While nursing home residents and their caregivers are considered a top priority for COVID-19 vaccination, only 38% of nursing home personnel accepted shots when they were offered, new data from the Centers for Disease Control and Prevention revealed Monday.
For weeks, anecdotal reports have been circulating that nursing home staff declined vaccination offers, but these are the first figures nationally.
“These findings show that we have a lot of work to do to build confidence and really understand the barriers to vaccination in this population,” said Dr. Radhika Gharpure, lead author of the study and member of the CDC’s Vaccine Task Force.
The report cited previous survey data to suggest why workers have refused vaccines.
Many were concerned about the side effects of vaccines. Others said they didn’t want to be among the first to receive the vaccines, which were first approved in December. Some said they did not trust the government or made false claims about the shots.
It’s also possible, Gharpure said, that some people were not vaccinated because they didn’t work when the injections were distributed, or because they work in multiple facilities and were only counted on one.
Residents, meanwhile, are accepting many more vaccines, with 78% receiving at least one injection, according to the new report, which examined vaccination coverage at more than 11,000 long-term care facilities across the country between December 18 and January 17.
Any additional doses of vaccine will be returned to the United States, although there are no numbers nationally to determine how much will be returned, said Dr. Ruth Link-Gelles, a co-author of the report and the leader of the CDC for his Pharmacy Partnership for Long-term Care Program.
The Trump administration started the Pharmacy Partnership with drugstore chains CVS and Walgreens, who agreed to make three visits to each participating nursing home, vaccinate the first twice as many people as possible, and provide the second required dose on subsequent visits.
The vaccines are provided for free, with pharmacies charging private insurers and Medicaid and Medicare administration fees.
More staff members are signing up for admissions on the second and third visits, suggesting the hesitation may at least ease somewhat, Link-Gelles said.
That fits the experience of drugstore chains.
“Overall, we see higher staff uptake on our second visits,” said Mike DeAngelis, senior director of Corporate Communications at CVS.
Lack of information about the vaccines may explain some of the hesitation, the report said.
The Trump administration promised to launch a public information campaign about the vaccines for months, but it never materialized.
A nursing home-specific “toolkit” became available at the end of last year, roughly at the same time as vaccinations. The Centers for Medicare & Medicaid Services and private groups are also launching communication initiatives.
Link-Gelles said she understands the vaccine is new and hopes more people will take it because they see it working well in others.
“We’ve seen hesitation not only a problem in this group, but across the country,” she said. “Other data has shown that as people become more comfortable with the vaccines and… obviously don’t see many very serious side effects, people will feel more comfortable. Hopefully this population is no different.”
Adoption of health workers appears to be increasing in facilities that have done more to educate staff about the safety and effectiveness of the COVID-19 vaccines.
Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine, Nashville, Tennessee, said his hospital went to extraordinary lengths to provide staff with information – both in groups and one-on-one.
It’s been worth it, he said, because they’ve “moved the needle” the opinion of the staff, from nearly two-thirds hesitantly late last year, to 75% agreeing to get the vaccine early this year.
Now, he said, they are reaching out to those who are still hesitant, with “people in our faculty who look like them,” to try a more individual approach.
Of particular concern, he said, are false rumors that the vaccine could affect fertility. “Balderdash,” said Schaffner at the idea. “It’s amazing the nonsense out there.”
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There is no biological plausibility for the fertility concerns, Schaffner said. The Pfizer BioNTech and Moderna vaccines, which use a technology called messenger RNA, do not get into the nucleus of the cell, so they cannot affect the cell’s genetic code.
“Once this messenger RNA delivers its message, it breaks down and the body removes it, so it doesn’t persist in the body,” he said.
Also against rumors that the vaccine blocks fertility, Schaffner said hundreds of people in the vaccine studies were asked not to get pregnant when volunteer work did.
“So of course you can get pregnant even if you got the vaccine,” he said, noting that pregnant women who become infected with COVID-19 are more prone to serious illness.
But it’s important to respect the concerns of those who are reluctant to take the vaccine, he and other experts stressed, listening to what they say and addressing their concerns with real information.
At CommonSpirit Health, which includes 139 hospitals and more than 1,000 care sites in 21 states, about 80% of staff have already been vaccinated or say they are likely to be vaccinated, said lead nurse Kathleen Sanford.
Sanford owes the high level of acceptance of its organization to surveys conducted to understand the reluctance and efforts to train staff. “No matter how good your education and communication is, sometimes you have to repeat yourself,” she said.
Company leaders post photos of themselves getting vaccinated, Sanford said, and many who initially said they wanted to “wait and see” how other people fared with the vaccine are starting to change their minds.
Most health care facilities, including nursing homes, do not require staff to be vaccinated against COVID-19, but they strongly encourage it and hope to achieve flu vaccinations, which are now generally above 90%.
About 42% of employees at Ballad Health, which serves 29 counties in Northeast Tennessee, Southwest Virginia, Northwestern North Carolina, initially signed up for an opportunity, said Jamie Smith, the organization’s chief infection prevention officer. But as of last Monday, 56% of the network’s healthcare team has received their first dose.
“It’s what we expected,” said Swift. “We knew we had people who just wanted to wait, see how the process went and talk to their colleagues. It’s one thing to hear the national statistics, it’s another to talk to someone you work next to about how they felt to be vaccinated.
For many, vaccination is surprisingly emotional, and so are the staff who inject their colleagues.
“We have had to deal with extreme illness for so long. Just to be able to give the vaccine was such a healing process. People just cry, ”Swift said.
She has seen a real change in attitude after the first few people are inoculated into a unit.
“These are health workers on the front lines, fighting a battle that not everyone sees every day. It’s just the feeling of relief and hope, it energizes that whole unit when you get someone vaccinated. “
Kathleen Unroe, a geriatrician and nursing home physician, helped conduct a survey of primary care health workers across Indiana on behalf of the state department of health in November.
Her study, cited in the CDC’s new report, found that 45% of the more than 8,200 health professionals would consider getting vaccinated immediately after it became available, and an additional 44% were willing to consider using it in the future.
While she wished vaccination coverage was higher, Unroe said she was encouraged by those numbers. Some may want to wait to see others, especially people they trust, take the vaccine safely.
“I get that,” Unroe said. “If they have to take a moment to look at it, I think that’s reasonable.”
Unroe said the Indiana nursing home center where she works has faced a long list of challenges over the past year in coping with the pandemic.
But now 70% of the workforce is vaccinated, and she hopes that persistence, solid messaging, and helping people talk through their fears will make most of the rest go away.
“The vaccine offers hope and a way out for us,” Unroe said. “So I think we’ll get there.”
Elizabeth Weise contributed to this report.
Please contact Karen Weintraub at [email protected].
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This Article Originally Appeared on USA TODAY: Nursing Home Workers Are Hesitant to Get COVID Vaccine, CDC Study Finds