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Utah is nudging hesitant nursing home employees to get the coronavirus vaccine

Health experts say those on the fence in a recent survey probably won’t be hard to convince.

(Leah Hogsten | The Salt Lake Tribune) Roger, a nurse anesthetist at the Veterans Affairs Medical Center who declined to give his last name, takes a selfie as he receives the COVID-19 vaccine on Wednesday. Salt Lake City's George E. Wahlen VA Medical Center is one of 113 VA medical centers across the country to receive the first limited supply of the Moderna COVID-19 vaccine. As frontline health care workers in Utah hospitals continue to get vaccinations this week, those who work at long-term care facilities are scheduled to get their first doses Monday.

A new survey of Utah nursing home employees shows just over half say they plan to be vaccinated for COVID-19 — but health experts say they think they can reach herd immunity in such care centers by bringing the “maybes” on board.

Staff and residents in Utah’s long-term care facilities are scheduled to begin receiving the first of two vaccine doses on Monday.

Of more than 1,200 employees at nursing homes and assisted living centers who responded, 52% said they “definitely” will receive the vaccine, said Linda Edelman, a University of Utah nursing professor who helped create the survey. It was conducted by the U. and the Utah Department of Health.

Another 26% said they are considering getting the shots but aren’t yet certain.

Together, that would be nearly enough to reach the 80% vaccination rate that amounts to “herd immunity” — where enough of a population is vaccinated to protect those who are not, said Michelle Hofmann, who manages the state health department’s program for health care associated infections.

“Our goal will be to encourage those 26% who are still a little hesitant to definitely say yes, and to hopefully convince the 20% who now are saying no that they should consider having the vaccine,” Hofmann said.

With Monday’s scheduled start, there isn’t much time to change hearts and minds. But distributors anticipate it will take about four weeks to get the first doses to each care facility in Utah, Hofmann said. In the meantime, the state has produced promotional material — posters, stickers and social media ideas — to get more employees on board.

(Image courtesy of the Utah Department of Health) State officials are distributing sticker templates for nursing home to give employees to promote COVID-19 vaccination. The vaccines will be distributed in Utah's long-term care facilities starting Dec. 28, 2020.

At least one Utah care facility has shown a simple campaign can work.

At The Auberge at Aspen Park, a memory care center in Salt Lake City, only about half of the employees said they would be vaccinated as of two weeks ago, said Emma Schilling, the facility’s health service director.

But administrators put up posters and held a webinar for all staff with the medical director. “They had a lot of questions,” Schilling said.

Now about 90% of the staff has agreed to get their shots, Schilling said. And about 95% of the 55 residents are expected to be vaccinated, she said.

“I think it was just really important to keep the lines of communication open with everybody,” Schilling said. Administrators of care facilities have gotten a lot of information about the vaccine, she said, “but the staff? Not necessarily.”

A lot of nursing home employees are earlier in their careers, have fewer years of formal training, and aren’t paid as well as hospital staff, Hofmann said. That means they may not be as tied into the latest information about the vaccine and may absorb more misinformation about it, Hofmann said.

On the survey, the No. 1 reason employees gave for feeling reluctant to receive the vaccine was that they were worried its rollout was rushed and it might not be safe, Hofmann said. That fear is dispelled somewhat once people learn that while the trials were on a more compact timeline, they were conducted on as many as ten times the number of subjects included in tests of other drugs that were developed more slowly.

But in the question and answer session at The Auberge, staff had a lot of other questions: Would the vaccine actually give people the virus and would that make them contagious? (No.) Do people get sick upon receiving the vaccine? (In some cases yes, but symptoms are mild.) How long is it effective? (That’s unknown). Does the vaccine change your DNA? (No.) Will a tracking microchip be embedded into people who receive the vaccine? (Big no.)

Kevin Castaneda was one of the employees in the webinar, and initially he had misgivings about receiving the vaccine. Castaneda, who is in charge of building code compliance, maintenance and housekeeping at the center, said he was concerned about potential short- and long-term side effects and wasn’t sure the vaccine would end up being worth the risk.

But the session with the center’s doctor put him at ease, and he decided to get the vaccine after reading more about the role of vaccines in other disease outbreaks in history, from polio to H1N1. Just looking at the case numbers fall precipitously in those earlier crises was compelling, he said.

“You can drastically see the benefit,” he said.

Castaneda said he still is a little worried about having a potential bad reaction to the virus — but the possibility of leaving the coronavirus in history, alongside measles and smallpox, made that small risk seem worth it.

“Nothing is 100%,” he said.

(Photo courtesy of Emma Schilling) Staff at The Auberge at Aspen Park memory care center pose with superhero cutouts in photos displayed on fliers to promote vaccines for nursing home employees.

Still, the percentage of staff planning to get vaccinated at The Auberge is far higher than what the statewide survey found — and the federal vaccine schedule for nursing homes is relatively tight: staff will have two chances to get their first doses. The vaccine is being administered in Utah centers by the national chains CVS and Walgreens, and by Utah nonprofit Community Nursing Services.

“It is critical that we get as many vaccinated as possible in this effort,” Hoffman said. “As successful as we can be in getting everyone vaccinated when we do this big push, it makes the one-offs less at risk. We’re working feverishly.”

Nursing home employees also haven’t enjoyed the same recognition as heroes that a lot of hospital workers have, Edelman noted, even though they have been exposed to the worst infection and death rates in the state. One in five residents and employees in Utah’s long-term care facilities has contracted the virus, Hofmann said, and residents have accounted for about 35% of the state’s coronavirus deaths.

After viewing the jubilant social media posts of newly vaccinated hospital staffers, Edelman said she hoped long-term care workers who were initially ambivalent about the vaccine might similarly get caught up in the celebration.

“Tweeting, putting it on Instagram, putting on Facebook pictures of staff — their peers — getting the vaccine, is probably as valuable as anything,” Edelman said. “They see their smiling friends doing this, and they’re proud they’re one of the first groups in the country to receive this vaccine. It’s recognized they’re doing such important work.”

(Photo courtesy of Emma Schilling) Staff at The Auberge at Aspen Park memory care center pose with superhero cutouts in photos displayed on fliers to promote vaccines for nursing home employees.

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