Community pharmacist Ade Williams considers the issue of vaccine hesitancy across diverse communities, health inequalities, and the confidence that community pharmacy can offer patients to promote vaccine uptake
Community pharmacies involvement in the Covid vaccination programme is a unique opportunity to help us heal our communities and renew trust – not just in the NHS, government or science, but also in broader society.
Our ability to successfully help address hesitancy – increasing vaccine confidence and employing our expertise to keep up the rollout’s exceptionally rate – reveals the integrated NHS working model that every Secretary of State espouses. Playing such a visible and much-needed role can only help build our case as ‘NHS remodelling’ looks set to begin again.
However, my conviction from time spent delivering the vaccines in our community is that community pharmacy’s unique strength is bringing societal healing and restoring trust. Like all community pharmacy colleagues, I am aware of the abiding trust invested in us as NHS professionals. Freely afforded to us, we rarely spend much time earning it; instead, our prerogative is to do our best to ensure this confidence is never misplaced or abused.
Our NHS, shaped by core values including “everyone counts, improving lives and respect and dignity,” belongs to all the people, but is sadly still leaving some people behind. A well-established uncomfortable truth is that ethnic minority groups, especially people from Black African and Afro-Caribbean heritage, have significantly worse health outcomes, both for physical and mental health measures, than the rest of the population. This is a sad fact that those with minority characteristics and marginalised socio-economic groups are blighted by.
A lot of research has gone into understanding why. Why also do some in these population groups sometimes avoid seeking early support, waiting until the grip of an otherwise manageable health condition has robbed them of so much, including the chance of restorative healing? A soul-wrenching reality played out too often.
Many songs and slogans have lent themselves to help carry the Black Lives Matter message. Some are easily misconstrued and even controversial in language and origin; one such line retains an echo in my head: “All I know is that they don’t really care about us”.
This chant, a lyric from a song with its own mired history, could help us all – especially community pharmacies seeking to understand the health injustice evident across ethnic and socio-economic character or tackle misinformation and vaccine uptake hesitancy, including amongst minority ethnic populations and other groups.
Sadly, where society permits injustice, we forfeit trust. In the deficit of trust, it is easy to malign and misconstrue. A lot of effort is now being put into correcting misinformation and tackling vaccine hesitancy across diverse communities like Bristol.
In our clinics, I am drawn to the eyes of our patients. Looks of anxiety, fear and even relief – the realisation that it is a local pharmacist behind the mask: ‘I am so glad it is you’.
As we talk through the consent process, I deliberately allow silent pauses for them to speak. ‘‘Will it hurt? Is it safe? Can you take a picture/video for my grandkids? It has been so tough this last year. Have you have had yours? It is my birthday today. I became a grandad again this morning.’’ Our humanity converging, yet the obvious single question unspoken: Can I trust you, Ade?
I answer questions openly and honestly, shaping our discussions around reputable sources of evidence without boxing anyone into binary choices. We must all respect each other’s choice even as we seek to influence and share the truth.
Ultimately, one key issue unmasked by the pandemic is how social injustice, in its many vices, can become so embedded into our societal physique that we do not even hear the cries of despair – a most damning indictment of our collective moral state. Think also of adult social care and the unfair burden on individuals and loved ones.
Do we really care? This is not a question for only community pharmacy to ponder, but a society-wide soul-searching. In answering, we must care about every life, protecting it not just from the coronavirus but defending and advancing dignity, health, and social justice. This message wins trust and breaks barriers.
As each patient encounter concludes, my favourite bit after the vaccination is their: “Is that it!?”. It’s usually followed by: “I really do not know what I was so worried about, thank you.”
Over the past year, I have tried to understand health inequalities and ‘being left behind’, from much sober introspection and patients with lived experience – hearing the voices of
those suffering injustice, long before the coronavirus pandemic began – and whose lives it has sadly decimated the most. I am committed to using all that is left of my career, and long after: articulating and amplifying their cry for change.
Many people will never trust the vaccine, science or even any government (irrespective of the political ideology). Trust in their community pharmacy team, however, will give them confidence and assurance.