I just finished reading yet another damning opinion piece about our industry. It shifted so much between truth and sensationalism that it seemed less like a balancing of the scales of justice and more like a windmill caught in a tropical storm.
For every cheek-stinging authentic insight there was also an outrageous distortion of data. Yet at its core, this piece rightfully pointed out what could end up being yet another black mark on our reputation: COVID-19 vaccinations have been made available to most nursing homes around the country, yet many caregivers are opting out.
I’ve personally worked with a nursing home where only 11% of direct caregivers agreed to be vaccinated. The rate of willingness to be vaccinated across the U.S. does not seem to exceed 40%. Here we are poised to receive something so positive, so important for our staff and residents … and yet it seems we might fail and end up in a negative headline.
Yes, these percentages will doubtlessly improve. Time and broader experience will better assure us all of the safety of the vaccine. The documented low rates of side effects will come to be widely understood, and the many wrinkles in distribution and administration will be solved. However, widespread acceptance of the facts will be slow in coming, and this will result in more lives lost.
General distrust of our government and the pharmaceutical industry — and of nursing home facility administration/owners — is a commonly cited reason for vaccine refusal. Yet this isn’t the only weakness we have in communication, in listening to each other. When I share this unwillingness to be vaccinated with people outside our industry, inevitably the response is, “Well, can’t they just be forced to take it?”
Who are the “they” that should be forced to accept this new vaccine that was produced at “warp speed” during what has been, arguably, the most tempestuous year in modern history? According to the Kaiser Family Foundation, 48% of the “they” are people of color. A higher proportion of this diverse group works in nursing homes than is reflected in our general U.S. population.
You do not have to go very far back in time to see how our public institutions, and in particular our government, have failed these communities. In 1972, the “Tuskegee Study of Untreated Syphilis in the Negro Male” was determined to be “ethically unjustified” — but only after the study had already been going on for 40 years. From the Tuskegee experiments, which were, of course, just one example in a chronicle of racism, to the many inequities revealed during this pandemic, one begins to understand the reluctance to immunize.
Make no mistake, though you will not see me on television rolling up my sleeve for the vaccine, I eagerly await my turn to receive it. I believe in the safety and efficacy of both the FDA-approved vaccines and have obtained both firsthand and secondhand knowledge to inform my decision to move forward. I acknowledge that I have not personally endured the struggles and burdens of the tragic legacy that I referenced above. But I also believe that our nation’s long-belated reckoning with systemic racism, which has marked this past year as a parallel — and often intersecting — challenge in the midst of the pandemic, underscores the necessity of addressing these issues.
Coronavirus Vaccine Hesitancy in Black and Latinx Communities offers insights into the named communities and explores their COVID-19 experiences and reasons for hesitancy. Fundamentally, to encourage vaccination, the study recommends transparency as well as open and honest communication.
That outreach should ideally be delivered by someone who can fully empathize with each community’s reasons for hesitancy. If you yourself are not a person of color, you might not be the best person to help educate and motivate resistant staff, but perhaps people from outside the organization — such as respected members or leaders from the communities involved — can be powerful and effective allies in what must be a respectful and sensitive dialogue.
With inconsistent messaging and uneven support from our elected leaders regarding the vaccine, we must take the initiative and call upon our professional associations, our communities and ourselves to help all those who need it most: our dedicated and heroic staff who are on the front lines, whose well-being we are morally responsible for, and who are our partners in caring for our nation’s most vulnerable citizens.
Steven Littlehale is a gerontological clinical nurse specialist and chief innovation officer at Zimmet Healthcare Services Group.