The vaccine conversation is at a crossroads.

Currently, there is a massive negative sentiment against vaccinations. The conversation is fueled by conspiracy theories and inaccuracies. This misinformation is mutating, feeding off fear and uncertainty, impacting vaccination rates, and threatening public health globally. Social media amplifies this message, providing misleading information, causing a greater potential for the public to make misinformed decisions about vaccination.¹⁻³

• Vaccine hesitancy is ranked as one of the top 10 threats to global health by the World Health Organization (WHO).⁴

• The 2025 flu vaccination coverage is trending similar to 2024 with about 45.2% of adults vaccinated for the flu as of February 22, 2025. This number has decreased since the 2020 flu season.⁵

  • During the 2021-2023 influenza seasons, influenza vaccine coverage was 20-25% below the recommended targets for adults.⁶

  • As seasonal influenza activity remains elevated, the CDC estimates that there have been at least 24 million illnesses, 310,000 hospitalizations, and 13,000 deaths from flu so far this season.⁷

• With falling vaccination rates, measles outbreaks are being reported across the globe.⁸

Vaccines have also become a victim of their own success. As a society, we have short memories when it comes to infectious diseases and their impact. Thanks to vaccines, many diseases that were once widespread are now rare, which can lend weight to the misguided perceptions that they’re no longer a threat or that vaccines are unnecessary.⁹˒¹⁰

Current vaccination efforts and campaigns aren’t hitting their mark. While efforts to combat hesitancy frequently focus on debunking myths and correcting misconceptions, a more effective approach may be shifting the conversation toward the tangible benefits of vaccination. While vaccines have greatly reduced diseases globally, people can still become seriously ill, suffer from serious complications, or even die from vaccine-preventable diseases. This is especially true for infants/young children, older adults, immuno-compromised people and others with serious health conditions. Vaccines are the best way to protect people and communities from vaccine-preventable diseases.²˒⁶˒¹¹⁻¹³

Research confirms that a combination of provider recommendation, broad vaccine campaigns, and strong community engagement address vaccine hesitancy. Vaccine campaigns should be not only product focused, but evidence-based, context-specific, and culturally appropriate.¹⁴

A mindset shift

The vaccine marketplace needs a mindset shift.

We need to drive the mindset shift from unaware -> interested -> open -> committed.

But how?

One way to do this is to reframe the narrative, focusing on disease awareness education and societal impact. Think back to the height of COVID-19 – people saw firsthand how quickly diseases could spread when communities were unprotected. As time has passed, the discussion has moved away from disease prevention and back into polarized debates about the vaccines themselves. This shift has contributed to waning interest and increasing skepticism.

Vaccines protect individuals from many preventable diseases, severe illness, reduce the spread of infectious diseases, and contribute to herd immunity, safeguarding vulnerable populations. Focusing on positive outcomes, such as preventing hospitalization and keeping communities healthy, makes the message more compelling. The conversation needs to be contextualized by discussing the potential impact of the associated vaccine-preventable disease to not only the individual, but their family, friends, and community. Side effects still need to be discussed for a balanced conversation, but they shouldn’t be the focus.¹⁵⁻¹⁷

However, in order to have these conversations, it is important to equip trusted sources with the information and resources needed to engage in meaningful discussions.¹¹

The power of community pharmacies

While vaccine hesitancy remains a challenge, there’s a solution sitting at the heart of healthcare: community pharmacies. “Community pharmacies are a captain in the vaccine world – in collaboration with a patient’s medical provider, they’re both leading the charge,” said Lura Thompson, PharmD, USA Network and Program Support Lead for CPESN East Region and managing network facilitator for CPESN Virginia.

