 I can hear some physicians saying, “You are infringing on my right to practice the way I want to practice. You are going to make me give out naloxone. You are going to make me counsel my patients. You are labeling these drugs in a way that I do not think is appropriate for my patients.” I’m sure there are providers that say, “I want my autonomy here.”

 Can you name 1 doctor who would say it is not a good idea to educate a diabetic about hypoglycemia?

 No one who is not in prison at the moment.

 Exactly. It goes back to understanding what is normal and what is good medical care, emphasizing that good medical care means looking at the risks involved in any treatment: the good, the bad, and the ugly. The ugly is not breathing anymore and dying, whether it is intentional or unintentional. When we prescribe opioids with the best of intentions, to people who we have done very well, there still is a risk. That risk can be somewhat mitigated by the appropriate discussions and the appropriate use of naloxone. Hopefully, that that would resonate with more people. They can appreciate that this is the best practice, as they would do in their other areas of medical care.

 What are some strategies here? In other words, we agree. I suspect if you put this in the abstract, all physicians would agree that living is better than dying. Overdoses are bad; naloxone prevents them. How do you get from here to getting physicians onboard and saying everybody should be doing this?

You have to change policy; that is the first step. Then you prescribe often. You get over your reluctance to do it, and there will still be physicians who will be reluctant, but I am sure you all know somebody who has gotten the call that said, “I’m so happy I had that naloxone, it saved my life.” Or someone may say, “I feel more secure that I have that.” These are the things happening in our state.

 It is a combination of carrots and sticks. It takes a policy to hit a certain group of folks. It comes with the reward of lowering the bar and making it easy. Or if you back up even further, we need to make folks think that this is both a good idea and with the policy, that it is required. Letting folks know that this is a good thing, making it easy, eliminating the need for a prescription when you can, and then having some antidote data to explain why it’s a good idea will all result in success.

We did a naloxone training a few years ago at 1 of the hospitals that I work at, and that night 1 of the nurses who works at the hospital saved her daughter. It does not take many cases like that to get a small microcluster of folks onboard very quickly.

It is not 1 effort that will hit everyone. Some physicians need sticks to get them moving in the right direction—maybe a lot of them do—but a mix between positive and negative reinforcement in addition to other stories that pull at folks’ heartstrings a little—a combination of all those things is the most effective.

 I also think that education starts early in our careers. If we can start educating the health care professionals in the beginning of their training, so it becomes integral to what they do, it will also help, because they’ll be coming out of their schooling with it being normal for them to do this.

One of the things that we have done is we have pharmacies that have overdose response protocols. We think there is an overdose in a pharmacy once every single day. I know many of my colleagues and students have saved people in the parking lot and in the bathrooms, just as some have said. I just heard this week that we have lots of overdoses in Rhode Island. We were in the top 10 areas for many years. We are probably going to be in it this year. But at 1 of the major hospitals’ associated primary care clinics, someone overdosed and there was no naloxone, and none of the physicians or nurses or pharmacists carried it. They had to call EMS [emergency medical services] to their primary care clinic. I ask you, do all of you have naloxone, and is all your staff trained to use it? Dr [Jeremy] Adler is. nodding yes. It’s interesting: They said we’ve got risk assessment and legal involvement. I’m like, this is a no-brainer. All of you are health professionals. You should have had it. My student was walking past a hospital and saw someone having an overdose and a nurse who was walking at the same time, had naloxone, saved the person, got them connected to care.

Theresa Mallick-Searle, MS, RN-BC, ANP-BC:

 It’s the same sort of public health initiative as CPR [cardiopulmonary resuscitation]. It is going to take more, unfortunately. People do not like to be told what to do at any level, and this needs to be a mandate. We need to work together. I’ve seen the biggest push in terms of the promotion of naloxone for patient safety recently. I’m learning about what these EDs [emergency departments] are doing, and it is a great thing you are doing in New York, but it has really been the pharmacists pushing this. I get patients who come back to clinic and educate me with all that they learned from the pharmacist about the availability of naloxone. It is working together.

