The first of the month, the COVID-19 vaccine arrived at the facility where I work. In the days before its arrival, the “campus” was buzzing with conversation about who was getting the shot, who wasn’t and why. 

Throughout U.S. nursing homes, an average of 29% of long-term care workers have been hesitant to accept the first round of the vaccine, slightly higher than the 27% rate in the general population. To counter hesitancy, most facilities offer staff education about the vaccine through handouts and webinars such as these excellent resources from the California Association for LTC Medicine. 

The nursing home I’m in had a greater staff acceptance rate than average, with over three quarters of the workers getting vaccinated. Perhaps being in the pandemic epicenter in March, April and May influenced their decisions. 

Personally, I was enthusiastic about being vaccinated and annoyed that it took two weeks to receive it after U.S. approval, especially because the positivity rates in New York were on the rise. 

Professionally, I was curious about why some of my coworkers declined the vaccine, so I asked them. 

Workers who chose not to be vaccinated mostly fell into three camps: those who didn’t trust what was in the vaccine, young women seeking to safeguard their fertility against the unknowns of the vaccine, and people who wanted to see how it worked in others before getting it themselves.

Vaccine skeptics

From my observations and training, my impression is that there’s almost nothing that would change the minds of those in the skeptical group except, perhaps, studies showing minimal side effects and high efficacy of the vaccine over time. 

Fertility concerns

For workers concerned about maintaining their fertility, general safety information about pregnancy, fertility and vaccine development might allay some apprehension if specifics regarding this particular vaccine are not yet available. 

More information about the impact of COVID-19 on fertility and pregnancy would help this group weigh the risks of the vaccine against the risks of the virus. 

According to this study, for example, pregnant women are more vulnerable to illness. The authors point out that the impact of having COVID-19 during pregnancy extends beyond the potential effects on “implantation, fetal growth and development, labor, and neonatal health,” to “reduced access to reproductive health services, increased mental health strain, and increased socioeconomic deprivation,” areas that might not typically be considered during the decision-making process.

In addition, early research suggests that COVID-19 may have an impact on male reproduction and pregnancy outcomes, so this isn’t an issue affecting only young female workers.

The cautious group

To best encourage those who said they didn’t want to be “guinea pigs” in the vast vaccine roll-out, it would be helpful to have vaccination providers come to each facility at least four times. 

This would allow those who immediately regretted not getting the vaccine the opportunity to receive the two-part series beginning with the next visit. Employees who wanted to forego the first round entirely in order to observe their peers and see more data would be able to get the two-part series during the last two visits.


While most of us merely had sore arms the next day, several workers weren’t feeling well for a day or two and some called out sick. As I imagine this was the case around the country, it would be sensible to provide additional staffing during the week of the vaccinations to ensure adequate coverage for resident needs.

Additional responses

Aside from having a sore arm for a day, the other side effects I experienced from the vaccine include improved sleep, a deep sense of relief, and the ability to consider what the future might hold if we don’t live in fear of contracting COVID-19. 

I’m eagerly counting down the days to my second shot.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her at