Only 38% of nursing home workers accepted COVID-19 vaccines, new data shows

While residents of nursing homes and their caregivers have been considered a top priority for COVID-19 vaccination, only 38% of nursing home staff accepted shots when they were offered, new data from the Centers for Disease Control and Prevention revealed Monday.

Anecdotal reports have been circulating for weeks that nursing home staff members were turning down vaccination offers, but these are the first national-level figures.

The report cited previous polling data to suggest why employees have been declining COVID-19 vaccines.

Many raised concerns about vaccine side effects. Others said they didn’t want to be among the first to receive the vaccines, which were first authorized in December. Some said they didn’t trust the government, or referenced false claims about the shots.

Residents, meanwhile, have been much more accepting of vaccines, with 78% receiving at least one shot, according to the new report, which examined vaccination rates at more than 11,000 long-term care facilities nationwide between Dec. 18 and Jan. 17.

The Trump administration contracted with drugstore chains CVS and Walgreens to pay three visits to every participating nursing home, vaccinating as many people as possible the first two times, and providing the second required dose on the later visits.

Lack of information about the vaccines may also explain some of the hesitancy, the report said.

Pharmacists prepare doses of the COVID-19 vaccine at the Life Care Center of Kirkland on Dec. 28, 2020 in Kirkland, Wash. The Life Care Center of Kirkland, a nursing home, was an early epicenter for coronavirus outbreaks in the U.S.

The Trump administration promised for months that it would launch a public information campaign about the vaccines but it never materialized.

Nursing-home specific information became available late last year, at about the same time vaccinations became available.

According to the new report, “barriers to (skilled nursing facility) staff member vaccination need to be overcome with continued development and implementation of focused communication and outreach strategies to improve vaccination coverage.”

Facilities that have done more to educate staff members about the safety and effectiveness of the COVID-19 vaccines appear to have increased acceptance among health care workers, some have found.

Dr. William Schaffner, an infectious disease expert at the Vanderbilt University School of Medicine, Nashville, Tennessee, said his hospital has gone to extraordinary lengths to provide information for staff – both in groups and one-on-one.

It’s been worthwhile, he said, because they have “moved the needle” of staff opinion, from nearly two-thirds hesitant late last year, to 75% agreeing to receive the vaccine early this year.

Now, he said, they’re reaching out those who still remain hesitant, with “people on our faculty who look like them,” to try a more individual approach.

Particularly disturbing, he said, are false rumors that the vaccine can affect fertility. “Balderdash,” Schaffner said at the idea. “It’s amazing the nonsense that’s out there.”

There is no biological plausibility to the concern about fertility, Schaffner said. The Pfizer-BioNTech and Moderna vaccines, which use a technology called messenger RNA, don’t get into the nucleus of the cell, so they can’t affect the cell’s genetic code.

“No sooner does this messenger RNA deliver its message, it disintegrates and the body gets rid of it, so it does not persist in the body,” he said.

Also countering the rumors that the vaccine blocks fertility, Schaffner said several hundred people in the vaccine trials, who were asked not to get pregnant while volunteering actually did.

“So, obviously, you can become pregnant even though you’ve received the vaccine,” he said, noting that pregnant women who become infected with COVID-19 are more apt to have a serious bout of illness.

But it’s important to respect the concerns of those who are hesitant 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 members have either been vaccinated already or say they are likely to be vaccinated, said chief nursing officer Kathleen Sanford.

Sanford credits her organization’s high rate of acceptance to surveys conducted to understand hesitancy and efforts to educate staff members. “No matter how good your education is and your communication, sometimes you need to repeat yourself,” she said.

The company’s leaders post pictures of themselves getting vaccinated, Sanford said, and many who initially said they wanted to “wait and see” how other people fared on the vaccine are starting to change their minds.

That matches the experience of CVS and Walgreens.

“Generally speaking we are seeing a higher uptake by staff members on our second visits,” said Mike DeAngelis, senior director of corporate communications for CVS.

Most health care facilities, including nursing homes, are not requiring staff to get vaccinated against COVID-19 but they are strongly encouraging it and hoping to reach levels of flu vaccination, which now generally top 90%.

Kathleen Unroe, a geriatrician and nursing home physician, helped conduct a survey in November of front-line health care workers across Indiana on behalf of the state department of health.

She found that 45% of more than 8,200 healthcare workers said they would consider getting vaccinated immediately after it was available, and another 44% was willing to consider getting it in the future.

Although she wishes the vaccination rate were higher, Unroe said she’s encouraged by those figures. Some want to wait until they see others, especially people they trust, take the vaccine safely.

“I get that,” Unroe said. “If they need to take a little time to look at it, I think that’s reasonable.”

Unroe said the Indiana nursing home facility where she works has faced a long list of challenges over the last year coping with the pandemic.

But now, 70% of staff have been vaccinated, and she hopes that persistence, solid messaging, and helping people talk through their fears will bring most of the rest around.

“The vaccine provides hope for us and a way out,” Unroe said. “So I think we will get there.”

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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