 Your analogy is apt. A few years ago, it was, “Let’s get defibrillators everywhere.” A defibrillator, I must tell you, in an unexpected location, saved the life of my best friend who went down with VFib [ventricular fibrillation]. It is so much easier to do naloxone; it is silly. To involve lawyers with a drug that has no real downside, no adverse effect, and has only an upside just seems to be [saying]: It is cheap, it is available, it works, and it saves lives. So what am I missing here?

Videos

Multidisciplinary panel of clinicians discuss whether recommendations made by national, state, and local agencies infringes upon clinical practice autonomy.

Are Recommendations Infringing Upon Practice Autonomy?

 What are the challenges in adopting biosimilars in your practice? We have a great mix of panelists: Ryan has the academic perspective. Tim is in New York, where he has his own mecca of cancer center that drives decisions across the country. Brandon comes from the community side, so we’re trying to understand the various dynamics that play a role in biosimilar adoption. We’ll start with Ryan in terms of the challenges seen for biosimilar adoption in the oncology and nononcology space.

 Great question. We’ve had different stories between oncology and nononcology, and I’ll lead with that. Initially, about 3 to 4 years ago, we started having our first biosimilars really integrate the growth factor space with pegfilgrastim. A lot of discussions were coming up with biosimilars. In academic institutions, a lot of physicians and providers were very much against biosimilars initially. They had their opinions. This was for patients in curative state. The thought was, “How could we experiment with their lives with biosimilars?” Oh, has that changed.

Coming from there, we did a survey. We figured out the biggest education gaps in terms of biosimilar adoption. What are things we can focus on? Through time and familiarity, and with help from our payers forcing us to use some biosimilars, our providers got a lot more familiar with utilizing them across this space. For oncology, it’s become very accepted to utilize biosimilars. We’re also being a lot more sensitive to the financial toxicity and total cost of care of value-based contracts that our organization may join in. From that perspective, our providers are on board and have almost deferred to pharmacy at this point through a P&T [pharmacy and therapeutics] proposal to select the most appropriate biosimilar for a patient as long as it’s the same therapeutic drug. That’s been a huge lift for us, and it’s allowed us to be very adaptable and excel the practice of our pharmacy team while being good financial stewards and utilizing biosimilars by carrying costs and therapeutic selection.

But within the nononcology space, it’s been a little slower uptake. When we think of rituximab, it’s used across oncology and nononcology. Oncology providers were more receptive to uptake it, especially in the patient population for hematology. But when we have our nononcology areas, such as gastroenterology and rheumatology, there has been a little more hesitation around switching. There is a little more lack of awareness about immunogenicity data and concerns there. Now there are some rituximab products that come up that have switching data, specifically within rheumatology, and that’s been really helpful to leverage so that we can be a strong utilizer of biosimilars in the oncology area.

 That’s great. You guys are doing some amazing things, and I’m sure that there’s significant adoption across your territory.

Ryan Haumschild, PharmD, MS, MBA, provides insight on biosimilar adoption both in oncology and non-oncology practice settings.

Adopting Biosimilars in Clinical Practice

 What are the recommendations the CDC put out, and are they being implemented? Are they mandatory? What’s the deal here, Jeffrey?

 This is what I said before. Everyone is a first responder, so everyone needs naloxone. My colleagues had a federal grant-funded program where you can go online, watch a training, and they will mail you naloxone. This is fantastic. Actually, in more than half the states in the country, the pharmacy-based naloxone nonprescription laws allow you to call your pharmacy, fill it, and have your insurance pay for it, and they will mail it to you.

