The Progression of Immunization - Episode 9
Raising Awareness on Booster Vaccines
A discussion on the importance of booster vaccines and how to effectively raise awareness to target populations.
Troy Trygstad, PharmD, MBA, PhD: Let’s talk about specific circumstances—so boosters. What’s our talk track on boosters? What should we be telling folks on boosters?
Tana Kaefer, PharmD: Depending on the vaccine that they need them?
Troy Trygstad, PharmD, MBA, PhD: Sure.
Tana Kaefer, PharmD: Yes. So how do you target those patients?
Troy Trygstad, PharmD, MBA, PhD: I’ve already had this vaccine. How do you even get to that point in the conversation, so you can say, “Oh, but”? How do you get to the “Oh, but” part, and then how do you close the deal on getting the booster?
Tana Kaefer, PharmD: Right. Specifically thinking about booster with Tdap [tetanus, diphtheria, pertussis], you know patients—especially the younger cohorts—don’t think they necessarily need that unless something happens. When I’m giving those types of immunizations, I try to give them targets to empower them as well. So not, “You’re going to need this in 10 years,” but “You’re 30 right now. When you’re 40, I want to see you again.” You know.
I give them something that they can remember. “Oh, she said 10 years, but was that when I was 29, 30, I don’t remember.” So I give them a hard target. That’s kind of a tool that I use. And then letting them know that we need to booster those things. I think with Shingrix, specifically, folks are very aware that that needs to happen and are waiting in line for their next shot. But for some of the other ones, I don’t think they necessarily realize.
Troy Trygstad, PharmD, MBA, PhD: Right. Because in the social consciousness, once we’re vaccinated, we think we’re good.
Tana Kaefer, PharmD: Right.
Troy Trygstad, PharmD, MBA, PhD: What does that conversation look like? How are you having that conversation with the patient? “Oh, yes, you’ve gotten your first vaccination, but here’s how this works.” How are you coaching them and educating them on the importance of boosters?
Tana Kaefer, PharmD: And specifically with Tdap [tetanus, diphtheria, pertussis] we talk about what the risks are, right? Really, we’re worried about whooping cough or pertussis in unvaccinated infants and that it doesn’t really last as long as we might think it does. And so it’s really important that everyone is protected, but not only for you. As adults we get this and it doesn’t feel good. You know it’s an inconvenience, but how are we affecting others? A lot of this cohort is definitely around children, so they’re very concerned, as you mentioned earlier, about how they are affecting other people.
Troy Trygstad, PharmD, MBA, PhD: And are you using that as a conversation with some number of patients?
Tana Kaefer, PharmD: Oh, absolutely. And especially in pregnancy. The recommendation is that females get it every pregnancy. And as Dorothy mentioned, too, what about everybody else? What about the grandparents? What about the fathers, what about the other siblings?
Troy Trygstad, PharmD, MBA, PhD: Right. But it speaks to the old model versus the new model. The old model was, somebody walks in the door, usually with a stethoscope and a long white coat and says, “You’re supposed to get this.” Right. “Take this med. Get this vaccination.” And the patient says, “OK, I was told to do it.” And I may or may not do it. I may, you know, I’m getting a vaccination maybe when I’m in the office there. I may or may not get my medication but I’m just taking it on face value [that] what you’re describing in this new model is, hey, you’re really teaching them about the rationale, the why, the motivator for it. This sort of motivational interviewing in some way.
Tana Kaefer, PharmD: But still making that recommendation.
Troy Trygstad, PharmD, MBA, PhD: But that’s a sea change. You’re making the recommendation.
Tana Kaefer, PharmD: You know obviously there’s a choice, right? But you still want to say, “This is the recommendation.” Because a lot of times you tell patients, “Based on how you answered these questions, this would be good for you.” A lot of times they’re just like, “OK, that’s what I’m going to do.”
It’s when you get pushback that you need to do more of that motivational interviewing and kind of meeting them where they are. What are your fears? Let’s talk about that, and helping them work through that. Dorothy, how do you not lose that patience? Here’s the recommendation: “We recommend that you get this booster.” “Oh, no thanks.” “Well, OK, you can pick up your prescription at the end of the counter.” So what, again, is that point of capture, that opportunity, that window of opportunity? How do you coach your team on educating on the why? Here’s why it’s recommended, or the consequences, or how it works. Do you spend a lot of time training on that?
Dorothy Loy, PharmD, MBA: Yes. I think it goes back to confident recommendation. Having that confidence to really stand behind what you’re saying. I think using facts and data, we talked about that a few times. You know, saying that this is CDC [Center for Disease Control] recommended. This isn’t something that I’m making up. This is something that really is helpful for you, for the general public, for the people around you. Again, making it relevant for them and training our pharmacists to have, you know, specific kind of talking points when it comes to a specific vaccine and maybe a specific age group. We talked to pregnant women, saying, “This is going to be helpful for you as well as your baby.” And so making it, again, relevant to their situation.
Troy Trygstad, PharmD, MBA, PhD: Yeah, I’ll tell you, when I’m in a pharmacy on nights and weekends, for 20 years now my 2 least favorite questions are: “What can I do for weight?” and “Can I take this when I’m pregnant?” Those are always complex, involved conversations. I enjoy the interaction, but identifying whether somebody is pregnant when she asks for a flu vaccination can be a tricky. It can be a tricky challenge, right?