Q&A: Pharmacists Can Overcome Vaccine Hesitancy Through Trust and Communication | APhA 2025

In an era of persistent medical misinformation and deep-rooted health care disparities, addressing vaccine hesitancy has become a critical challenge for health care professionals. The ongoing spread of myths about vaccine safety, coupled with systemic barriers that disproportionately affect minority communities, continues to undermine public health efforts and vaccination rates across the United States, according to Lauren Angelo, PharmD, associate dean for academic affairs at Rosalind Franklin University.

Pharmacists are now focusing on innovative strategies to rebuild trust and improve vaccine uptake, recognizing that traditional top-down communication approaches have fallen short. By leveraging community health workers, developing patient-friendly messaging, and engaging in collaborative conversations, health care providers are seeking to dismantle the complex web of misconceptions and structural barriers that prevent individuals from accessing vital immunization services. The goal is not just to dispense medical information but to create meaningful connections that empower patients to make informed health care decisions.

In an era of persistent medical misinformation, addressing vaccine hesitancy has become a critical challenge for health care professionals. | Image Credit: lubero | stock.adobe.com

Drug Topics: What are some of the most common myths or misconceptions you've encountered regarding vaccine safety and efficacy?

Lauren Angelo, PharmD: Some of the more common myths we've seen lately, I would say, fall into 2 buckets. They center around vaccine safety or really complacency around the diseases they prevent, and one of the ones we're seeing lately is back to measles and the MMR vaccine, and there's still that belief that it can cause autism, which we know is not true. We've spent decades disproving it. A lot of energy and resources, but that is still out there. With the COVID-19 pandemic, we saw a lot of misinformation and myths around the COVID-19 vaccines, and even just the last week, I saw a post that said something to the effect of vaccines aren't tested. They don't work. So we know it's real, and we're still seeing these things. There are some who think getting natural immunity from the disease is better than getting the vaccine. We've seen parents are still concerned that the vaccines will overwhelm their [children's] immune systems. We know that's not true. We've heard, mostly around our younger, healthier patients, that getting the flu or getting COVID is not so bad, but if we look at this year's flu season, it's the worst it's been in a long time. Our hospitalization rates, our deaths, they're approaching numbers we saw in 2011. We saw over 150 children have died this year from influenza, and that's a lot of heartbreak and grief among families. So we know that getting these diseases is a real thing, and if we can prevent them, that's the better way to go, and I would say, with these measles outbreaks, oh my gosh, even though this isn't really vaccine-related, we're seeing that vitamin A prevents measles, and that obviously is not true, and it's a very dangerous place to be.

Drug Topics: What are the historical and sociocultural factors that contribute to vaccine distrust in these communities?

Angelo: Trust is something that, in most cases, needs to be earned, and if that trust is lost, it is a very difficult hill to overcome to regain that trust. We've seen structural and systemic racism in our health care system for years, and that really has caused some challenges when we talk about outcomes in patients. The COVID-19 pandemic really shed light on that. We saw a lot more deaths, a lot more severe disease among our racial and ethnic minority groups. Getting access to health care, getting access to vaccines was a problem, and it still is today. It's something we are still working to overcome. I think that distrust is just rooted in years of negative experiences with our health care system.

Drug Topics: What are some barriers to vaccine access that are more prevalent in underserved communities?

Angelo: The list of barriers can be very long, so I'll try to summarize some of them. But you know, it's just something we're faced with on a recurring basis, and we're struggling to really find solutions to a lot of those barriers. We can look at some of the long-lasting effects that redlining has had, and it's created an increased level of poverty in a lot of communities across our country. When we couple that with our pharmacy closures and the pharmacy deserts that's created, getting access to health care and getting access to vaccines has been a real challenge for a lot of patients. We also see getting health care insurance is difficult. Transportation issues are a real thing. If the nearest pharmacy or the nearest clinic is 5 miles away, but you don't have a reliable car or reliable public transportation, getting that access is not feasible. We see a lot of individuals working multiple jobs so they don't have the time, and trying to get into a clinic or find health care services that are available with extended hours is very difficult to do. So we do have a lot of things to overcome, and we're still working through a lot of those challenges.

Drug Topics: How can pharmacy professionals tailor their communication strategies to address the specific concerns of minority and underserved communities?

Angelo: My answer is a little bit indirect, and that has to do with community health workers. If pharmacies can partner with community health workers, that's such a great way to bridge those communication gaps with their communities, and we are seeing some pharmacies hiring community health workers, or they're training their staff to be community health workers, and the great thing about community health workers is they're out there in the communities. They are building that trust; they're building the rapport; they're able to get access to services that patients might not otherwise have; and we actually saw during the COVID-19 pandemic the impact that community health workers had on vaccine uptake, and working with some of those under-resourced communities really made a difference in getting those vaccines on board to patients that might not have had that service available to them.

Drug Topics: How can pharmacists effectively counter vaccine misinformation with evidence-based information?

Angelo: We are still struggling to answer that question. I think when it comes to trying to relay information that's based on fact or science, we do a great job of talking amongst ourselves and sharing that information within our own circles, but we're not great at getting outside of that circle and sharing information with patients in a way that they can understand it. If you look at, we've got webinars, we've got podcasts, we've got CE programs, but they're all really for health care providers. So in essence, we're preaching to the choir in a lot of these situations. So if we can learn how to build patient friendly messages, maybe work with our community leaders, get out into the communities, have focus groups, and work to develop information that is fact-based but resonates with our patients, I think that will go a long way.

Drug Topics: How can pharmacists tailor their communication style to individual patients to build trust and rapport?

Angelo: I think to build that trust and rapport, we need to be present, and we need to be seen as a resource within our community. So if we're able to step outside of the pharmacy and offer clinics or educational sessions that are off-site and during extended hours so patients can attend, that will go a long way in building that trust and rapport and working at that individual level with specific patients. When they come back into the pharmacy, and they've seen the pharmacists out in the world and in their communities spreading those messages, working with the local health departments, working with the Medical Reserve Corps, it's a great way to be present. I think when we're talking at an individual level, let's be honest, nobody likes to be told what to do. So if the recommendations and the suggestions that we're making around vaccines are perceived that way, I think they will be met with resistance, and so working to have more of a collaborative conversation with patients and work as a team to make those decisions to be vaccinated and to proceed with vaccinations in the way that works for patients. I think that will be beneficial when we're talking about overcoming some of that hesitancy and some of that resistance that we see.

Drug Topics: How can pharmacists identify and address a patient's underlying concerns and fears about vaccines?

Angelo: Our first step, I think, is to ask them and to really explore what their beliefs and perceptions are, and so if we can encourage them to share their stories with us, I think that is going to go a long way in terms of uncovering their reasons for hesitancy or their just issues around getting vaccinated. We're going to probably encounter 2 different groups. You're going to have one group who's just adamant about not getting the vaccine. You might have another group who's on the fence or thinking about it, and those are the patients we really can make a big difference in. We can work with them. We'll get probably more more value out of those conversations, knowing that maybe they just need a little encouragement or reassurance to move that needle to go ahead and get vaccinated.

Drug Topics: Is there anything else you would like to add?

Angelo: I think the theme of all of this, when we're talking about conversing with patients, is we don't have all of the answers, and a lot of research is still being done to explore what is best in terms of communicating with patients. How do we disseminate a lot of these myths? And we're not there yet. So I think as we continue to have these conversations, it's important to take a step back see what's working and what's not working, and how do we change that. I think if we're going to see a difference in hesitancy and improve vaccine uptake, something does need to change, and having more patient friendly messaging and marketing materials is probably one of the first steps that we need to make sure we take.

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