Nursing home workers are passing on their chance at early access to the COVID-19 vaccine, officials say, blowing a crosswind against a scarce supply of doses and a pandemic in a tailspin.
Gov. Mike DeWine first drew attention to the issue Wednesday, claiming during a televised press briefing that roughly 60% of staffers who were offered the vaccine declined it.
“I think in this case, [DeWine] is on target,” said Pete Van Runkle, executive director of an industry association representing Ohio’s long term care facilities.
“I talk to a lot of members on a regular basis. They are reporting a pretty low uptake among staff.”
Patrick Schwartz, a spokesman for Leading Age Ohio, an elder advocacy group, said he’s hearing mixed reports of some providers finding that 90% of staff chose to take the vaccine while others are “well below 50%.”
He attributed the shortfalls to misinformation and fear surrounding the potential for an adverse reaction to the vaccine.
“Many staff are simply ‘not yet ready,’ which will hopefully change as they see more and more colleagues vaccinated without side effects and confidence continues to build,” he said.
“By contrast, an overwhelming majority of residents seem willing to accept the vaccine, with many coming from the generation that saw polio and other deadly diseases wiped out by life-saving vaccines.”
The local Service Employees International Union surveyed its members on the issue, it said in a statement Monday.
The responses, according to SEIU 1199 President Becky Williams, indicate a trust problem between an exhausted, underpaid, underappreciated, and in many cases already-infected staff and health authorities.
She said this is a “substantial issue” that’s bigger than just the union and requires outreach and education from the state.
“Workers commented that the vaccine appeared rushed and unproven without enough data to show that it would be effective,” she said.
“Some workers are also concerned that the vaccine could cause fertility issues among women who may want to have a child. There are trust issues among frontline health care workers — some of which preceded the pandemic. These trust issues continue after so many nursing home workers have been on the frontlines of the pandemic without hazard pay and support such as needed personal protective equipment.”
Several news outlets have debunked this notion of ‘fertility issues’ related to the vaccine. A quick scroll through the right Facebook group can deluge visitors with this and similar pieces of misinformation relating to the vaccine.
The Ohio Capital Journal called 13 state long-term care facilities Monday, who have each reported at least 100 COVID-19 cases among their residents, to discuss vaccination among their staffs. No administrators agreed to an interview.
Two vaccines (one from Moderna and one jointly from Pfizer and BioNTech) are currently approved for emergency use against COVID-19. They are both two-dose vaccines, taken several weeks apart.
Company data reviewed by the Food and Drug Administration shows both vaccines are about 95% effective preventing symptoms of COVID-19. While side effects (sometimes more intense than a standard flu vaccine) have been reported with both products, none of the vaccine trials have reported any serious safety concerns, according to information from Johns Hopkins University.
Before coming to market, both vaccines underwent large scale clinical trials over the course of months. They are now under review via continuous monitoring for problems and side effects from the FDA and the CDC.
The vaccine hesitancy comes as COVID-19 has infected 727,000 Ohioans, put about 39,000 in the hospital, and killed at least 9,143 since March.
At least 4,856 of those deaths occurred among residents of Ohio’s long-term care facilities.
Nationally, more than 353,000 Americans have died of COVID-19 and nearly 21 million have been infected.
There are several theories as to why nursing home workers would rebuff a vaccine dose, according to Tory Hogan, an Ohio State University professor who researches nursing homes and infection control.
She said some probably just don’t trust health authority; some have “been in the trenches” of the pandemic for a year now, prompting them to shrug off the unknown risk of vaccine for the better-known risk of infection; some probably just don’t want to be the guinea pigs.
“There has been so much misinformation about everything in this process,” she said.
Wood County Health Commissioner Ben Robison said he’s detected some vaccine hesitancy and refusal across all industries. However, some who deny at first are likely to come around.
“Anecdotally, we’ve heard among some of the populations we’re reaching with our vaccine, some have initially said no and then later said yes,” he said.
Some employers, especially in the health care industry, mandate the flu vaccine and other immunization. However, Van Runkle said the industry is already dealing with a widespread staffing shortage, only worsened by the pandemic.
He said most of Ohio’s nursing homes do not even mandate the flu vaccine. Mandating a COVID-19 vaccine would worsen staffing problems.
“We don’t need another reason for people not to work in our facilities,” he said.
A vaccine mandate would backfire
Hogan agreed that a vaccine mandate would backfire, and Williams, from SEIU, said education and outreach should drive universal vaccination.
The Ohio Department of Health has shipped 341,100 Moderna first-doses, as well as 9,750 Pfizer first-doses plus another 9,750 Pfizer second-doses, according to ODH spokeswoman Melanie Amato. Only about 162,942 Ohioans have started the vaccination process, which is prioritizing health care workers, first responders and nursing home staff and residents.
ODH said it is not actively tracking vaccine declination rates. CVS Health, a company administering the doses in state long term care facilities, isn’t either.
“We do not have visibility to how many staff members at a facility decline to be vaccinated,” said CVS Health Spokesman Charlie Rice-Minoso.
“While we aren’t provided with full staff rosters, based on feedback from our teams in the field we’re seeing more vaccine hesitancy among staff when compared with residents.”
Walgreens, another company administering the vaccines, did not respond to inquiries.
Looking at the bigger picture, Hogan said governments from the federal to local level need to do a better job understanding why some are declining vaccination. Similarly, she said they need to emphasize, as they did during the polio years, that vaccination is the patriotic thing for Americans to do.
“It takes consistently pushing the right message, the correct and accurate information,” she said. “That takes money, a federal response, all levels. We’re struggling with that a lot.”
Jake Zuckerman is a statehouse reporter. He spent three years chronicling the West Virginia Legislature for The Charleston Gazette-Mail after covering cops and courts for The Northern Virginia Daily.