Navigating Travel Vaccines: Best Practices in Counseling and Care

Dr. Walker:

This is VacciNation on ReachMD, and I’m Dr. Robert Walker. Here with me today to discuss how we can utilize shared decision-making when counseling patients on travel vaccines is Dr. Nic Garner. He is the District Support Pharmacist Leader at CVS Pharmacy in Texas with more than 10 years of community pharmacy management experience. 

Dr. Garner, welcome to the program.

Dr. Garner:

Thank you very much.

Dr. Walker:

To start us off, Dr. Garner, can you provide a little background on the importance of travel vaccines and the potential risks of traveling unvaccinated?

Dr. Garner:

Certainly. So travel vaccines are becoming more and more common. They have been around for a little while and cover a variety of diseases. The benefits of getting a travel vaccine are prevention and avoidance of problems in certain areas. So depending on the location you’re going to, things like the yellow fever vaccine would prevent that versus cholera vaccines or several other vaccines that are around, but the benefits are huge because it prevents you from coming home with problems. They’re more and more common, and traveling unvaccinated is really kind of taking your life in your own hands because you can certainly end up with any number of diseases depending on where you’re going, and you become more and more susceptible to them, so it’s certainly a good idea to protect yourself.

Dr. Walker:

And how would you typically initiate a conversation about travel vaccines? Are there any prompts or cues you use to identify patients with upcoming travel plans?

Dr. Garner:

So typically speaking, not so much. We don’t really have a lot of ways to tell if people are doing that. I do have patients that walk in and say, “Hey, I’m going to be traveling to this area. What do we need to do?” And that’s really a starting point. There are times where patients will off the cuff mention that they’re going to be going out of the country for a couple of weeks and need to get their medications caught up. That’s when I usually go into my conversation about travel vaccines depending on where they’re going and what they’re doing. And my best recommendation for them is to start with the CDC website and pull up what they need to be doing and go to the area they’re searching in. If they have questions, I could actually help them with that as well.

Dr. Walker:

As a quick follow-up to that, what information do you like to gather when you’re assessing patients’ potential vaccination needs?

Dr. Garner:

So where they’re going, how long they’re going to be there, how old they are, and what they’re potentially going to be doing there tend to be the biggest starting points for us.

Dr. Walker:

For those just joining us, this is VacciNation on ReachMD. I’m Dr. Robert Walker, and I’m speaking with Dr. Nic Garner about utilizing shared decision-making and travel vaccination counseling.

So, Dr. Garner, once you identify patients who would benefit from travel vaccines, how do you go about presenting your recommendations with them?

Dr. Garner:

If I get the chance, I try to sit down with them and go over what they’re going to be doing, what potential problems they’re going to have there, and see where they are with their vaccines and how up-to-date they are. If they’ve been there recently, they may be caught up. If they’re not, then we need to get them caught up and go through what could potentially be problems there and what the recommendations are from the CDC so that I can guide them properly and help them pick out the right vaccines for their trip.

Dr. Walker:

Now what are some common concerns patients raise regarding travel vaccines, and how do you address them?

Dr. Garner:

The most common ones typically are side effects from vaccines, which is pretty easy to mitigate. Most of the time it’s just going to be a sore arm because it’s usually just a shot in the arm. Sometimes they’re a little more concerned with “Hey, I’ve got to have, like, six vaccines. How am I supposed to get those all at once?” Ideally, you don’t. You spread them out over time. Some of them are requiring multiple doses, so you need to be prepared ahead of time—but going through that and kind of calming their fears. 

Especially if they’re going somewhere that’s going to require a multidose vaccine, I want to make sure they get there early, and we can go through the process. Then we can get a couple of them done each trip, and they can get a little bit less side effects, a little bit less of a sore arm, and they can properly prepare for things, so that gives us time to get the vaccine in if we don’t have it. That gives us time to make sure we’ve got everything set up, and we can schedule their stuff around their schedules and help them get prepared.

Dr. Walker:

Finally, Dr. Garner, do you have any recommendations on best practices for integrating these approaches into routine practice?

Dr. Garner:

It’s really about knowing your patients and knowing your customer base. If you have patients that travel quite a bit, pay attention when they come in for the medicines and pay attention to what they’re saying and what they’re talking about because everybody tends to travel at a couple of key times a year. Usually, it’s summertime and then quite often around Christmastime, so you know people are going to be traveling. And sometimes they take bigger trips, and so just getting to know your patients and being able to talk to them about everything. 

If you can gain their trust and they can listen to what you have to say, then they’ll be happy to talk to you about trips they’ve got upcoming and what’s going on and where they’re going to be going and what they’re going to be doing. They get excited about those things, so being able to sit down and talk to them and listen to them and kind of go through that with them helps out tremendously.

Dr. Walker:

Those recommendations are a great way to round out our discussion. And I want to thank my guest, Dr. Nic Garner, for joining me to discuss shared decision-making and travel vaccination counseling. Dr. Garner, it was great having you on the program.

Dr. Garner:

Thank you very much.

Dr. Walker:

For ReachMD, I’m Dr. Robert Walker. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening.