Pharmacy Times interviewed Lauren Posteraro, PharmD, a pharmacist with Allegheny Health Network (AHN), to discuss vaccine hesitancy. With the upcoming flu season, Posteraro stresses the importance of staying up to date with routine vaccinations and immunizations to slow the spread of illness or other diseases. For those who spend a lot of time online or have access to technology, Posteraro also discusses the dangers of misinformation and the importance of researching to find factual information.
Pharmacy Times®: Can you introduce yourself?
Lauren Posteraro, PharmD: My name is Lauren Posteraro, and I am a pharmacist with Allegheny Health Network (AHN).
Pharmacy Times: Whatare some common reasons for vaccine hesitancy, and how can pharmacists (and other health care providers) effectively communicate the benefits of immunizations?
Posteraro: A lot of people, they just think, "I'm healthy." For instance, we're nearing flu season, so people often think, “I'm healthy, I don't need to get the flu shot,” or “Every time I get the flu shot, I get sick.” [Health care providers] hear a lot of these answers. Also, some people think that it's unnecessary for small children [to get vaccinated] because they think, “When I was a child, I got half as many vaccines as they want to give my kid now, and the schedules are even earlier.” So, there are a lot of those [responses] as well.
But I always just say vaccines have been around for a very long time and they have almost eradicated a lot of diseases, so, if we didn't have them, there would be a lot more people that are affected by these diseases, deaths, and things like that. I always think that's a good thing to just always remember.
And some diseases are only like a plane ride away—for example, poliovirus or measles and can be spread much easier as people travel. I know there's a lot of hesitancy, but we have to remember why [vaccines and immunizations] came about, and the good that they can do for everyone.
And there are potential side effects of the flu shot or COVID-19 booster, [for example]. Yes, you can have those side effects…it’s just your body mounting an immune response. [With] the side effects, you could be out for a day or 2…I know that sucks, but it means the vaccines are working. Would you rather be down for 2 days, or would you rather, [for example,] get shingles which can cause blindness or [postherpetic neuralgia] pain that can last up to a year?
Pharmacy Times: How has vaccine hesitancy impacted public health efforts, particularly during recent outbreaks? What are some things that people may not realize?
Posteraro: So, one thing I think that patients may not realize is that herd immunity is a real thing. It reduces infections in individuals who may like lack immunity, and the reason that we don't have as many outbreaks as [we have had] in the past—maybe with our parents or the smallpox outbreak—is because we're vaccinated, and we were just able to stop the spread. But if less and less people get the vaccines, or parents are not wanting to get their children vaccinated, it will threaten more people and more outbreaks will occur. We have to also just realize [is] you want to get these vaccines, not only to stop the spread and to protect yourself, but also protect others. We have older populations and patients that are immunocompromised—or even have comorbidities—that are just more at risk and more susceptible to getting diseases, and if they were to get [a certain disease], their chances of hospitalizations, death, and complications are [much higher] than those who are not considered at risk.
Lately, we have been having more outbreaks of measles and [other diseases], and if you do some research, it doesn't appear to spread as much as [it previously did], the damage might not be as great, because we have people that are vaccinated and we do have herd immunity. But if [those diseases] were to hit...areas in which people might not believe in getting vaccinated—an outbreak of measles, for example—could wipe out all of those people. So, it's just something like to keep in mind when considering getting vaccinated.
Key Takeaways
- Vaccine Hesitancy and Misconceptions: Posteraro discusses how any people hesitate to get vaccinated because of a range of common misconceptions, such as believing they don’t need vaccines because they are healthy or associating vaccines with side effects that make them sick. Similarly, parents may hesitate to vaccinate their children, with Posteraro noting one common reason is the amount and frequency of vaccines. She also explains that any side effects people may experience following a vaccination, such as feeling unwell after getting the flu shot, are often mild and simply indicate the body’s immune response to the vaccine.
- Herd Immunity is Critical For Public Health: Herd immunity is a powerful protective factor in reducing the spread of diseases, especially among people who may lack immunity. Posteraro explains that vaccination has helped stop the spread of serious diseases, such as smallpox and measles, significantly reducing outbreaks in the past. Protecting vulnerable populations, such as the elderly, those with compromised immune systems, or people with multiple health conditions, is a vital aspect of immunization efforts because these groups are at greater risk of complications and death from diseases that may be mild in healthy individuals.
- Barriers to Vaccination: Posteraro highlights how access to vaccines can differ significantly between high-income and low-income communities. For lower-income individuals, practical barriers such as lack of transportation, limited access to educational resources, and even difficulties in finding reliable information online make it challenging to stay up to date with immunizations. In contrast, individuals in higher-income groups may have the resources and access to health care, but face challenges relating to the overabundance of information. Increased internet access can expose them to misinformation spread by influencers, celebrities, or public figures who may have strong anti-vaccine views. Posteraro is concerned that, unlike those with a health care background, many people may not have the background to discern accurate health information from misleading sources, making it harder for them to make informed decisions about vaccination.
Pharmacy Times: How do immunization programs differ between high-income and low-income communities, and what are the unique challenges/barriers faced by each?
Posteraro: Sure, I think people that are considered higher income, they might not have as many barriers as someone of a lower income [community]. The barriers that those lower-income people face may be transportation, accessibility to computers to get information on vaccines, and other educational barriers.
On the flip side, I do think people who are higher income…sure, they have that accessibility to computers and to educate themselves, but sometimes the increased access can become harmful. For example, say you follow a blogger on the internet, and they have their opinions that are very strongly against vaccines. That could sway someone, even if they may have used to say, “I'll get every vaccine.” I do feel that that's a challenge with people like that, and some of these influencers or celebrities can just make it worse.
We're always on our computers or our phones researching things, and there's a lot of information out there that's just not right. These people aren't health care providers, but they have millions of followers so if they say something, they can easily sway a large population. So, I definitely think that's a barrier for people of higher income. I know I go on my phone, and I follow a lot of people, and I think because of my background as a pharmacist, I'm able to disseminate what's right and wrong, but someone else may not be able to. Some people don't have that background or knowledge to break apart what they're saying and say, “That's right, that's not right.”
