APhA 2025: A Pharmacist's Guide to Overcoming RSV Vaccine Hesitancy

Pharmacy Times® interviewed Chad Kodiak, RPh, PharmD, CEO and president of KODOCARE Pharmacy, on his presentation at the American Pharmacists Association (APhA) Annual Meeting & Exposition.

Kodiak focused on Pfizer's respiratory syncytial virus (RSV) vaccine (Abrysvo), discussing its efficacy with 81.5% effectiveness against RSV lower respiratory tract disease (LRTD) and key safety considerations for adults over 60. Kodiak shared practical implementation strategies, including the approach of recommending the vaccine during other vaccination visits. The discussion highlighted the importance of motivational interviewing and listening to patients' concerns, particularly when addressing vaccine hesitancy among older adults. Kodiak emphasized the critical role pharmacists play in vaccination efforts, stressing the need to seize opportunities to provide preventive care and potentially prevent hospitalizations.

Pharmacy Times

What are the key efficacy findings from Pfizer's RSV vaccine trials?

Chad Kodiak

For efficacy, at the end of season 1, Abrysvo was found to have an 88.9% reduction with 3 or more symptoms, and a 65.1% reduction with 2 or more symptoms. Across 2 seasons, it was 81.5% effective against RSV LRTD with 3 or more symptoms, and 58.8% effective with 2 or more symptoms.

Pharmacy Times

What are the main safety considerations for the RSV vaccine?

Kodiak

The main safety considerations above 10% or fatigue at 15.7 headache at 12.9 pain at the injection site at 10.7 and muscle pain at 10.2 in adults aged 60 and older.

Pharmacy Times

What is the latest CDC guidance on RSV vaccination?

Kodiak

RSV is recommended for everyone over the age of 75 years old, and for people between the ages of 60 and 74 that are at increased risk for severe RSV.

Pharmacy Times

Can you describe a practical strategy for implementing RSV vaccines in a pharmacy.

Kodiak

Sure. I'll tell you about a strategy we have at our pharmacy. It's called the butts in the chair. We have found that people are more receptive to recommendations if they're already receiving another vaccine. For instance, when people come in receive a flu vaccine, we'll talk to them about RSV, and we have found that they are more likely to receive that recommendation and take it when they're already receiving another vaccine.

Pharmacy Times

How would you address patient concerns about RSV vaccine safety or effectiveness?

Kodiak

Listen. The number one thing I hear from people is no one listens to me. No one's taking the time to hear what I have to say. I think we forget that. I think especially as pharmacists, we know so much and we want to share that information, and the intent is correct, but sometimes we're so impatient to share information that we don't take the time to listen to their concerns.

I wasn't taught this in pharmacy school, but I've recently been hearing about what's being taught in schools now, and I learned about it's called motivational interviewing. And what I like about motivational interviewing is it's saying, let's find out what's important to the patient, and then figure out how to make the recommendation. I think with vaccines, and especially with RSV vaccine, that's so important. Let's have a conversation about the disease state, let's have a conversation about their concerns and your goals. Then we can turn that into, okay, let's talk about how we can help you get there — and one of the ways is through vaccination. That has been effective for us, and I think that's so important.

Then the other one is when you're addressing these things, is really thinking about hesitancy and what hesitancy is, right? And people are hesitant. For some people, this is a big decision. So, for me, I like to think about, well, when have I had to make a big decision? Well, when I was about to buy my house as a big decision, I was hesitant, right? And so just addressing it as hesitancy has been helpful as well.

Pharmacy Times

How would you address RSV vaccine hesitancy among older adults?

Kodiak

For older adults that are hesitant, I go back to the relationship that I've had with them. The story I can tell you is as a woman who I've known for years has come to our pharmacy for years, she was so excited to tell us about her granddaughter's wedding. She couldn't wait to dance at her granddaughter's wedding, and how this was coming up, and she had been planning and prepping.I said, man, that sounds great, and I know how excited you are. I want to make sure that you're there and then you can dance. And the best way to do that is to give you some prevention against other things that might happen to you between now and then. Suddenly, the light bulbs went off, right? Like, oh yeah, absolutely, of course, that's what I want to do. I want to go dance at my granddaughter's wedding, and you're telling me that I can help from getting sick or potentially going to the hospital by receiving a vaccination. Those are the ones that I enjoy.

Pharmacy Times

Is there anything you would like to add?

Kodiak

When I think about pharmacists vaccinating, I think about all the other things that we can do, and I know there are bigger things that we can do. I think about some of the pharmacists out there that are working with other disease state management processes. They're working on anticoagulation, and this might not be as exciting. However, this is our chance. If we don't do this, if we don't vaccinate these patients, somebody else will. We have this opportunity to do this, and we have to take it, because I don't know if the opportunity will come again, and I know that if we don't do it, somebody else will.