We made these adaptations for COVID-19. This helps decrease that stigma. If an officer or off-duty officer comes to my house because my neighbor overdosed or someone is at risk in my apartment complex, they say you need naloxone, and they either drop it off or, if they do not have enough, they say you can call your pharmacy and they’ll ship it right here. Those are the things that are necessary. This report also said the majority of opioids being used illicitly are synthetic opioids, and that’s what’s killing people. There were more overdoses in the 12-month period leading into and including May 2020. There were more overdoses than ever reported, over 81,000, and the majority of those involved synthetic opioids. There is not just a rise in synthetic opioids where I live on the East Coast; it is happening in the Northeast, California, Washington, Oregon, New Mexico, Utah. In these places, the number of overdoses as a result of the misuse of synthetic opioids is still increasing.

Dr Lynch, I think, talked about making sure that naloxone gets in the hands of people after prison. I know New York has that. Rhode Island has that, and we are expanding that. Now we are expanding drug treatment for opioid use disorder treatment in prisons. Treatment is prevention as well, but we are making sure that we prescribe and dispense naloxone with people who are on pharmacotherapy for opioid use disorder. That is where that ties in with the health alert.

 Not only do we need—and I think the CDC said this—to be sure naloxone gets out there, but people have to understand naloxone and how to use it. For example, the half-life of naloxone may be shorter than the half-life of some of the opioids, so you may need another dose. People need to understand that. There needs to be a widespread education program. Nobody is jumping in on this.

 In regard to the public health aspect, we have also worked hard educating the public about good Samaritan laws. When naloxone is used, you still should call 911. When the police come, they are not hauling everybody away in most cases. It is still recommended that you call for emergency services after naloxone is used. We have partnered with some local health departments and put naloxone rescue boxes on walls. They are similar to what an AED [automated external defibrillator] cabinet would look like. At the site of an overdose, someone from the health department will usually come out within a couple of days with a box that has naloxone in it, some gloves, a little business card of instructions, and on the outside, instructions to call 911. We have colocated those with AED boxes, but we have also put them in odd spots such as bathrooms of certain places, public transportation, etc. There is no alarm or anything that goes off when you open the door. Somebody watches them, and when they are empty, the health department replenishes them.

Jeffrey Bratberg, PharmD, FAPhA, and Joshua Lynch, DO, EMT-P, FAAEM, FACEP, discuss highlights from the December 2020 CDC Health Alert and application.

December 2020 CDC Health Alert Highlights and Implementation

As the FDA and CDC have paused use of the 

 vaccine in the United States, research is ongoing to understand whether cerebral venous sinus thrombosis (CVST) is directly linked to the vaccine.

AstraZeneca vaccine has faced similar concerns

 in Europe, said Michael Haydock, senior director of therapy area analysis for cardiovascular, metabolic, and infectious diseases at Informa Pharma Intelligence. In an interview with 

, Haydock said that because researchers do not really know the rate of naturally occurring CVST, they are trying to establish whether vaccine-related rates of the condition are higher.

Because the single-shot approach of the Johnson & Johnson vaccine could potentially accelerate vaccination efforts in the United States, Haydock said the pause in use could significantly slow down the vaccination campaign, especially among young adults. Because younger adults often believe themselves to be at a lower risk, and therefore do not see the vaccines as necessary, any additional risk posed by the vaccines—even if the benefits outweigh the risks—could give young adults a reason to not receive the vaccine. This could be the biggest potential problem, Haydock said.

Despite these concerns, Haydock said he still believes that the benefits far outweigh the risks for both the Johnson & Johnson and AstraZeneca COVID-19 vaccines.

As the FDA and CDC have paused use of the Johnson & Johnson COVID-19 vaccine in the United States, research is ongoing to understand whether cerebral venous sinus thrombosis (CVST) is directly linked to the vaccine.

Johnson & Johnson, AstraZeneca COVID-19 Vaccines Share Concerns About Rare Blood Clots

 One last thing I want to talk about is implications of secondary patents and what a skinny label is—that’s the term we hear in the current market. Brandon, I would like to understand your explanation on that.

