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The Vaccine Quandary: Addressing Conflicting Thoughts on the COVID-19 Vaccine in Long-Term Care Facilities

By Julie Bordo
March 03, 2021

Long-term care (LTC) facilities have very clear business reasons to require that all staff and residents get vaccinated for COVID-19. Your residents are in the high-risk category for the virus. Nearly 40% of COVID deaths in the U.S. are LTC facility residents. LTC staff have also suffered disproportionately. You and your staff are in close contact with residents and must take reasonable measures to prevent virus transmission.


On the marketing side, potential residents and their families will seek transparency about facility infection prevention measures that now include the vaccine. Their decision whether to select your facility will weigh heavily on your ability to protect them from infection and keep them from the pain of separation and isolation that has plagued facilities globally during the pandemic.


Vaccine Hesitancy


On the other hand, caregivers may be part of a population group that is hesitant about vaccines. A recent CDC report found a 37.5% vaccination rate for nursing home staff compared to 77.8% of residents. There are many forces pushing against each other in this debate.


A top concern is that the vaccine was developed too quickly and the potential long-term side effects have not been sufficiently studied. Some say science has become a victim of its own success, while others say they’ll wait for more evidence before taking the vaccine. It comes down to trust and maybe even a little bit of faith.


Trust in America has been in decline and is abysmally low. Throwing fuel on the fire is the increase in conspiracy theories and the use of social media igniting the debate. This makes national campaigns to vaccinate, run by state and local governments, very challenging.


Kaiser Health News reports that vaccine hesitancy is on the decline. In a story written by my niece, Emmarie Huetteman, it appears vaccines are being more widely accepted particularly by Black adults. But the poll found that 13% of respondents overall said they will “definitely not” be vaccinated.


The Kaiser poll found some arguments were persuasive such as hearing that the vaccines are nearly 100% effective at preventing hospitalization and death from COVID. Others said they would be more likely to get vaccinated if it were easier to do while going about their daily lives, or made going about their daily lives easier. Certain measures were persuasive such as if the vaccine were offered during a routine medical appointment or their employer arranged for on-site workplace vaccinations.


Financial incentive made an impact. 38% would be more likely to vaccinate if their employer offered to pay them an extra $200. Interestingly, travel restrictions also moved the needle. Some would be more likely to get vaccinated if airlines required it of passengers, or if the CDC said vaccinated people could travel freely and without masks.


With 1 in 5 Americans already vaccinated, hopefully the rest of the population will follow.


Facility’s Vaccine Policy


As a facility owner and employer, you have to weigh the merits of your vaccine policy considering whether to mandate vaccines. You also have to adhere to the law in doing so. Legal experts generally agree that you may mandate vaccines with some consideration for exceptions under the law. Our counsel at Cozen O’Connor has created this helpful employer guide to COVID-19 vaccination addressing these matters. Today (3/5/2021),


The question then becomes, should you mandate vaccines? How would this affect staffing? Short of a mandate, you may consider incentives, like a paid day off to get the vaccine. You must ensure your incentives comply with the law. Please consult our Pandemic Resources page and, as always, we recommend consulting local counsel. The New York Times also recently published an article addressing these Coronavirus vaccine mandate questions that will help shed some light on the issues surrounding a vaccine mandate, and how others are finding ways to tackle them.


Those looking closely at this dilemma point to emotionally intelligent approaches. According to a recent article in The Atlantic, vaccine hesitancy is not one thing. It may involve distrust, dissent, deliberation, and indifference. Facilities like yours where you are more likely to have a small or family setting and stronger relationships with staff, residents, and their families are more likely to develop an effective policy. Trusted leaders in your organization or community who are informed about the vaccine and can meet people where they are in the vaccine hesitancy process will have greater success creating understanding and acceptance of the vaccine. Please consider identifying those people and starting conversations that will lead to better outcomes for everyone.