Expert Discusses Current Recommendations for Respiratory Syncytial Virus, Influenza, COVID-19 Vaccination

In an interview with Pharmacy Times, Gretchen Garofoli, PharmD, an associate professor at the West Virginia School of Pharmacy, discussed the current recommendations for COVID-19, respiratory syncytial virus (RSV), and influenza vaccines and vaccine hesitancy.

Alernon77 -stock.adobe.com

Pharmacy Times: Could you give me a brief rundown of the most current recommendations for COVID, RSV, and flu vaccinations?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: So that's a great question. First, I'll talk about the COVID vaccines. We're anticipating there being a new vaccine coming out this fall that covers the XBB variant. That's what was stated at the June Advisory Committee on Immunization Practices meeting, so we're waiting for more information on that to see when that vaccine becomes available. But currently, we have the bivalent vaccines which we are recommending for our patients who are not currently up to date with their COVID-19 vaccines. With regards to the flu shot, that will be recommended for everybody 6 months of age and older, and that should be coming out any day now and should be vaccinating through the fall. For the RSV vaccine, there are 2 new vaccines that are available, and they are recommended for those 60 years of age and older through shared clinical decision making. Each individual patient should be having that conversation with their physician, their pharmacist, any healthcare provider who's taking care of them, and decide if that's the best option for them to protect them from RSV. There's also a monoclonal antibody that's available now; it's not a vaccine, but that is available for our youngest patients. So for infants and neonates who are entering their first RSV season, or who are born during the RSV season, they should get that monoclonal antibody.

PT: What are the predictions for this fall's COVID, RSV and flu seasons?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: So it's a little bit too early to predict what exactly will happen this fall. We know last year was a rough year, especially for RSV and the young kiddos. So it's too early to predict what will happen this fall. But I think that we all need to take the precautions necessary by getting vaccinated when there are vaccines available, and also remembering the things such as washing our hands and staying away from others when we're sick, so that we don't spread disease unnecessarily.

PT: How do you think the COVID-19 pandemic changed the way individuals think about vaccines?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: I think patients have a lot more questions now, which I always encourage my patients to ask questions. I like to be able to answer their questions and to have them understand why a vaccine is recommended for them and how it can benefit them. I think that that is one of the things that I've really seen come out of the COVID-19 pandemic is that a lot of patients have questions. We as healthcare practitioners need to stay on our game, we need to make sure that we know the most recent recommendations so that we can provide that information to our patients, and that we can accurately answer all of their questions. Because with information changing as new things become available, we need to be able to ensure that we are staying up to date so that our patients can feel confident in the answers that we're giving them.

PT: How can pharmacists overcome the hurdle of vaccine hesitancy and ease concerns that patients may have about vaccinations?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: So in order to overcome vaccine hesitancy, I think that we really need to instill vaccine confidence into our patients. We need to listen to their concerns. I've been vaccinating for a number of years now, even before the COVID-19 pandemic. Listening to your patients concerns; 1 patient may have concerns that are completely different from another patient. Being able to listen to them, make sure that they understand that you really do care about them, you care about answering any questions they may have, you care about their concerns, and being able to provide them with thoughtful answers. I've really learned a lot about communicating with patients over the past few years, that it takes a lot of time. Early in the COVID-19 vaccination effort, we were vaccinating patients, everybody wanted to be vaccinated, and then as time progressed, patients had more questions and more concerns. It took a little bit more time and it took a little bit more research. We sat down with patients upwards of a half an hour to look up answers to their questions, so that they felt confident in getting the vaccine, and most of the times we do end up with a patient getting the vaccine after they've had all of their questions answered. I think just taking that time to listen to your patients and sharing your personal experiences. So for example, I was pregnant last year, and when the COVID-19 bivalent boosters came out, I got that vaccine to protect myself and my unborn baby. That is a story that now I can share with my patients and say, “Listen, this is what I did, this is why I did it. I got my 7-year-old vaccinated, I got him the bivalent booster.” Explaining why I made those decisions for my family so that patients could feel more comfortable getting those vaccines for their families.

PT: Do you feel that different age groups react differently to the prospect of vaccination? Do you think it's been challenging from a pharmacist’s perspective in getting the message out about the importance of vaccinations, especially to the most at-risk groups?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: So I think that a lot of times are most at-risk groups know they're high risk, and they're the first that are in line to get vaccinated. Those patients, they might have questions for us, and we're able to answer those pretty quickly. Usually, it's like, “What am I due for, when do I need to get a vaccine,” versus questions about the vaccine in general. We typically have those patients that are high risk coming into the pharmacies, and getting their vaccines. And like I said, sometimes patients just don't know which vaccines are recommended for them. Providing that education taking that extra time, and we as pharmacists can do a great job of educating our patients. We’re the most accessible health care practitioners, and patients come into our pharmacies on a regular basis and we're able to take a few minutes and say, “This is a new recommendation, this is what we recommend for you based on your conditions, based on other risk factors,” and be able to provide those vaccines then in the pharmacy. And I think that with the COVID-19 pandemic, pharmacists have been able to provide vaccines to a wider range with regards to the age of patients. Now patients can go to the pharmacy and get everybody vaccinated. The second year of the COVID-19 pandemic, we had flu vaccine clinics, and parents were so happy to be able to bring their kiddos to those clinics with them. And we vaccinated mom, dad, and all the siblings, and the kids could see that mom and dad are getting the vaccine that they're getting, and it helped to make the kids feel more comfortable as well. I think that those types of things are great, where you have clinics that are available to provide the vaccines to all of the family members, and not have to have parents take kids to different offices and have to make separate appointments themselves.

PT: What role can pharmacists play in helping to get the most at-risk people vaccinated in time for the fall, and continue their healthy habits to prevent severe illness?

Gretchen Garofoli, Associate Professor, West Virginia School of Pharmacy: Pharmacists can reach out to those patients early, they can start having those conversations now. If patients come into the pharmacy for a refill of their medication, and you know that that's a high-risk patient, you can say “Listen, Mrs. Smith, I know with your conditions that we would recommend this vaccine for you. We want to ensure that you are protected as we get into the fall.” Talking to them about the new RSV vaccine for those high-risk patients, talking to them about getting their influenza vaccine, and getting it on their radar that there will be a COVID vaccine this fall that they should get. So talking to the patients about the different options and starting those conversations early, because with the likelihood of three vaccines being recommended for our senior patients, they might want to spread those vaccines out, they might not want to get 3 in 1 appointment, even though it's perfectly fine to do so, patients may want to spread those vaccines out. So providing that information, helping them to mentally prepare, so that they know what to expect and know why these vaccines are recommended to protect them as we get into the respiratory season.