 If you’re a drug manufacturer of the originator biologic product, you have a goal to maintain patent rights on your drug for as long as possible. If you’re a biosimilar company trying to create a biosimilar, you have a goal to get it to market as cost-effectively as possible. I think of secondary patents and skinny labels as the 2 of the tools that each side has at its disposal. A secondary patent is when you make a change in formulation of an existing product, which can change how it’s delivered. It can change any number of things, and then you get a patent on that. A good example of this might be the Neulasta [pegfilgrastim] on-body injector. There are biosimilars for Neulasta [pegfilgrastim] for the syringe, but not for the on-body injector. They’ve been able to extend their patent by creating this different formulation.

Another thing you’re seeing more of recently is other drugs like rituximab and daratumumab, which have subcutaneous formulations. That is a secondary patent where they create it in a different dose form and are able to extend all the rights and privileges of rituximab, the originator product, in this new form. Skinny labels are on the other side; that’s what a biosimilar company might do. Rituximab actually is a fantastic example of this because rituximab is used for nearly a dozen rheumatoid conditions and B-cell lymphomas. It’s used in a lot of places. For example, Ruxience [rituximab] does not have on its package insert “rheumatoid arthritis.” They did not pursue that as part of their strategy. By doing that, I assume they have been able to save money on developing that particular thing on Ruxience [rituximab]. They’re able to get it to market in a more cost-effective way, and it may very well be used for rheumatoid arthritis because we use rituximab for rheumatoid arthritis. There can be interesting legal implications on this. Even recently, not in the biologic world, but there’s been ongoing debate with Coreg [carvedilol]—it’s actually still an ongoing piece of literature or piece of legislation—that, depending on how the courts decide how that ends up, could impact what skinny labels look like and if they’re advantageous or not.

 That’s a great summary. I also wanted to ask our panelists, does that have implications in your practice, having a drug with a skinny label? Brandon, perhaps you can answer that. Does that have any implications in how you utilize a biosimilar in your practice?

 In a community setting, a lot of what steers our practice is payer driven. If a payer is unwilling to pay for something that’s not on the package insert, then it absolutely has an impact. We will not use that product. But many others and many times it does not. Many payers prefer biosimilars because it’s more cost-effective and because they do, as we’ve learned already, go through a high burden of proving they’re similar.

 Also to note, I think NCCN [National Comprehensive Cancer Network] Guidelines are also driven payer reimbursement. So having these indications in the NCCN Guidelines helps us with payer coverage. Payers will definitely be talking more about that. Tim, what biosimilars are currently approved from a therapeutics perspective in oncology?

 From a therapeutic standpoint, our first biosimilar that was approved was the first of currently 2 approved bevacizumab biosimilars, and that was in 2017. As we know, our first biosimilar that was approved was in 2015 in the supportive care context with the first filgrastim. But since we started seeing the approval of our first bevacizumab therapeutic biosimilar, we’ve had 3 biosimilars FDA approved for rituximab. Now we’re up to 5 biosimilars approved for trastuzumab. As you might expect based on other discussions about biosimilars, not all these are available in the market because of numerous patent litigations and all these types of things that cause these significant delays. We’ve talked about rebate traps and that type of thing, which is another legislative discussion that’s certainly ongoing as far as I know. But that’s where we stand for therapeutics, and all 3 of those therapeutic monoclonal antibodies have additional biosimilars in the pipeline. Clearly, we’ll see some more coming from other targets as well.

 There are definitely more biosimilars for many of the approved biosimilars, so it’s really exciting to have this competition.

The impact on biosimilar utilization in clinical practice caused by secondary patents of biologics and skinny labels of biosimilars is discussed.

Using Secondary Patents and Skinny Labels

, Kelly Gaertner, PharmD, an oncology clinical pharmacy specialist with Allegheny Health Network, said that a slew of new treatments for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer offer exciting new possibilities for this patient population, although questions remain about optimal sequencing.

Gaertner will be presenting on the topic on Friday at the Hematology/Oncology Pharmacy Association’s virtual 2021 conference.

