Talking About Vaccines & Integrating into Workflow

Everyone at my pharmacy has made themselves approachable, and they just talk to people. When someone says something, they heard on social media, they don’t respond with, “That’s crazy.” Instead, they just respond with what the data show or share their personal experiences with the vaccine. We are just being human about it.”

Rural Arkansas pharmacist

You are not alone if you feel reluctant to ask people whether they’ve been vaccinated. As the COVID-19 vaccination schedule becomes similar to the schedule for influenza, discussing the vaccine may pose new challenges. You know your patients well and you can probably anticipate how some will react when you offer the vaccine. However, as one of the most trusted sources of medication information and possibly the only reliable source of vaccine information your patients have access to, you can play an important role in addressing vaccine concerns in your community. The key is to maintain the patient’s trust while providing the most updated information about the vaccine, its benefits, risks, and safety. By sharing your personal experiences with the vaccine or why you trust it, you can help people feel more comfortable discussing the vaccine.

The ASORT process

Below we share a five-step process, ASORT, that rural pharmacists have used with success to talk with people about the COVID-19 vaccine in a non-confrontational way. This process can take less than three minutes from start to finish! Click each tab to learn more. A PDF describing the ASORT process is provided both here and in the Resources page.

Here are some examples of how rural pharmacists have integrated the ASORT process into their workflows.
See this Resource Page for more details

MedSync

Incorporating ASORT into MedSync efforts to identify and engage patients.
By reviewing patients’ medication profiles during MedSync appointments, you can proactively discuss and recommend appropriate vaccines using ASORT. This approach not only enhances patient care but also streamlines the workflow for pharmacists.

Dispensing software, for example, PioneerRx

Set criteria within the pharmacy dispensing system to identify patients who are due for vaccines. PioneerRx can generate lists of patients who have not received certain vaccines based on their age, medical history, and previous vaccination records.
Create automatic alerts in PioneerRx to notify pharmacists when patients are eligible for vaccines. These alerts can be set to trigger during MedSync activities or during their routine prescription pickups.

Technicians

Technicians can incorporate the ASORT “Ask” step into daily MedSync calls. If a vaccine-hesitant patient is identified, they can pass the concern to a pharmacist to continue the ASORT process and make a recommendation.
Train every technician and cashier to ask each patient at the point of sale if they are up to date on their vaccines.

Incorporate ASORT during other patient care service visits, for example, for a different vaccine.

A

Ask if they would like to receive a COVID vaccination

People who are not interested in the vaccine or are hesitant aren’t going to ask about it. That’s why it’s important for pharmacists to initiate the conversation with people who they think may be hesitant. This conversation does not have to be uncomfortable though!

“While you’re here today, let’s see if you’re up to date on your vaccinations.”

“Have you heard about the new recommendations for the COVID-19 vaccine?”

“Hey! I noticed when I was filling your medications that we don’t have records of these vaccines in the last year for you.”

Assumptions about who has and has not been vaccinated are not always correct, so it’s important to ask people if they’ve been vaccinated.

“John, while I’m giving your flu shot, I just thought I’d ask if you’ve gotten your COVID-19 vaccine yet.”

Offer praise to people who are up-to-date on their vaccination.
For people who you think are highly hesitant or opposed to vaccinations, you can start the conversation by asking about the vaccine more generally.

“I’m trying to decide how much COVID-19 vaccine to order for the pharmacy this Fall. Would you be interested in getting the vaccine?”

“I’m so happy to hear that you’re up-to-date with your vaccinations.”

For those who haven’t received their annual vaccination yet and do not say yes to receiving it when you ask, move to the letter S in the ASORT process.

S

Solicit their main vaccine concern

According to the American Pharmacists Association, most people who are vaccine hesitant want to be heard. Listening to their concerns is key to keeping negative emotions and reactions to a minimum.
People often have multiple concerns about the vaccine, but one concern will likely loom larger than the others, so this is the concern to focus on.
Some people may start talking about their concerns right away when you ask them if they’ve been vaccinated. Make sure you understand which of their concerns is the most important to their decision to vaccinate.
“You mentioned that you’re concerned about the vaccine side effects. Is that your main concern about the vaccine?”

