Dr. Alexandria Yarborough Answers Our Pharmacist Questions
Written by Melissa Schenkman, MPH, MSJ
Alexandria Yarborough, PharmD, has been working on the frontlines of healthcare long before the term, ‘frontline healthcare worker’ became popular during the COVID-19 Pandemic.
When you think about it, who is often the first person you or your fellow millennials seek healthcare from even before heading to urgent care or your established primary care doctor? The answer: Your local pharmacist. We visit them for accessible advice in the same way we search for a medication to quickly alleviate our symptoms.
As a community pharmacist and Pharmacist in Charge at Sam’s Club in South Carolina, Yarborough has built relationships with patients that make her role go far beyond dispensing medication. She provides prevention, education, recommendations, and vaccinations to keep her community healthy.
“We are the most accessible healthcare professionals. You can come up to us at places such as Sam’s, Publix, or CVS, and you don’t need to make an appointment,” Yarborough said. “We have a unique opportunity to prevent errors, which we are required to do quickly. That quick thinking can keep you out of the hospital and [to me] that’s a big deal.”
This includes navigating the opioid crisis “an epidemic within the pandemic.” As a community pharmacist, Yarborough reviews all the medications patients take to determine if the combination could potentially be harmful and cause an unintentional overdose. She educates everyone about what their medications are for, their side effects, how best to take them, and potential interactions with other medications. She also looks to see if a patient has been visiting multiple doctors and pharmacies to obtain the same medication or harmful combinations.
“I have to have those hard conversations,” she said. “I never thought I would experience and have to deal with the hostility and pushback from patients when what I’m doing is what I’m supposed to be doing…keeping them safe.”
However, she is used to a different type of pushback that so many millennial-aged women are familiar with in their careers, a lack of trust in experience based on how young you look.
Dr. Yarborough giving a patient their annual flu shot.
The Road to Becoming a Pharmacist
Yarborough earned her doctorate in Pharmacy (a PharmD) and started working as a pharmacist at just 24 years old.
She chose the intense two-plus-four program at Wingate University, where after two years of 18-20 hours of undergraduate coursework per semester, she went straight to graduate school at Presbyterian College School of Pharmacy.
It was not your typical experience, as many of the students training to be pharmacists alongside her already had four-year degrees or a career and went back to graduate school.
“A lot of people aren’t aware that pharmacists are trained at the doctorate level before even doing a residency, so we can take care of you. It is typically an eight-year program,” Yarborough said. “Even though you see us while grocery shopping, we are highly educated. You can trust us and come to us for advice.”
Medication and Mental Health for Millennials
Many people do, including those from her same generation. The most common questions she gets from millennials are about medications for mental health conditions—drugs that are within the top 200 types of medications most frequently prescribed to millennials.
Now that the topic of mental health is not as taboo, she said, it’s been an advantage for millennials, many of whom have sought talk therapy and medication.
“I feel like most people aren’t taught to see it as a tool that’s in your toolbox and not as something that is going to fix you temporarily,” Yarborough said. “I always encourage patients to realize that it’s going to take time to see the benefits.”
She tells patients to think of mental health medications as a basic need to survive, like eating food and drinking water.
There’s a lot happening in society that can make it difficult for millennials to seek help, let alone take medication. She finds that “we” have this reputation for being too sensitive and focused on learning about our emotions and not wanting to work. In reality, we are just trying to take care of ourselves.
“People think we want to take the easy route of wanting a medication to fix everything. That can’t be further from the truth,” Yarborough said. “Visiting healthcare providers and using appropriately prescribed medication, especially for mental health, is part of a healthy lifestyle. Millennials are way ahead of the curve by taking these steps.”
Perhaps if people spent a day in her shoes or the countless other millennials in and outside of healthcare during the COVID-19 pandemic, they might have a better understanding of the burdens on our generation and the critical, but challenging role of the community pharmacist.
Dr. Yarborough’s feelings about the increased workload at the height of the pandemic.
A Day in the Life of a Pharmacist During the Pandemic
Yarborough works 10-hour shifts in her pharmacy and never had the option to work from home or be part of the shutdown other than when she came down with COVID-19 herself.