Prior to December 2019, Gaertner said the standard first-line therapy for HER2-positive metastatic breast cancer was trastuzumab plus pertuzumab and a taxane. Second-line standard therapy involved ado trastuzumab emtansine. Third and subsequent lines of therapy had no standard regimen, however.

Over the past 18 months, the FDA has approved 4 new regimens for HER2-positive metastatic disease, including trastuzumab deruxtecan; neratinib plus capecitabine; tucatinib, capecitabine, and trastuzumab; and the monoclonal antibody margetuximab. Although questions still remain about the optimal sequencing for these treatments in third and subsequent lines of therapy, Gaertner said the approvals are exciting developments.

Over the past 18 months, the FDA has approved 4 new regimens for HER2-positive metastatic disease.

New Therapies for HER2-Positive Metastatic Breast Cancer Show Promise, Although Research on Sequencing is Needed

 Now that we have been at the front and center of this whole vaccine for COVID-19 and its protocols, the role of pharmacists as a frontline vaccinator and administration has really emerged with this pandemic. The federal government is giving [the vaccine], as a national strategy, to all community pharmacies, to have more access points for the nation. The emerging role of pharmacists is interesting, as you were saying before. People wouldn’t even get vaccines like the shingles or flu [from the pharmacist]. But with this whole frontline spot, what do you think about the pharmacist’s role? You talked about that, Michael, but I want to get it from Esty’s perspective. What do think with the immunization, and what does it take to get a pharmacist to be a certified immunizer?

 I’m very similar to Michael. I had to take that APhA [American Pharmacists Association] course many years ago, in 2005. I didn’t have it in pharmacy school. We have through local societies the availability and through colleges the ability to have these courses readily available, to have more immunizers in the community who are pharmacists. It was a course, and there’s a certificate. There’s BLS [Basic Life Support] certification in the state of Florida, and then there’s a continuing education requirement as well.

And there’s an insurance waiver. Insurance needs to include the pharmacist. That should be in our system to perform immunizations. Through all this vaccine process, a pharmacist has a role, especially in the community setting, in the ambulatory care setting. In those types of settings, a pharmacist can provide a bigger role to patients. We can have the availability to vaccinate more patients and the capability of giving access to these patients who may not get them through clinics or hospitals yet. We have that availability to get those vaccines. We have an influence in decreasing the incidence of COVID-19 in our community.

Pharmacists play a key role. I’ve always been an advocate for pharmacists to be in the community doing these types of services. This has provided an opportunity to show what we can do, not only with the COVID-19 vaccine but with the influenza vaccine, with pneumococcal vaccines, and with all the other vaccines that we need for preventive medicine. This has really highlighted it. When our leadership team said, “All hands-on deck for the vaccine process,” I went and they told me, “Just go out there and vaccinate.” I hadn’t done this in many years. But when I went out there, I had that feeling of vaccinating, of having a part in that hope for that patient. If we can have that part in a community setting where we really have an impact with a lot more patients and community, it is very noteworthy. The pharmacy is changing.

 I’m very proud of our profession and what we’ve been able to contribute to end this pandemic. I want to thank both of you for joining us, and I want to thank our viewing audience. I hope you found 

 to be rich and informative. Thank you for joining us today.

Madeline Camejo, PharmD, and Estela Trimino, PharmD, BCPS, discuss the emerging role of the pharmacist on the front line of vaccine administration.

Practice Pearl 3: Emerging Role of Pharmacists on the Front Line of Vaccine Administration

 Esty, what were some of the unexpected challenges you experienced during the COVID-19 vaccine rollout at Baptist [Health South Florida]? One of the things I remember is, when we were creating the schedules for employees to come in, 1 of the things is that you were mixing for a certain number. Let’s say 300 employees that were supposed to show up for the day and only 250 showed up. One of the things that we never expected in the beginning, which was a big challenge, is how do you deal with the no-shows? What do you do with the vaccines that you had to mix but now had to throw out? One of the things we ended up doing is calling all kinds of people. But what other challenges did you have to deal with on the fly, especially as you get 1 lot this day and another lot the next day. We were trying to change lot numbers, trying to do things on the fly. Those were some things that I remember. What were some of the other things you experienced in the pod?

