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10/07/2021

SK pharmacists on frontlines against vaccine hesitancy

With COVID-19 cases at record highs in the province of Saskatchewan, pharmacists are manning the front lines with more than just syringes of vaccine in their hands. 
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Myla Bulych, director of professional affairs for PAS on duty

With COVID-19 cases at record highs in the province of Saskatchewan, pharmacists are manning the front lines with more than just syringes of vaccine in their hands. 

Vaccine hesitancy has been a problem across the country, and Saskatchewan is no exception, says Myla Bulych, director of professional affairs for the Pharmacy Association of Saskatchewan (PAS). 

“It's hard for everybody,” she says. “We’re hearing that there are angry, upset patients, feeling pressured into receiving the vaccine. But also we’re hearing about patients that are crying and so afraid, because they’re feeling pressured. So at the end of the day, it appears that it’s all fear-based, but how it’s expressed is either crying or anger.” 

As the “fourth wave” of the pandemic hits Saskatchewan, about 63% of the population has been fully vaccinated and 67% received at least one dose. Of the new cases reported in September, about 78% were not vaccinated or were within three weeks of their first shot, along with roughly the same percentage (77.6%) in hospitalized cases. The percentage rose to nearly 88% of those admitted to ICU. 

As of October 6, 371 pharmacies across the province have administered a total 389,233 doses of COVID vaccine, since April when pharmacies joined the Saskatchewan Health Authority in administering vaccines. Of roughly 2 million doses delivered to the province, over 79% have been administered. The total 1.58 million doses administered in Saskatchewan to date includes about 750,000 fully vaccinated. Yet, in spite of the continuing rise in cases in recent weeks, demand for COVID vaccines has been lower. 

Read: How to help with vaccine hesitancy

PAS is part of the Saskatchewan Health Authority’s support organization, Vaccine Uptake Support to promote best-practice strategies with a variety of resources and webinars.  

The best strategies are to listen to the patient’s concerns, and confirm those concerns without alienating them. 

“Discounting [their concerns] will only move them farther away from wanting to get a vaccine,” Bulych explains. “So, confirming their concerns, but also providing them with reliable information that will help them understand and become more educated.” 

The ability to book appointments with patients has allowed better patient tracking and better overall outcomes for planning and staffing, Bulych adds. 

“What we’re also hearing is that the conversations are taking much longer, that they’re 30 to 40 minutes. If you have the time, and you have a good foundation for how to connect with people, you can really make a big difference, but it is a very time-consuming process, absolutely. You have to really have a strategy on how to talk to people based on what their needs are.” 

Reasons for vaccine hesitancy have changed over time, Bulych says, with some topics popping up regularly, such as concerns around pregnancy. People’s perceptions about the speed of vaccine development and other issues have also been raised. Anecdotally, she has noted an increase in requests for support materials. 

The number of pharmacies offering vaccines has dipped from 371 at the peak of summer to 333 currently participating. Where the demand is lower than the minimum quantities required for ordering the Covid vaccine, pharmacies are strategically working with other healthcare facilities in the community, such as the Saskatchewan Health Authority. As well, pharmacy students who had been assisting in vaccine delivery in summer have returned to school this fall.

“We’re just trying to respond very quickly to a massive additional scope of practice. Every pharmacy still wants to do their part to provide the public with COVID shots, but the reality is they also need to take care of themselves and prevent burnout.” 

SHA’s resources are useful because they are scrutinized by health care professionals and provide solid evidence to present to patients who have concerns. 

“There’s all sort of theories out there and false information floating around,” Bulych says. “So our role can only be to provide solid evidence. And let’s be honest, sometimes that doesn’t do it. Sometimes people are so ingrained in their way of thinking that we have to find that balance of affirming them but not causing them to dig their heels in even further. It really isn’t easy, especially if you’re working in a busy dispensary.” 

Read: We need to mobilize now: Alberta and Saskatchewan's health systems at breaking point

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This graph shows the rise in pharmacy flu vaccinations in Saskatchewan in recent years

Flu shots already in “soft launch” 

Flu shots have already begun in the province, as well. Normally, flu shots begin in late October, and pharmacies order what they expect to need for their communities. This year, over 350 pharmacies had registered to give flu shots by September 3.  

For the first time, flu shots were brought out in a “soft launch” that began in September, Bulych says. Since the number of cases of flu was lower last year, the province was concerned about potentially lower natural immunity, and sent 100,000 flu shots across the province before pharmacies ordered them, based on last year’s ratios. 

As well, guidelines on separating vaccines have been relaxed, allowing pharmacies to co-administer flu shots and COVID-19 vaccinations during the same appointment, depending on patient eligibility for COVID first or second doses, or booster shots for those considered vulnerable. The ability to schedule appointments for flu-shots has been available since last year, and has also helped ease the situation. 

“Most pharmacies are really enjoying the appointment process,” Bulych  adds, “because it’s predictable and pharmacies are doing very well at staying on time. It’s loved by the pharmacies and the public.”

Last year, pharmacies handled over 70% of the flu vaccines in the province, or roughly 20% more than last year. This year the demand is expected to be even higher, Bulych says. 

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