Joan Phillips, a certified nursing assistant at a Florida nursing home, loved his job but feared the danger of going to work during the pandemic. When vaccines became available in December, she took the chance to get one.
Months later, it seems that the danger has disappeared. After the launch of Covid vaccines, the number of new Covid cases among the nursing home staff dropped 83% – from 28,802 in the week ending December 20 to 4,764 in the week ending February 14, data from the Centers for Disease Control show. Medicare and Medicaid Services.
New Covid-19 infections among nursing home residents fell even more sharply, 89% in that period, compared with 58% in the general public, data from CMS and Johns Hopkins University show.
These figures suggest that “the vaccine appears to be having a dramatic effect in reducing cases, which is extremely encouraging,” said Beth Martino, a spokesman for the American Health Care Association and the National Center for Assisted Living, an industry group.
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“It’s a big relief for me,” said Phillips, who works at the North Beach Rehabilitation Center outside Miami. Now, she said, she is encouraging hesitant coworkers and anyone else who can “go out and get the vaccine”.
After a brutal year in which the pandemic killed half a million Americans, despite unprecedented measures to curb its spread – including masks, physical distance, school closures and economic downtime – vaccines are giving hope that the end is over. in cash.
It is difficult to obtain national figures on infections from healthcare professionals elsewhere.
Research in other countries suggests that vaccines have caused major drops in infection. A study of publicly funded hospitals in England indicated that a first dose was 72% effective in preventing Covid-19 among workers after 21 days and 86% effective seven days after the second injection.
Lost on the Frontline, a one-year KHN and Guardian data and reporting project, is investigating more than 3,500 Covid deaths of health workers in the United States. The monthly number has been decreasing since December, but deaths are often weeks or months behind infections.
Along with other health professionals, health care workers and residents were first in line to receive vaccines in December because elderly people in congregated settings are among the most vulnerable to infection: more than 125,000 residents died from Covid, show the CMS data, while more than 550,000 members of the nursing home team tested positive and more than 1,600 died.
However, the vaccination rate among employees is much lower than that of residents. When the first clinics opened from mid-December to mid-January, a median of 78% of nursing home residents took a dose, while the median for staff was only 38%, according to the Centers for Disease Control and Prevention. . Now, several associations of nursing homes have said that the team’s vaccination rate has gone up, based on informal surveys.
Absorption of the vaccine by nursing home residents has been “very promising,” said Dr. Morgan Katz, an infectious disease specialist at Johns Hopkins University who is advising Covid on nursing home responses. “I think this is a big contributing factor” to the drop in employee cases, she said.
Having at least one or two people vaccinated in a building can delay transmission.
Another factor, said Katz, is that “many nursing homes have already experienced major outbreaks – so there is likely to be a significant proportion of residents and employees who are already immune”. In addition, Covid’s rates fell nationally after a peak in vacation travel and meetings in November and December, so employees have less exposure in their communities.
But, “although we are seeing a really wonderful change in the number of cases,” she said, “we need to remember that as long as the team is 50 or 30% vaccinated, they remain vulnerable and are also placing long-term care residents. incredibly vulnerable at risk. ”
Vaccination efforts are running out of time as new variants of Covid circulate and some states have dramatically relaxed Covid’s restrictions, facilitating the spread of the virus.
Mistrust fuels the hesitation of the vaccine
The question of why some workers refuse the vaccine is approaching. The New Jersey Veterans Memorial Home in Menlo Park suffered a major outbreak last year, in which more than 100 Covid workers and more than 60 residents and a certified nursing assistant, Monemise Romelus, died. Shirley Lewis, president of the union representing CNAs and other workers, said it was traumatic. Still, only about half of the workers there got the vaccine, Lewis said, and one is sick with Covid.
“Many of my members are not very excited about getting this vaccine because they are scared,” said Lewis.
Some workers want to wait a little longer to see if the vaccine is safe, she said. Others say they do not trust vaccines because they were developed very quickly, she said.
Other officials “feel it is an experimental drug,” said Lewis, “because, as you know, blacks, Latinos, other groups were used for experiments,” like the study of Tuskegee’s syphilis, she said.
Vaccination hesitation is greatest among people aged 30 to 49, rural residents and black and Hispanic adults, according to the KFF.
Certified nursing assistants, who make up the majority of long-term workers, are historically less likely to receive flu shots than other healthcare professionals, noted Jasmine Travers, assistant professor of nursing at New York University who studies hesitation to the vaccine. Nursing homes typically do not have nurse educators, who address workers’ concerns about vaccines in hospitals, she said, and CNAs also face structural barriers, such as limited internet access.
Nursing homes tend to be hierarchies usually led by white officials, while about 50% of CNAs, at the base of the power structure, are black or Hispanic, she added.
With the Covid vaccine, some fear having to miss work due to illness and do not want to burden their co-workers, who are already understaffed, Travers said.
Deliberate misinformation
The low absorption of the vaccine among long-term care workers has been a national concern – so much so that LeadingAge, a national group representing non-profit long-term care facilities, organized a virtual city hall on vaccine safety on 4 March with black Coalition against Covid-19.
The event, which attracted more than 45,000 spectators, was aimed at long-term black workers.
Dr. Reed Tuckson, co-founder of Black Coalition Against Covid-19, said viewers raised concerns about fertility, pregnancy and contraindications. He said the event also had “many provocateurs” who insisted, “it’s all a myth, it’s all a lie.”
His group plans to hold more public information sessions for black people.
“There is no doubt that the three vaccines we now have available are extraordinarily safe and tremendously effective,” said Tuckson, a former public health commissioner in Washington.
The nursing home sector has set a goal of having 75% of employees vaccinated across the country by the end of June.
Hesitation does not mean refusal
Most nursing homes do not have mandatory vaccinations, industry officials say, out of fear of losing employees. As vaccines have been authorized on an emergency basis, responsibility is also a concern.
Juniper Communities, which runs 22 long-term care facilities in four states and employs nearly 1,300 people, had 30 workers quitting their jobs after vaccinations were mandatory, according to Dr. Lynne Katzmann, president and CEO.
Even when the team is initially reluctant to get vaccines, “it does not mean that this is a permanent refusal,” said Travers.
In southwest Ohio, Kenn Daily runs two nursing homes run by Ayden Healthcare. About half of his staff and 85% of residents were vaccinated in mid-February, he said, and have had no cases of Covid since. Still, he said, vaccine resistance persists among younger employees who read incorrect information online.
“Facebook is the curse of my existence,” said Daily. Workers say they fear “they will put a microchip on me” or that the vaccine will change their DNA.
Now that that time has passed since the initial launch, Daily said: “I hope to put a little pressure on my team to come forward and get vaccinated”
His message: “It’s working, guys. It is working very well. “
KHN data editor Elizabeth Lucas contributed to this report.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operational programs of the KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides information on health issues for the country.