 One of the ones that I very much remember is when we have 3 lot numbers of vaccines, toward that last couple of weeks we had to stop and set up tables. Or when you have 2 products—we had the Moderna and Pfizer vaccines. We were doing double vaccines. Some of these appointments for the second vaccine were at the same time. It was difficult. In a room there were about 13 vaccinators. Lots of people in line. One of the biggest things unexpected is that we have both vaccines on the same day. How are we going to do this? We divided the room out, made sure that mixers in the area were the pharmacy—I call it the pharmacy Hilton IV [intravenous] room, which is where the pharmacy production of the vaccines were. We had about 7 mixers at a time in that room, in that pod. We made sure that half the room was doing 1 vaccine vs the other.

Then we got to a point that we had both vaccines and then different lot numbers. We had to be sure because our inputters into Florida SHOTS wanted to have the right lot number. We needed to be sure we had the right product that we were administering to keep that lot number consistent with what the patient was receiving and the vaccine. We wanted to keep it straight. One of the unexpected things is when we were vaccinating and 1 was 21 days vs 28. They bunched up together. That was a big deal. But we got through it. We did find a system, and it worked. We had multiple days like that, and more no-shows than we expected on certain days and then finding who else was on that list who could come in right away before the medication expired or we closed the site. That was challenging because it was down to the wire, right before we closed. We didn’t want to waste any of those vaccines that were already made. That was unexpected and challenging.

Did you have the same in Texas? In Florida, we got Pfizer and then suddenly the states changed, and we got Moderna. The challenge was, we had Moderna to do for a couple of weeks and then changed back to Pfizer. It was interesting what was happening here. How was that in Texas?

Pretty much similar to what you guys have already described. Our biggest, unexpected challenge was, as the word started to get out that the second-dose adverse effects were worse than the first, some patients did not want to come back for the second dose. That was an unexpected challenge. We had more cancellations for second-dose appointments than we did for the first ones. Everybody was excited about the first one. That was an unexpected challenge, but we quickly adjusted. We had more vials of vaccine left over from second doses. We kept those vials, and we were able to consolidate them and offer it to others who wanted the vaccine. That’s how we had to deal with that challenge. But it’s not that 100% of people who received the first dose wouldn’t come for the second dose, but 1 was that they were scared the adverse effects of the vaccine would be more severe.

Health system pharmacists discuss challenges with the COVID-19 vaccine rollout, such as having multiple vaccine types and lot numbers on hand and appointment no-shows

Practice Pearl 3: Unexpected Challenges with the COVID-19 Vaccine Rollout

Looking toward the future, I would love your opinions in terms of what you feel are the unmet needs and continued challenges in the treatment of neuroendocrine tumors. What do you see in the next 5 years? What is it going to look like for the treatment of neuroendocrine tumors?

 We are going to continue to expand treatment options for the neuroendocrine tumors, and we are going to continue to look for ways to have more curative approaches too for our more locally advanced or localized neuroendocrine tumors. One thing I want to encourage the audience and pharmacists to do is make sure you are staying up-to-date with the data. They are changing, and knowing these medications, the mechanism of action, the safety, and the efficacy of each of these is important because they will continue to evolve, as will the more targeted agents that we can now use and will continue to use. I would also encourage everyone to tell their patients about ongoing clinical trials and the importance of enrolling our patients in clinical trials to continue to advance the treatment of these neuroendocrine tumors.

 Ideally, of course, there will be more information on how to best sequence our treatment options, especially because there may be more agents coming on the market in the future from a number of ongoing clinical trials. If they show good results, we can expect more treatments in the future.