Part of her job entails medication therapy management with all her patients to keep them adherent with their medications and up to date with their immunizations—something she’s even more passionate about now.
Knowing the science behind immunization, she has been shocked by the controversy over vaccines and the behavior of some adults at her pharmacy and other vaccine clinics she has voluntarily run. It’s hard for her to comprehend people believing vaccines are optional and acting like she is offering them poison. Some tell her she is getting money from big pharma to give vaccines. It could not be further from the truth.
“They’re almost questioning my character because they don’t see the intent behind it,” Yarborough said. “I went to school and chose a career to serve others. I didn’t learn about certain disease states to benefit me, but to help all different types of patients.”
Others who wanted the COVID-19 vaccine, would come to the counter and forcefully say “vaccine,” not even say “hello.” Some attempted to use bribery or their connection with her to get vaccine appointments. Patients even asked for her cell phone number and tried to befriend her on Facebook to get an appointment.
This inappropriate behavior, rudeness, and mistrust patients had from misinformation about vaccines has made her and her pharmacy colleagues feel kind of dehumanized when all they were and are trying to do is help people stay safe.
“When the pandemic came, there was a huge shift to basically pharmacy technicians and pharmacists being the equivalent of fast-food workers with the vaccine. It was super challenging because people just saw us as having a hot product.”
Meanwhile, in addition to the thousands of COVID-19 vaccines, her pharmacy has given, she has gone to great lengths to educate others, producing charts with the vaccine’s risks and benefits, making a step-by-step training video to teach fellow pharmacists to administer the COVID-19 vaccine, and creating a Facebook page with reliable vaccine information.
“I used to want to change the world with community pharmacy,” Yarborough said. “Every night, I go to bed thinking, ‘Have I done everything that I can do for my patients?’ and I just don’t know anymore because I can only do so much for the ones that don’t trust me and that’s really hard.”
Dr. Yarborough with her goddaughter Lorelei visiting her at work. Lorelei, who has Cystic Fibrosis, is one of the many people Yarborough hopes to help protect in her community by administering COVID-19 and flu vaccines to patients.
From Pharmacist to Author
Earning patients’ trust, but for a new segment of her community—children under age 12—is what led her to take her knowledge and experience outside the pharmacy.
Before COVID-19, in South Carolina, anyone ages 12 and older could get a flu vaccine without a prescription (18+ for all other vaccines). Unfortunately, so many children missed their immunizations over the last few years, the state lowered the age. So, now Yarborough sees toddlers in her chairs.
“While our training was adequate, the experience is not the same,” Yarborough shared. “Kids are coming to Sam’s Club thinking they are going to get samples, not a shot. They’re screaming at the top of their lungs and parents are holding them down, while I’m trying to vaccinate them.”
She knew there had to be a better way. So, after not finding any vaccine books for children, she decided to write one of her own.
With a relatable main character and a storyline about the emotions children experience such as the fear of the pain and anxiety surrounding the shot, her book, Our Best Shot, educates children about getting their flu shot, but it applies to all vaccines. It teaches them the concepts of why we get immunizations—to keep ourselves and other people healthy in our community.
Yarborough keeps a copy at her pharmacy, so children can read it before getting their shot. She hopes it will change kids’ experience of getting a shot from painful to doing something more powerful.
“We are just afraid of what we don’t know. Children don’t understand the concept of immunizations and why they are getting a shot,” Yarborough said.
Although the book is written for children, the concepts apply to every age. Most millennials don’t want shots themselves because they see it as an unnecessary chore.
“As millennials, we are at an age where we might be healthy enough not to have long-term impacts if we get sick from vaccine-preventable diseases but it’s not worth the risk. Even if you don’t feel you need protection, consider your peers, young children, nieces/nephews, and older family members,” Yarborough said.
“You have to be an advocate not only for yourself but for others as well.”
This story is a part of YMyHealth’s COVID-19 Stories from the Field series. We will continue to share personal stories from millennials who are essential workers, caregivers, and those close to them, as long as the pandemic continues.
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