The Quandary Around the Choice to be Vaccinated

The toll of the pandemic on health care workers is real – being under siege operating in crisis mode for a full year will impact anyone.  So if there are options to protect oneself from COVID-19 and the now very virulent Delta strain circulating, why are vaccination rates so low particularly among health care workers in skilled nursing care?

Fully understanding and respecting that we all have a right to choose to be vaccinated, it’s worth exploring the reasons that motivate those who do and those who don’t.  The latter might offer a more varied response such as religious or cultural reasons.  However, education can be the antidote to fear if reluctance to receive the COVID-19 vaccine is seeded in skepticism or distrust.  Science-based, highly credible sources are the best place to gather information and to best assess how to protect yourself from a virus still on the war path.

The benefits of the vaccination roll out are evident in a recent analysis by the National Investment Center for Seniors Housing & Care (NIC) of data produced by the Centers for Medicare and Medicaid (CMS), indicating COVID case counts within skilled nursing facilities (SNFs) are down 98% since December 20 of last year and by mid-May 2021 account for about 0.3% of our country’s cases. In fact, NIC says nursing homes are the safest places for seniors required skilled nursing care. Good news indeed.

But see the problem potentially threatening the horizon:

Tracking back one year, from this month to last May, NIC’s tracker data reveals that despite the swift and immense impact of vaccinations, a troubling risk persists. The report states: “At the height of the pandemic, new cases among skilled nursing residents were 20% higher than among staff. However, the trend has reversed in recent weeks: newly confirmed cases among residents were 74% lower than among staff on May 16. We already know that even with the proper safety protocols and equipment, this vector represents a grave risk to the nursing home community.”

Here is a state specific example:

“In the Midwest, over three months into the U.S. vaccination program, Michigan reported the highest statewide general population increase in COVID-19 cases, jumping 612% from February 21 to April 11, reaching highs not seen since vaccines first became available. The state’s case count among residents in SNFs, however, declined 25% over the same period.

Meanwhile, cases among staff increased 281%. Between the weeks ending March 21 and April 11, COVID-19 vaccines prevented at least 2,000 new infections among SNFs residents in Michigan.”

Education, resources and a health care team unparalleled in demonstrating commitment to their residents have lowered the rate of infection within the long term care communities. This – in spite of staff and the outlying communities in some regions across the nation who continue to become infected and spread the virus.  But the glowing statistics that point to the success of our efforts to protect each other and our residents will change – there is no way it can’t if a high percentage of staff choose not to vaccinate.

The fear of being infected continues among health care workers yet again, long term care has a shockingly low rate of team members getting vaccinations – even with this statistic from the Kaiser Family Foundation /Washington Post Frontline Health Care Workers Survey:

One-fourth of frontline health care workers working in nursing homes or assisted care facilities say they tested positive for COVID-19 (24%) compared to less than one in five working in hospitals (18%), doctor’s offices or clinics (14%), or providing in-home care (8%).

We know vaccination is not mandatory and we don’t want to live in a country that starts mandating health care decisions. But there is a deep and disturbing contradiction that lies within a culture or community that pledges to care for the most vulnerable and stops short of maximizing its ability to do so.

We have a responsibility as health care providers to first, do no harm.

We must stay true to that promise.

Mark McKenzie

Founder and CEO