J.Oan Phillips, a certified nursing assistant in a Florida nursing home, was highly regarded, but feared the risk of going to work in the pandemic. When vaccines became available in December, she jumped at the chance to get one.
Months later, there appears to be a risk of a recession. Following the introduction of the Covid vaccines, the number of new Covid cases among nursing home workers fell by 83% – from 28,802 for the week ending December 20 to 4,764 for the week ending February 14 , data from the Centers for Medicare & Medicaid Services show.
New Covid-19 infections among nursing home residents fell even steeper, with 89%, in that period, compared to 58% in the general population, CMS and Johns Hopkins University data show.
These figures suggest that “the vaccine appears to be having a significant effect on reducing cases, which is very encouraging,” said Beth Martino, a spokeswoman for the Healthcare Association. America and National Center for Supported Living, an industry group.
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“It’s a huge relief for me,” said Phillips, who works at the North Beach Rehabilitation Center outside of Miami. Now, she said, she urges hesitant colleagues and anyone anyone else who can “go out and get vaccinated”.
After a brutal year in which the whole disease killed half a million Americans, despite unprecedented measures to prevent the spread – including mask wear, physical distance, school closures and economic closures – the vaccines hope there is an end in sight.
It is difficult to obtain national statistics on the diseases of health care workers in other settings.
Research in other countries suggests that vaccines have led to a sharp drop in disease. A study of publicly funded hospitals in England showed that the first dose was 72% effective in preventing Covid-19 among staff after 21 days and 86% effective seven days after the second sight.
Lost on the Frontline, a year-long data and reporting project with KHN and the Guardian, examines more than 3,500 Covid deaths of U.S. health care workers. The monthly number has been declining since December, but deaths often go down weeks or months behind diseases.
Along with other health care workers, nursing home workers and residents first wanted vaccines in December because older people in convalescent conditions are among the most vulnerable to infection: more than 125,000 residents have died from Covid, CMS data displays, and more than 550,000 Nursing home workers have been positive and more than 1,600 have died.
But the vaccination rate among workers is much lower than the resident level. When the first clinics ran from mid-December to mid-January, an average 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. Several nursing associations have now reported that the level of employee vaccination has been climbing, based on informal surveys.
Vaccination uptake by nursing home residents has been “very promising,” said Dr. Morgan Katz, an infectious disease expert at Johns Hopkins University who advises Covid’s responses in nursing homes. “I think this is a big reason for the decline in staffing,” she said.
Even one or two people in a building can have a slow transmission.
Another feature, Katz said, is that “a lot of nursing homes have already broken out – so there seems to be a good number of residents and staff who are already vulnerable.” Also, Covid rates have fallen nationally after a spike in holiday travel and gatherings in November and December, so employees in their communities don’t have as much experience.
But “even though we are seeing a very good turnaround in the number of cases,” she said, “we must remember that as long as 50 or 30% of employees are vaccinated, they are still vulnerable, and they also put vulnerable long – term care residents at risk. “
Vaccination efforts are racing against time as new versions of Covid circulate and some states are taking a deep toll on Covid ‘s restrictions, making it easier for the virus to spread.
Loyalty fuels vaccine trust
The question of why some workers are rejecting the vaccine. A major outbreak erupted last year at the New Jersey Veterans Memorial Home at Menlo Park last year where more than 100 employees contracted Covid and more than 60 residents and a nurse assistant died with certificate, Monemise Romelus. Shirley Lewis, president of the union representing CNAs and other workers, said he was sorry. However, only about half of the workers there have been vaccinated, Lewis said, and one out there is sick with Covid.
“Many of my members are not excited about getting this vaccine because they are scared,” said Lewis.
Some workers want to wait a little longer to see how safe the vaccine is, she said. Others tell her they do not trust the vaccines because they were developed so quickly, she said.
Other employees “feel it is an experimental drug,” Lewis said, “because, as you know, Blacks, Latinos, other groups were used for trials” like a Tuskegee syphilis study, she said.
Vaccine hesitancy is higher among 30- to 49-year-olds, rural residents and Black and Hispanic adults, according to KFF.
Historically, certified nurse assistants, who make up the majority of long-term care workers, are less likely to receive flu vaccines than health care workers. another, Jasmine Travers, a professor of nursing at New York University who is studying vaccine delay. Nursing educators are typically not in nursing homes, which addresses staff concerns about vaccines in hospitals, she said, and CNAs also address structural barriers such as inter-hospital access. restricted nets.
Nursing homes tend to be a hierarchy typically led by white workers, and about 50% of CNAs, at the bottom of the power structure, are black or Hispanic, she said.
With the Covid vaccine, some fear they have to take sick time to lose work and don’t want to burden their colleagues, who already have short-lived employees, Travers said.
Deliberate misinformation
Low vaccine uptake among long-term care workers has been a cause for concern nationally – to the extent that LeadingAge, a national organization representing nonprofit long-term care facilities, has maintained a significant town hall of safety vaccinated on March 4 by the Black Coalition against Covid-19.
The event, which attracted more than 45,000 spectators, was aimed at Black long-term care workers.
Dr. Reed Tuckson, co-founder of the Black Coalition Against Covid-19, said observers raised concerns about fertility, fertility and contraindications. He said the event had “a lot of motivators” who called out, “it’s a myth, it’s a lie.”
His group plans to hold more public information sessions aimed at Black audiences.
“There’s no question that the three vaccines we have now are extremely safe and extremely effective,” said Tuckson, a former public health commissioner in Washington.
The nursing industry has set a target of getting 75% of vaccinated workers nationwide by the end of June.
Hesitancy does not mean denial
Most nursing homes have not received vaccines, industry officials say, for fear of staff losses. Since the vaccines were 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 left 30 workers after prescribing vaccines, according to Dr. Lynne Katzmann, president and Chief Executive.
Even when workers are initially willing to take vaccines, “that does not mean that this is a permanent refusal,” Travers said.
In southwest Ohio, Kenn Daily runs two nursing homes run by Ayden Healthcare. About half of its staff and 85% of residents received the vaccine by mid-February, he said, and they have had a case of Covid ever since. However, he said, the fight against vaccination continues among younger workers who read false information online.
“Facebook is the bane of my life,” Daily said. Staff tell him they are worried “they’re going to microchip me,” or that the vaccine will alter their DNA.
Now that time has passed since the first release, Daily said, “I hope to put some pressure on my staff to step in and get vaccinated.”
His message: “It works, guys. It works very well.”
KHN data editor Elizabeth Lucas contributed to this report.
KHN (Kaiser Health News) is a national newsroom that provides in-depth journalism on health issues. Along with Policy Review and Voting, KHN is one of the three main operational programs of KFF (Kaiser Family Foundation). KFF is a complex non-profit organization that provides information on health issues to the country.