a religious oppo- sition to vaccinations are also not vaccine hesitant. They are ineligible to be vaccinated because of a non-medical reason. However, this does not make their need for protection differ- ent from anyone else who cannot be vaccinated. It is important that every member of the health care team responds accurately and empathetically when talking with the vaccine hesitant. Several issues should be considered when dealing with vac- cination hesitancy, including understanding the concerns being expressed, providing accurate information at all times, and not arguing with the patient who is hesitant. While health care providers agree that vaccines are a personal and public necessity, these same members of the health care team often do not attempt to understand why anyone would refuse. Or, worse yet, they want to try to argue with the hesitant to try to change their minds. However, health care providers should try
Table 2: Vaccination % Required for Herd Immunity
Infectious Disease Vaccination % Needed US 2017 Vaccination Rates
Diphtheria
83
83.2%
Measles
92-95
91.5%
Mumps
75-86
91.5%
Pertussis
92-94
83.2%
Polio
50-93
92.7%
Rubella
83-85
91.5%
Smallpox
80-85
world-wide elimination
Vaccination rates are expected to be lower following the COVID pandemic because people have been afraid to seek routine medical care. This will offer an incredible opportu- nity for pharmacy technicians to be a part of the solution in increasing vaccination rates and helping children “catch up” in routine vaccinations. World-wide success in the eradication of smallpox is attributable to effective vaccination programs, administered around the globe. Most recently, the continent of Africa was declared to be polio-free for the first time ever. The control of these diseases is a direct result of immuniza- tion programs and the work of public health professionals. It is important to note that herd immunity is NOT a first-line strategy for disease prevention. Immunizations and proper personal hygiene are the first-line strategies in all cases. Personal vaccination is the best protection a person can have against infectious disease. Avoiding transmission by wearing a mask, staying home, and washing or sanitizing hands is also very important. The concept of herd immunity as a protective strategy is intended to help protect those who cannot be vacci - nated. It is NOT intended as a mechanism to avoid vaccination. Remember, herd immunity only exists for those diseases that are transmitted between humans. There is no herd immu- nity for a disease such as tetanus, where the bacteria exist in nature and is not shared between people. Furthermore, there is no human herd immunity for diseases spread by insects or other animals because protecting the humans does not stop the vector. For these diseases, the only protection for the patient is to avoid exposure and receive their own vaccination. Walking the Talk and Stopping Mis-Information Pharmacy technicians are in a unique position to encourage vaccines and to stop misinformation. Often, the first member of the pharmacy team that the patient or the caregiver encoun- ters is the in-take pharmacy technician. When a patient or caregiver asks, “Have you had your vaccine?”, it is important to be able to answer truthfully in the affirmative. This is known as “walking the talk.” No one can simultaneously advocate for vaccines and the public protection they provide and refuse to be vaccinated themselves. There will be vaccinators who cannot be vaccinated because of a medical condition or therapy. For these professionals, the best answer to the question, “Have you had your vaccine?” is, “No, I cannot be vaccinated, so you getting your vaccine protects us both.” People are motivated by their ability to help others, and this message may be the
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