Addressing Vaccine Hesitancy Through Culturally Competent Care

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Providing culturally competent care is one way pharmacists can help improve vaccine uptake in their communities.

Jacinda C. Abdul-Mutakabbir, PharmD, MPH, assistant professor of pharmacy practice at Loma Linda Unversity, sat down with Drug Topics® to discuss the importance of culturally competent care in improving vaccine uptake in minority communities.

Drug Topics®: What are the factors that contribute to vaccine hesitancy in minority communities?

Jacinda C. Abdul-Mutakabbir: There are various factors that contribute to vaccine hesitancy within minoritized communities. But the biggest of all [is] the historical context. There's a lot of history associated with vaccines in minoritized communities but more importantly, there's a long history of mistreatment by the United States public health system. And then, more contemporary situations where individuals of minoritized communities may go into the doctor's office; racial concordance is not something that they are often privy to because individuals of these communities are less likely to pursue extended training. With that being said, because of the historical issues—we know the Tuskegee experiment and the mistreatment there—but in addition to experiences that individuals have every single day, now they're in the place of “Well, why would I receive this vaccine?”

There’s a history of not receiving adequate health care. We know that there's a history of misusing individuals of minoritized backgrounds; we know the HeLa cells, we know the misuse of scientific information pertaining to Black communities and minoritized communities in general. But then now, when I'm going to the doctor's office, I'm having these poor experiences. Now I'm less likely to believe and trust in science [and] in the scientific community, and as well as the vaccines.

I believe that it's important for us as pharmacists to understand this hesitancy, to understand the historical factors, and to know that there are definitely credible reasons as to why individuals wouldn't want to receive those vaccines, but having that information, developing strategies. Those strategies can be you know, identifying that “I know that this exists.” If you are not someone who can directly and intimately associate with that experience, provide that information of, “I know this exists. I know that I don't directly identify with this experience that you had. However, I believe that the vaccine is important for X, Y, and Z reasons.” I think that's a really big place where pharmacists can shine, [and] also show you know, that we are those that we want for you to trust in terms of receiving the vaccines.

Drug Topics®: What role can pharmacists play in ensuring that vaccines are distributed to minority communities in an equitable fashion?

Abdul-Mutakabbir: There are several roles that pharmacists can play to ensure that vaccines are equitably disseminated across minoritized communities. I think the biggest one is advocacy, and then action. So, advocating for the vaccines to be placed in this community.

I will say that the National Pharmaceutical Association, the Society of Infectious Disease Pharmacists, and the American College of Clinical Pharmacy have collaborated to make statements that were disseminated to the CDC and to the health equity task force in terms of placing both vaccines, as well as oral antivirals, into racially and ethnically minoritized communities. I think that's a big place that we don't really think about. These public official officials—while they aren't maybe easily accessible, they are accessible, and we do have ways that we can get messaging to them. I think that's important to advocate in that way and to make those into make that statement that pharmacists are positioned here to ensure that vaccines can be adequately distributed, but we need support to make sure that this is a reality, and really outlining the issues that that are there that prohibit that.

Also, creating assessable models [such as] community pop up clinics, mobile vaccination clinics—modes of health care that are right there in the communities, so that when individuals are unable to access pharmacies where the where the vaccines may be, well, now we've created this model where we've placed those vaccine clinics right there in the heart of the community. And now we’ve promoted uptake because we've made accessibility that much easier.

Drug Topics®: What is your top tip that pharmacists can put into practice to help improve vaccination rates in their communities?

Abdul-Mutakabbir: My top tip would be to be culturally competent. I think that when we talk about cultural competency, individuals look at it solely from the perspective of racially and ethnically minoritized communities. While that is a major factor and is important, what cultural competency really means is that we are acknowledging that every single person is different; every single person has different external factors.

We have to realize that and make sure that we keep that in mind when we communicate regarding vaccines or health care in general. I think that we have to remember to be culturally competent, to be empathetic, and to treat individuals that we interact with—our patients—with the respect and kindness that we would want them to treat us with should the roles be reversed.

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