At nursing homes across the country, residents are stepping up for a shot of what Mary Lynn Spalding, CEO of Christian Care Communities, calls "liquid gold." But staff have been more hesitant to receive a COVID-19 vaccine.
The Kentucky-based senior-living provider's staff vaccination rate was at about 60% after the first round of on-site clinics in late December. Since then, more workers have signed up to receive the vaccine, Spalding said.
"I think we're going to continue to see our numbers increase as consumers get more comfortable," Spalding said.
But it's unclear if that optimism will translate to other nursing homes across the country. As of Jan. 3, about 50% of nursing home workers were declining to be vaccinated against COVID-19, said Ruth Katz, senior vice president of policy at LeadingAge, an association representing aging services providers.
"It does look like there's clearly some room for all of us to make some progress," Katz said during a LeadingAge webinar.
In the U.S., 1,084,177 people — staff and residents — in long-term care facilities had received the first dose of a COVID-19 vaccine through the Federal Pharmacy Partnership for Long-Term Care Program as of Jan. 13, according to the CDC. That's less than a quarter of the 4,556, 575 doses of the vaccines distributed so far.
Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, which represents more than 14,000 nursing homes and assisted living facilities across the U.S, said vaccine hesitancy is the organization's primary focus right now.
"Uptake among residents and staff is varying widely, but in general, staff seem to be mirroring the general public's reaction: excitement mixed with hesitation about the vaccines' development and safety," Parkinson said in a prepared statement.
To that end, the AHCA/NCAL launched a vaccination campaign encouraging those living or working in long-term care to get vaccinated.
At Rose Villa Senior Living, a life plan community in Portland, Ore., about 80% of workers have been vaccinated. CEO Vassar Byrd partially attributes that to the open communication leaders have had with staff.
"It is my responsibility to make sure they understand how dangerous it is if they do get COVID-19," Byrd said. "You don't look at the cost and benefits of the vaccine in a vacuum. It's right next to the cost and benefits of getting COVID-19, and I think sometimes people lose that."
Byrd said she wanted to make sure the staff was educated about the vaccine and knew what she knew; she didn't pretend to be an expert.
"You give them the opportunity to learn as much as you know, and then everybody gets to make their own minds up," Byrd said.
For the community's first clinic, about 70% of workers chose to get vaccinated. Supervisors then reached out to those who had declined to get a better understanding of their concerns: Was it related to a health condition, wanting to wait to see how the vaccine affected others or because the vaccine seemed unnecessary at a place like Rose Villa where only one resident and just a handful of staff have tested positive for COVID-19.
They found that some had been vaccinated at another job, others were in the middle of vaccines for other diseases and couldn't participate yet and some said it was too soon; Rose Villa had its first vaccination clinic Dec. 21, just 10 days after the FDA issued an emergency use authorization for the Pfizer-BioNTech vaccine.
Byrd is pleased with the vaccination rate among staff at her facility but said leaders have had conversations about whether they would require vaccination as a condition for employment once the vaccine receives full FDA approval. So far, they plan to give workers as much information as they can about the vaccine without mandating the jab. At some point, it may be unpleasant for those who have not been vaccinated because they will continue to need to wear full personal protective equipment while others will not have to, Byrd said.
Dr. Ruth Faden, a professor of biomedical ethics at Johns Hopkins University, said organizations should try to make progress by listening to employees' concerns and bringing in trusted speakers before forcing them to take a vaccine.
"The question is whether it would be the ethical best course or if it's the prudent course," Faden said during a LeadingAge webinar Thursday.
Christian Care Communities' Spalding has found that workers have been more receptive to vaccination after their colleagues get the shot. Spalding was the first to receive the vaccine and was followed by directors and other leaders.
"A lot of the leaders kind of stepping in, I think, gave some confidence to the staff," Spalding said.
The organization began its vaccine education efforts right after Thanksgiving to make sure workers could get as much information as they could and have an opportunity to talk to their doctors before the clinics began.
"What we saw was that it's something new. There's a lot of information out there about the vaccine, and not all of it's accurate. There was a lot of concern, 'Is this going to hurt me?'" Spalding said. "I think apprehension to anything new is a normal human response."
That's why she thinks it's important for leaders to take care of their staff by providing them with information so they can make informed decisions. And, she said, it's appropriate for leaders to share their personal opinions about the vaccine if someone asks.
"People in my position, we need to take care of our people," Spalding said. "We feel like if we take care of our staff, our staff can better take care of these residents, and that's why they should get vaccinated."