A Pharmacist’s traditional role has revolved around the application and usage of medications. However, as the COVID-19 pandemic has demonstrated, many pharmacists are on the vanguard of safeguarding and protecting our Nation, especially in underserved communities. On the Navajo Nation, which sprawls across four States, this has included taking an active role in the planning, distribution, and dissemination of COVID-19 vaccines. At the Chinle Service Unit (CSU), Pharmacists actively engaged as leaders of the mass vaccination task force, logistics, and planning and strategized as to how to effectively and expeditiously vaccinate our remote population. As a result, by end of March 2021, at least 52% of our population (16 years and older) had received their first dose and more than 40% of this population of are fully vaccinated. The critical element and role that Pharmacists have and continue to play during this public health emergency towards the delivery of equitable health care in underserved communities is a testament to their status as transformative healthcare agents.

Background: Given the distrust (historical, contemporary) that characterizes the relationship between the black/African-American population and the U.S. Healthcare System, COVID-19 vaccine hesitancy is of great concern. A needs assessment of the Black/African-American community assessed willingness and explored the perceptions of community members regarding COVID-19 vaccination.

Methods: Using a mixed-methods approach, respondents (n=183) to a web-based survey were asked if there would take a COVID-19 vaccine barring any accessibility and affordability issues. A question on a semi-structured guide explored perceptions of community members through one-on-one interviews (n=30) and eight focus groups, with participants drawn from across various demographic characteristics. Survey responses were summarized using frequencies and proportions. A thematic analysis was conducted on the qualitative data.

Results: Thirty-four percent of respondents indicated “Yes” (i.e. willing to get vaccinated); 26.8% indicated “No”, while 37.1% expressed hesitancy (“Maybe” or “I don’t know”). Themes emerging from the qualitative data are grouped into categories: Vaccine accessibility (transportation, information, navigating healthcare system); Vaccine hesitancy (fears/concerns, risk perception, distrust, normative beliefs); Vaccine willingness (peer-pressure, demonstrated efficacy, policy mandate, fear fatigue); Vaccine confidence (vaccine literacy, efficacy, safety); and Vaccine ‘resistance’ (conspiracy theories, conflicting beliefs, distrust of Government).

Conclusion: Findings demonstrate a nuanced expansion of “vaccine hesitancy” to delineate groups with different issues and perspectives. Interventions to enhance vaccination rates in black/African-American communities should incorporate components that assure accessibility at the minimum, but also address non-access related issues. Pharmacists should prioritize vaccine literacy, information-sharing as efficacy and safety data emerge, and addressing specific concerns identified through community-engaged outreach efforts.

In response to the public health emergency of COVID-19, the U.S. Department of Health and Human Services added pharmacy technicians to the list of those they recommend administer immunizations to persons three years and older under the Public Readiness and Emergency Preparedness (PREP) Act. Many states, including Kentucky, agreed with this recommendation through executive regulation, which allows technicians to administer immunizations during this public health emergency. However, this regulation also requires technicians complete a minimum of 2-hours Accreditation Council for Pharmacy Education (ACPE)- approved training to provide immunizations. Faculty from the Sullivan University College of Pharmacy and Health Sciences quickly developed and launched a Pharmacy Technician Immunization Administration Training in January 2021 to ensure Kentucky’s pharmacy workforce was ready for this massive immunization initiative. The training covers core concepts of immunization administration including patient care considerations, vaccine storage and handling, vaccine administration technique, universal precautions, management of adverse reactions, documentation, and the technician’s role in working collaboratively with the pharmacist. Finally, and most significant, the required injection technique assessment was designed with diverse completion options available to meet rapid training needs, geographic equity, and learner preferences. Over 100 Kentucky technicians completed the training in the first month of implementation. As the Biden-Harris administration began direct vaccine shipments to retail pharmacies, the training was offered to technicians in other states to further support workforce needs. This presentation will describe the process of training implementation, early findings of technician impact on pharmacy-driven immunizations, and long-term considerations for technician immunizing authority.

The COVID-19 pandemic spurred rapid research and interest in potential treatments, including the drug hydroxychloroquine (HCQ). The purpose of this study was to describe and contextualize the impacts of public interest and demand for HCQ for COVID-19 and resulting consequences for patients with indicated uses of the drug, including treatment of lupus.

We extracted prominent events and Google Trends search data as a measure of public interest to develop a timeline of the emergence of and interest in HCQ for COVID-19 in North Carolina (NC) and nationally in 2020. Additionally, we conducted an online survey to explore reported impacts on HCQ access among patients with lupus (n=71) recruited from the University of North Carolina Healthcare System between November-December 2020.

Trends in public interest in HCQ surged in NC and nationally following public endorsements and policies facilitating COVID-19 uses. Demand surges led to national shortages of HCQ for patients with indicated uses, which were corroborated in our patient survey. Over half of respondents currently taking HCQ for lupus reported difficulties accessing HCQ prescriptions during the pandemic (61.8%, n=34/55). Approximately one-third of respondents reported missing a dose or completely running out of HCQ (32.7%, n=18) due to barriers including delayed refills (n=17), reduced medication supply (n=10), and increased costs (n=10).

Premature endorsement and uptake of HCQ for COVID-19 resulted in compromised access to medication for patients with lupus. Insights from the HCQ saga should inform healthcare policy and practice to protect equitable access to treatment during the COVID-19 pandemic and beyond.