Community pharmacists, who have long-term, personal relationships with their patients, can engage in ongoing, judgment-free conversations that gradually influence perceptions over time. Community pharmacies, in particular, have become the backbone of adult vaccinations. They are trusted, accessible, and deeply embedded in local communities.²˒¹¹˒¹⁹⁻²¹

Data shows that adults are more likely to receive vaccines at their pharmacy than at a physician’s office, making pharmacies a key player in public health.¹¹˒²²

Pharmacists play an integral role in their communities when it comes to health information, addressing vaccines concerns, correcting misinformation, and recommending vaccination. Using techniques like motivational interviewing—a known strategy to helps individuals explore their concerns and build vaccine confidence—pharmacists can engage in more effective, empathetic conversations that guide hesitant individuals toward informed vaccine decisions. With flexible hours, convenient locations, and being trusted sources of health information, pharmacists are integral to the vaccine conversation. Community pharmacies have the touchpoints to be able to combat this vaccine hesitancy narrative and influence whether an individual accepts health advice. They provide a level of trust that mass public health campaigns often lack. Yet, pharma has not fully leveraged this trust.²˒¹¹˒¹⁴˒²⁰˒²¹

Community pharmacy is uniquely positioned to lead the mindset shift.

A new mindset: From product promotion to public health impact

For pharma to maximize its impact, the mindset around vaccine promotion must shift. The focus should no longer be solely on increasing vaccine sales but on demonstrating the broader public health impact of disease prevention.

This mindset shift means moving away from transactional engagement and toward a collaborative, community-centered approach. Beyond promotional campaigns, pharma can enhance its impact by investing in partnerships that prioritize education, accessibility, and trust.

A new path forward for pharma

Pharma has an opportunity to actively shape and elevate the conversation. This means:

• Refocusing on disease awareness: Educating communities about the real risks of infectious diseases, rather than just defending the vaccines themselves. Thompson refers to disease education as “the biggest and most overlooked opportunity” in the space.

• Empowering pharmacies: Equipping community pharmacists with the right tools, resources, and messaging to engage in meaningful conversations about disease prevention. Studies show that pharmacist-led interventions can significantly improve vaccine acceptance rates.¹⁹˒²⁴

• Moving beyond arguments: Vaccine hesitancy won’t be solved with statistics and counterarguments. People need stories, real-world examples, and trusted voices guiding them toward informed decisions.

Pharmacy owns the vaccine marketplace, especially for adults.¹¹˒²² Now, it’s time for pharma to embrace this opportunity and collaborate pharmacy partners to build a stronger, more effective strategy. The path forward isn’t about winning arguments—it’s about changing the conversation entirely.

“I often say [pharmacists] are sometimes sitting on the bench – like, ‘Come on, put me in coach!,’” said Thompson. “We have to shift the narrative from this negative talk about vaccines and the change needs to come from these pharmacies because they are trusted members of their communities. They are deeply embedded in their communities, and people trust them, and we have to use that relationship.”

Why now?

The pandemic shed light on the vaccine infrastructure, highlighting how unprepared we were. This was used as a catalyst for reshaping the vaccine landscape. The vaccine marketplace is on the precipice of a revolution with an aging population and the rise of technologies, like RNA.²⁵

The vaccine marketplace is expected to expand, tripling the number of globally approved vaccines over the next decade. Patient skepticism toward new vaccines is likely to rise if they are developed using novel platforms or combinations. Therefore, educational campaigns led by trusted public health figures and community leaders will be essential in increasing patient acceptance.²⁵

Action steps to combat vaccine hesitancy

Community pharmacy has been on the front lines in the fight against vaccine hesitancy at a micro-level, even predating the pandemic. From posters and advertising HPV vaccinations in pharmacies across various states, to standardized letters and personalized phone calls recommending influenza and pneumococcal vaccinations.²⁶

Imagine the opportunities and impact that could be realized if community pharmacies mobilized at the network level. A CPESN-led pilot program to combat vaccine hesitancy in senior populations (those 55+ years) is under way in Northern Virginia to test this approach. The program aims to expand vaccine-preventable disease awareness nationwide via community pharmacies in the CPESN network by providing them with educational toolkits. These toolkits will act as “events-in-a-box,” equipping community pharmacists with the resources they need to host disease awareness events at local senior living communities, including guidance on how to address concerns and misconceptions.

