Gabriel Perna | April 14, 2021
It won’t be easy, but Walmart has a goal to vaccinate 13 million Americans every month, according to Cheryl Pegus, MD, the company’s executive vice president of Health and Wellness.
Considering 4,000 out of the 5,000 Walmart stores in this country are in a Health Resources and Services Administration [HRSA] designated medically underserved area, it’s an important goal in improving the low vaccine uptake among vulnerable communities, particularly for those in rural areas of the country. According to a recent survey, three in ten rural residents say they will “definitely not” get vaccinated or will only do so if required and 15 percent are waiting on someone they know to get vaccinated.
“Walmart is the health care service in some rural communities, they come to pharmacies and that is where they receive most of their services, but it is not enough. Success in underserved communities requires an understanding of what the gaps are in those communities,” said Pegus.
Pegus spoke about Walmart’s vaccination efforts as part of a discussion at the Health Evolution Virtual Confab 2021, Health Assurance in the Workforce: Improving Employee Health Outcomes and Equity. She was joined by Alexandra Drane, Co-Founder and CEO, ARCHANGELS and Craig Samitt, MD, President & CEO, Blue Cross Blue Shield of Minnesota.
While the retail giant is still scaling up towards this goal, any achievements it makes will be a testament to the work the organization has done in instilling vaccine confidence in its associates, empowering its pharmacists, and understanding how to reach these populations.
Since Pegus came on board in December, she said one of her first goals has been utilizing the health and wellness team to ensure the 1.5 million associates in Walmart understand and feel comfortable with immunizations. When it comes to COVID-19 vaccines, Pegus noted “there’s a lot of noise that comes out externally. As an employer, if you have trusted voices in your organization, you can help your associates feel like there are no stupid questions.”
She said there has been a lot of learning webinars, one-on-one meetings, and constant communication with the company’s associates. Walmart has also established vaccine ambassadors. “These are people who look like you, who work at the same level and are telling you they’ve gotten their vaccine, telling you it’s the right thing to do,” she said.
Another strategy to scale up vaccinations and improve overall confidence, Pegus said, has been working directly with and empowering the vaccinators themselves, the pharmacists. When vaccine efforts began in January, Pegus knew there would be concerns from these people about side effects, allergic reactions and giving it to high-risk populations, who were the first eligible to receive them.
“For our pharmacists, it was really letting them know that what I wanted was for them to feel as if these were their own patients, they were setting up their own practice and that they felt very confident in what they were doing,” Pegus said. “If you think we’ve trained our associates, just think of the training that the team, our chief medical officer, our pharmacy clinicians, have done to train our pharmacists across the country to be the very early providers of immunizations in different communities.”
Cheryl Pegus, MD, EVP of Walmart
There were not only medical concerns, but potential challenges around refrigeration, inputting records into databases and mixing the vaccine. For Pegus and the health and wellness team, all of these apprehensions meant allowing pharmacists to learn at their own pace.
“We said to them, ‘You’re going to open a file. It’s 10 immunizations. You should get really comfortable and confident in being able to do that and immunizing each other as pharmacists, allowing you to understand how you would utilize waste if it came up.’ [We were] listening and allowing people to get to that scale. We would start out our first day, 10 immunizations. Second day, 20. By a week, could we get to 100? Then how do we scale to 200 to 300 based on the stores?”
This process has helped vaccinators feel more confident and as if they were running their own business. It has also allowed them to connect more with the community and follow up with people who have concerns or questions. Creating this kind of trust between the community and the organization, Pegus said, is one of the critical factors in having vaccine (or any kind of) success in underserved communities.
“You can have the access, but what these communities also need is to have a relationship and trust with where they’re going to receive any kind of care, any information,” said Pegus. She notes that a few factors enable this trusting relationship to be formed. “We know from a lot of the work that’s been done on health equity, it requires cultural concordance. People need to see people like them to feel as if they understand their experiences.”
Along with cultural concordance, she says organizations must help improve health literacy, understand where their population lives and how they live, and lastly, possess the “humility of asking the community before you come in with your wonderful solutions.” She says the organization held 40 community events in February alone on COVID-19 vaccinations. This meant partnering with community groups, payers, and anyone willing to help.
“The success of COVID-19 vaccine rollouts has been probably for the first time, in a really long time, every stakeholder in health care said, ‘We need to work together to make this more accessible and to reach those who are in need and who may have vaccine hesitancy.’ I want to remember this time and I want us all to remember next year, two or three years from now, how we can continue to do this,” Pegus said.