“You mentioned a few things that worry you about the vaccine. Which thing worries you the most?”

“So what concerns you the most about the vaccine?”

After they’ve told you more about their main concern, move to the letter O in the ASORT process.

O

Offer to address their concerns

People have different levels of readiness to discuss the vaccine, so it’s important to ask for permission to share more information about their concerns.
Start by validating their concern so they know that you’re not judging them.

“I know several other people who have had that same concern and I’ve shared some information with them that they’ve found useful. I’d be happy to share that same information with you if you want.”

“I’ve been keeping up to date with the newest information about the vaccine and I’d be happy to share that information with you if you want.”

Most people will be open to having you share what you know. See Addressing Vaccine Concerns for suggested ways to address common vaccine concerns. Then move to the letter R in the ASORT process.
Some people won’t be ready for more information and that’s okay. Just let them know that you understand.
For individuals who aren’t ready, skip to the letter T in the ASORT process.

“Ok. No problem. Know that I’m here if you do ever want to talk.”

“Address hesitancy with respect, because if you scoff at them or make light of their concerns or act like they don’t know what they are talking about, then you’ve lost their trust. I’ve been on oxygen 24/7 since August 2020 because of having had COVID-19; because of this, it is not hard for me to convince people to get the shot. I say, ‘Look you don’t want to do this. You don’t want to be on oxygen. You don’t want to deal with the side effects of COVID-19.’”

-Rural NC Community Pharmacist, 2021

R

Recommend the Vaccine

The most important step of the ASORT process is to recommend the vaccine.
A recommendation from a trusted health professional is one the most effective interventions to increase vaccination uptake.⁴
Many people living in rural communities see their community pharmacist more often than they see their doctors, which means they trust you.⁵

“I recommend the vaccine for you.”

You can also tie your recommendation to any factors that may put them or their family members at higher risk for severe COVID-19 complications, including age. This makes the recommendation more personal.

“You’ve got COPD, which increases your risk for severe COVID-19 complications. I’d hate to see you go to the hospital if you could avoid it, so I’d recommend you get the vaccine this Fall since this really reduces the risk for people with breathing conditions like yours from going to the hospital.”

It is likely that many patients will ask about your vaccination status. If you are vaccinated and comfortable sharing, this can be a powerful motivator for those who are vaccine hesitant. Sharing your story and your reasoning can be very helpful.

“I wouldn’t recommend the vaccine if I didn’t think it was safe. I received it and I trust it. That’s why I recommend that you get the vaccine – because I care about you and want to keep you safe.”

“I got it because I want to stack the deck in my favor. Thinking about what could happen if I got COVID versus if I got the vaccine, it felt like the complications from COVID could be a lot worse.”

If the person agrees to be vaccinated, then vaccinate on-site if possible or connect them to other resources where they can get vaccinated.
If they are still unsure or refuse, then move to the letter T in the ASORT process.

T

Try again later if they refuse or are unsure

Many of the people you talk with will still be hesitant about the vaccine, or may refuse it.
As we’ve seen over the years, many people who said they would never get the vaccine have since changed their minds. So don’t be discouraged if they refuse. React in a positive way and let them know you’ll check in with them again.

“Thanks for considering it. I’ll check in with you again if I hear any new information about your concern.”

Because people can and do change their minds, it’s important to try again during one of their next visits to the pharmacy.
For regular customers, you can keep a list of people to follow up with or make a note in the pharmacy record to follow up.
For patients who you don’t know well, following up can be harder. You probably want to have several interactions with them so you can build a trusting relationship before you revisit the conversation.

“Hi Jennifer. I heard some new information about blood clots and the COVID-19 vaccine. Would you be interested in hearing about it?”

3-Talking About Vaccines