Programs like these are ripe for data collection and data-driven patient management. In this example, a clinical pharmacy dashboard for community pharmacies is being established to monitor patient activity, track immunization rates, take notes, and establish unified standards.

Time will tell if this strategy moves the needle on vaccine confidence. But one thing is certain—pharma cannot afford to sit on the sidelines. Community pharmacies have the trust, the access, and the relationships to shift mindsets, but they can’t do it alone. To counter misinformation and strengthen public confidence, pharma can take a bigger role in offering strategic support, education, and resources. The future of immunization depends on it.

Want to hear more from our conversation with Lura Thompson, PharmD? Check out our podcast episode here:

References

1. National Council on Aging. Winning the war against vaccine misinformation in dallas county. Updated 2024. Accessed March 2025.

2. Larson HJ, Gakidou E, Murray CJL. The vaccine-hesistant moment. NEJM. 2022;387(1).

3. Ruggeri K, Vanerslott S, Yamada Y, et al. Behavioural interventions to reduce vaccine hesitancy driven by misinformation on social media. BMJ. 2024;384.

4. Eiden AL, Drakeley S, Modi K, Mackie D, Bhatti A, A D. Attitudes and beliefs of healthcare providers toward vaccination in the United States: A cross-sectional online survey. Vaccine. 2024;42.

5. Centers for Disease Control and Prevention. Weekly flu vaccination dashboard. Updated March 2025. Accessed March 2025.

6. National Foundation for Infectious Diseases. Concerns about respiratory diseases among public drop to new lows, US health officials urge vaccination. Updated 2024. Accessed March 2025.

7. Centers for Disease Control and Prevention. Weekly US influenza surveillance report: Key updates for week 5, ending February 1, 2025. Updated February 7, 2025. Accessed March 2025.

8. Gavi. How misinformation is fueling the current measles crisis. Updated 2024. Accessed March 2025.

9. Rubin R. Influenza’s unprecedented low profile during COVID-19 pandemic leaves experts wondering what this flu season has in store. JAMA. 2021;326(10).

10. US Department of Health and Human Services. The reality about vaccine-preventable diseases. HHS. Updated 2024. Accessed March 2025.

11. Shen AK, Tan ASL. Trust, influence, and community: Why pharmacists and pharmacies are central for addressing vaccine hesitancy. J American Pharmacists Association. 2021.

12. Galagali PM, Kinikar AA, Kuman VS. Vaccine hesitancy: Obstacles and challenges. Curr Ped Reports. 2022;10.

13. Centers for Disease Control and Prevention. 5 reasons it is important for adults to get vaccinated. Updated 2024. Accessed March 2025.

14. Tuckerman J, Kaufman J, Danchin M. Effective approaches to combat vaccine hesitancy. The Pediatric Infectious Disease Journal. 2022;41(5).

15. Centers for Disease Control and Prevention. Explaining how vaccines work. CDC. Updated 2024. Accessed March 2025.

16. University of Rochester Medical Center. The truth about vaccine safety. Updated 2025. Accessed March 2025.

17. National Foundation for Infectious Diseases. Why vaccinations are vital for older adults. NFID. Updated 2021. Accessed March 2025.

18. CPESN. About CPESN USA. Updated 2025. Accessed March 2025.

19. Deloitte Center for Health Solutions. The role community pharmacies can play in reducing health inequities. Updated 2023. Accessed March 2025.

20. Fero A. The volving business model of pharmacy: Moving beyond dispensing. Pharmacy Times. 2025;91(1).

21. Patient Safety Network. The role of community pharmacists in patient safety. AHRQ. Updated 2021. Accessed March 2025.

22. American Disease Prevention Coalition. "Accessibility of adult immunizations in pharmacies compared to physician offices in low-income communities” shows pharmacists can increase vaccine access. Updated 2022. Accessed March 2025.

23. Carroll JC, Herbert SMC, Nguyen TQ, Schork CJ, Kampas LN, CB R. Vaccination equity and the role of community pharmacy in the United States: A qualitative study. Vaccine. 2024;42.