Reaching out to nursing home employees who refuse COVID-19 vaccine

Feb. 14—When the South Dennis nursing home that dietary aide Delmay Lopes works in offered the Pfizer vaccine to staff, Lopes signed up for both shots.

Being fully vaccinated against COVID-19 is a way to protect her health, said Lopes, a Harwich resident.

"I got it because I have a lot of underlying conditions and work in a nursing home. I don't want to get sick."

Lopes, who works at South Dennis Healthcare, formerly known as Eagle Pond, knows that not all employees feel the same as she does about the vaccine.

"They're afraid because they're feeling like it might have long-term effects," she said.

Although nursing home employees were in the first phase of COVID-19 vaccination for most states, the Centers for Disease Control and Prevention recently estimated that just about 40% of nursing home employees opted to get the vaccine.

State Sen. Julian Cyr, D-Truro, said recently that the rates in Massachusetts are better — 55% of nursing home employees are getting vaccinated.

Karen Moore, a family nurse practitioner hired in December as Barnstable County assistant public health nurse, said the percentage of long-term care employees taking the vaccine on Cape Cod ranges from 40% to 80%. depending on the facility.

The numbers seem to fly in the face of the effect the pandemic has had on nursing homes.

An AARP study found 34% of COVID-19 deaths in Massachusetts were among nursing home residents, up from 31%.

On the Cape the rate is even higher.

As of Thursday, when the state Department of Public Health issued its weekly report, 40% of COVID-19 fatalities in Barnstable County were among nursing home residents.

The total number of confirmed deaths in Barnstable County Thursday was 368, and nursing home residents accounted for 149-155 of those deaths. (In two cases in which a facility's fatalities were less than five, the DPH gave a range of 1-4 for the number of COVID-19 deaths.)

Dr. Stefan Gravenstein, a geriatrician and professor of medicine at Brown University, said that in regard to coronavirus mortality, "The oldest ones fare the worst, and the ones living in nursing homes the worst of the worst."

There are multiple reasons why less than 40% of nursing home employees nationwide took advantage of the opportunity to have the first COVID-19 shot, while residents of the facilities took up the vaccines at a rate of more than 70%, he said.

"I got the vaccine to protect myself and my family," said Mark Billard, a physical therapist at Liberty Commons nursing home in Chatham, where 80 percent of the employees have opted to be immunized.

"It really boils down to what the vaccine means for each person," Billard said. He said his wife is a nurse supervisor at Falmouth Hospital.

"We could be exposed and bring that virus home" to their mothers, who both live with them, Billard said.

Gravenstein, union and other officials said the reasons range from lack of trust in some official sources, historic medical discrimination against people of color, who make up a large number of nursing home employees, and limited access to paid sick days to deal with potential side effects from the shots.

Moore, Gov Charlie Baker and the SEIU 1199 union representing health care workers all are involved in information campaigns to address what is known as vaccine hesitancy.

Moore, who acts as a Barnstable County liaison with nursing homes on COVID-19 issues, said she has visited two nursing homes — Mayflower Place in West Yarmouth and Windsor Skilled Nursing in South Yarmouth — to answer staff questions about the COVID-19 vaccine.

She said she brings take-home materials in Spanish, Portuguese and French Creole for employees to review.

"They do have a real fear," Moore said. "A lot of them feel it's just too new."

"There's a lot of questions about infertility in the younger population of staff members," Moore said.

Older employees asked if they get side effects from vaccination who would take care of them and their families.

Marlishia Aho, spokesperson for SEIU 1199, of which Lopes is a member, said the union started rolling out informational webinars, virtual town halls and emails on the issue of vaccine safety weeks before Baker announced his media campaign.

Union members are health care workers that are covered in phase one of Massachusetts' vaccination schedule, Aho said.

But she said vaccine uptake involves more than information.

The union is advocating for an additional sick day for health care employees who feel ill after being vaccinated, Aho said.

In the relatively small percentage of cases of people who develop a fever, the symptoms are usually gone after 24 hours, vaccine researchers have said.

But currently, health care workers have to take the time out of their paid bank of sick hours.

"A lot of employers have scheduled vaccination shots before scheduled days off," which is an equity issue for employees who use their days off to care for loved ones, Aho said.

The SEIU 1199 union also is trying to address at the state level the exclusion of health care employees from emergency paid sick time under the federal CARES Act, she said.

People need information from a trusted source — and that is not always their employer, Aho said.

Relative to their numbers in the population, nursing home employees tend to be disproportionately women, women of color and immigrants, she said.

The history of medical abuse and disrespect for people of color and women is real, said David Hufford, professor emeritus at Penn State College of Medicine.

Hufford, whose family is biracial, said he was surprised but not surprised when he took an informal survey among people of color that he knows and found 50% were skeptical about the COVID-19 vaccine.

"These were intelligent and educated people," he said.

The skepticism can be linked to historic medical racism, one of the most egregious examples of which was the Tuskegee Experiment that for 40 years told black men they were being treated for syphilis when they were actually being given placebos, Hufford said.

The medical abuse and disrespect have more recent examples, including that of a Black woman doctor who was sent home from a hospital to die of COVID-19 after her symptoms were not taken seriously, he said.

In some cases, he said, people of color who are interested in the vaccine fear that any side effects or symptoms they get as a result will be dismissed. "The matter of trust is huge."

Lopes said one of her trusted resources in making her decision to get vaccinated was her physician.

"I was hesitant. But I talked to my doctor and (the doctor) said it was best to take it," Lopes said.

She said she had no side effects other than a sore arm after getting the shots and said her sister, who also works at South Dennis Healthcare, also has been vaccinated.

At this point, vaccination is not being mandated for health care providers and for good reason, health officials said.

They said nursing homes struggle enough to get staff and if the shots are mandated some people might leave their jobs.

"It's not people who are anti-vaxxers," Aho said.

"It's all about giving people time" and giving them educational materials in the appropriate cultural context, she said.

It's important for nursing home employees to hear from colleagues like Lopes who can talk about their experiences of getting the vaccine. "This is ongoing," she said.

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