With demand for the COVID-19 vaccine far outpacing supply, some healthcare workers have been caught in the decentralized scramble for vaccination, industry experts say.
Even months into vaccination efforts in the U.S., only 52% of frontline health workers have received at least one dose of a COVID-19 vaccine and just 42% have received both doses, according to a new survey by Kaiser Family Foundation and The Washington Post completed in early March that polled healthcare workers who are not self-employed.
While those numbers are partially explained by vaccine hesitancy, especially among Black healthcare workers and nursing home and assisted living staff, the other factor is availability. Thirty percent of home care workers have either scheduled a vaccine appointment or want to schedule an appointment but only 34% say they have been offered a vaccine by their employer, according to the KFF/Washington Post survey. Among healthcare workers who have been vaccinated, 84% received their jabs from their employer, the survey found.
"If we were in the perfect world, we'd give it to everybody. That's not where we're at," said Hank Drummond, a registered nurse and chief clinical officer of Cross Country Healthcare, a staffing company based in Boca Raton, Fla.
While the federal government recommended that all healthcare workers receive the vaccine first, distribution largely has been left to the states. Travel nurses, home health workers and others not affiliated with a hospital or a long-term care facility aren't given the same vaccination prioritization across the country. In some cases, healthcare workers have had to navigate the same systems as those outside of the medical field, anxiously scouring the Internet and refreshing websites looking for clinic openings.
"Each state/jurisdiction has its own plan for where clinicians who are not affiliated with a hospital or health system are supposed to get vaccinated," an American Hospital Association spokesperson said. "Some hospitals are willing and able; some are willing but not sure if they are able; and some cannot because they want to act in accordance with the state/jurisdiction plan."
Dr. Anna Loengard, chief medical officer at AccentCare, a nationwide home healthcare company based in Dallas, said AccentCare has had to go site to site — to pharmacies, health departments and other clinics — to find vaccination appointments for its employees. Trying to find vaccines at such a granular level "has been extremely challenging, to say the least," she said.
"We have essentially taken the tack of leaving no stone unturned," Loengard said.
The company had hoped to be able to contract with a pharmacy for mass employee vaccinations but instead the approach has been piecemeal, Loengard said.
"We know there's still a significant portion of our staff that would like to be vaccinated but hasn't had the opportunity," she said.
Instead, the home health workers who travel from home to home, seeing multiple patients a day, have had to fend for themselves for vaccines because there isn't a system in place to support them.
"It's both a risk to them and to their patients," Loengard said. "If we can protect our workers, we're going to protect the homebound patients they go see."
Home health workers are out seeing patients all day and don't have time to sit and refresh a browser window for hours looking for appointments, she said. And the company can't sign individuals up.
"They've been going in to care for these patients just like everyone else on the front line," said Leongard, who hopes the situation improves. "It just seems like it's an important piece that's been forgotten."
David Coppins, CEO of IntelyCare, a staffing firm and workforce management company that mainly serves nursing homes and assisted-living facilities, said that into January many long-term care facilities were reserving vaccines for their staff because they were afraid they would run out of doses. It was "frustrating" and "a little bit scary" that, there didn't seem to be an opportunity for contract workers to get vaccinated early on. The company worked with state departments of health to raise awareness, he said.
"Distribution has had some challenges," Drummond of Cross Country Healthcare said. "As with anything new, it kinds of takes a while to get a rhythm to it. We have limited supplies."
Susan Whitman, executive vice president and co-founder of Freedom Healthcare Staffing, said there's a lot of optimism about the vaccine among workers, and "client hospitals realize who important [travelers] are."
"It is again dependent on where they're assigned," she said.
But the situation is improving. President Joe Biden has said the U.S. should have enough vaccine doses delivered by the end of May to vaccinate every adult in the country.
"We're seeing an increase in including everybody in this as supplies become available," Drummond said.
Janet Knight, a nurse with Cross Country Healthcare who switched to travel nursing in November after working as a nurse for 26 years, has received both doses of the Pfizer COVID-19 vaccine. Early in 2021, she was on 13-week assignment in an intensive care unit in New Jersey and said she was "treated like part of the staff" during her time there.
"You are in the equation when it comes to offering the vaccine, as well," Knight said.
Mary Lynn Spalding, CEO of Christian Care Communities, a Kentucky-based senior-living provider, said any essential workers who have come into their buildings have been tested and offered the same protections as in-house employees, including immunizations.
"We treat the staffing agency employees just like they're our employees," Spalding said.
One challenge for travelers to get vaccinated is the necessary waiting period between each dose.
Staffing agencies like Cross Country Healthcare are encouraging travel healthcare workers to take longer assignments to make sure they can get vaccinated, Drummond said. And some clients have extended contracts to allow travelers to receive both doses of the vaccine from the same location, he said.
"At the beginning, there was kind of the logistical issues, the supply issues. Now, it's confirming the fact they are able to receive [the vaccine]," Drummond said. "We know that it's happening, and we're starting to see some of the documentation coming in that they have received it."