Addressing vaccine hesitancy in the pharmacy.

Mary S. Hayney, PharmD,MPH, BCPS, Professor of Pharmacy, School of Pharmacy, University of Wisconsin, Madison (mary. [email protected]) and John D. Grabenstein, PhD, Executive Director, Global Health & Medical Affairs, Merck Vaccines ([email protected]). The reluctance of some to be vaccinated, termed “vaccine hesitancy,” has contributed to decreasing immunization coverage in some communities and has likely contributed to outbreaks of vaccine-preventable diseases. According to the Centers for Disease Control and Prevention (CDC), measles outbreaks in 2015 were related to 68 unvaccinated US residents, where 29 of them stated religious or philosophic reasons for not being vaccinated.1 Immunization rates for the routinely recommended influenza and pneumococcal vaccines fall far below their Healthy People 2020 goals of 70% and 60% coverage, respectively. Influenza coverage for the 2014e2015 season was reported to be 47%2,3 and pneumococcal coverage in high-risk populations aged 19 to 64 years for 2013 was only 21%.4 Vaccine hesitancy is a continuum of behavior, with most falling somewhere between acceptance of all and refusal of all vaccines available.5 To address vaccine hesitancy, pharmacists should be able to understand and recognize it. The World Health Organization (WHO) provides the following definition6: “Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place, and vaccines. It includes factors such as complacency, convenience, and confidence.” Pharmacists play an important role not only in delivery of vaccines, but advocacy as well. This article provides valuable information for pharmacists and pharmacies to reference when confronting vaccine hesitancy. The Strategic Advisory Group of Experts (SAGE) on Vaccine Hesitancy, established to serve as an advisory group to WHO, created a matrix model to help