We want to mention that, for drugs shown to be beneficial in a clinical trial, some patients may want or need access to medications that are not necessarily approved for their neuroendocrine diagnosis but are on the market for other diagnoses. We should also be prepared to help patients obtain either insurance approval or through compassionate-use programs to obtain these medications if patients need them.

Both of you highlighted the unmet needs and challenges. One is the sequencing in terms of the treatments we have available. The next is that there is a wealth of various clinical trials in terms of newer agents that are being developed for neuroendocrine tumors. How can we quickly get access for those patients? Sometimes a phase 3 study for a clinical trial might take a long time to do, and we already have relatively good phase 2 data. Being able to introduce that access to patients earlier while they are waiting for possible phase 3 data to approve, mature, and ultimately get approved by regulatory agencies is going to be paramount moving forward.

With that, thank you both for doing this with me. It is helpful in terms of providing your expert opinions on helping patients with neuroendocrine tumors with the treatments that we have, as well as some of the challenges with the treatments we are potentially prescribing. We are able to look toward the future in terms of additional options that are going to be helpful for our patients. To our viewing audience, we hope that you found this 

 discussion to be rich and informative, and we look forward to seeing you next time. Thank you so much.

Megan May, PharmD, BCOP, Cecilia Lau, RPh, BCOP, APh, and Daneng Li, MD, share their thoughts on unmet needs in the management of neuroendocrine tumors.

Practice Pearl 3 Unmet Needs in the Treatment of Neuroendocrine Tumors

 Esty, you worked one of our big pods which was the Hilton. What were some of the measures taken by the pharmacy team to make sure we prevented vaccines from going to waste?

 We worked hard and diligently with our leaders who were scheduling these appointments to make sure we had enough vaccines for those. We weren’t going to waste any. We didn’t want to waste any, so we really looked at those numbers. We made sure when we were getting close to the end of the day, our days would be sometimes 7 AM to 7 PM on those big-number days when we had 600, 700 vaccines administered. We were down to those last 2 vials to make sure we were using those vials appropriately. If we weren’t, we wouldn’t open a vial. We tried to conserve and not waste anything. To my knowledge, our system didn’t waste any vaccines in any of our pods. Our leadership team was diligently working with all the other pods, with employee health and all the other teams, to be sure we were all educated on the same form of how we were giving these vaccines, how we were administering them, and how many people were receiving them. Some days we had a little more than a little less, but we would have enough for those vaccines and not waste.

One of the questions I just thought of is when we were getting the vaccines—I know it was the most exciting thing, I’ll never forget it too, Michael—how was it that once you got the vaccine you were ready to create your pods? What education did you provide your members and medical staff on the importance of getting the vaccine? There were a lot of people who weren’t sure. They were scared because they thought the vaccine was done too rapidly. How were you able to educate the medical staff and the health care workers of the importance of getting the vaccine?

Our organization partnered with human resources and employee health departments. We were able to obtain all the approved emergency use authorization literature that came with the vaccine. They’ve done a great job distributing that information, and we always had a pharmacist available [for questions]. We have offered training for nurses and other folks who helped with the logistics at the vaccine clinics, so they were well educated and informed. We were very transparent; that’s always the best policy. We always said that these are the possible adverse effects, but we also said that that the benefits of getting a vaccine certainly outweigh the risks of adverse effects. Having minor symptoms as an adverse effect of getting a vaccine is nothing compared with getting full-blown COVID-19. Health care workers had a firsthand account and could observe patients dying in ICU [intensive care unit] from COVID-19. Sadly, COVID-19 doesn’t discriminate—all ages, genders, cultural backgrounds, and nationalities. We used that information too—without specifics—about the increase in hospitalization and death due to COVID-19 to persuade folks to think about vaccination. That’s really the only way to prevent the disease and to have enough of the population vaccinated, to hopefully eradicate the disease. That’s why I’m excited about this year. I’m hoping to see COVID-19 rapidly decline and be minimized.

The experts discuss measures taken by pharmacy to prevent waste of vaccine doses and the education provided to members of the medical staff.