Kimberly Marselas

As a coalition of long-term care medical and infectious disease experts Tuesday called on healthcare facilities to require COVID-19 vaccines as a condition of employment, I couldn’t help but think of Tom Gorman.

I’d seen Tom earlier that morning, outlining his battle with Guillain-Barre syndrome following receipt of Johnson & Johnson’s COVID-19. The avid hiker was partially paralyzed by the condition, though he is working toward recovery.

Despite his struggles, Gorman told “Today” he remains pro-vaccine, noting that Guillain-Barre has also been associated with COVID-19 itself. The Food and Drug Administration this week decided to add a warning label about the neurological condition to the already-beleaguered J&J vaccine, with 95 of the 13,000,000 Americans who have gotten that vaccine requiring hospitalization for Guillain-Barre symptoms.

Those who oppose vaccine mandates might point to Tom as a way to illustrate their reluctance.

I see Tom as a shining example of personal sacrifice on behalf of the greater good.

Yes, he got sick after a vaccine. But he realizes his chances of getting sick existed outside of getting a shot — and that getting COVID might have left him in worse shape or even dead. The same can be said for the extremely small group of individuals who had a rare type of stroke after getting the Johnson & Johnson shot. The FDA found that risk so rare, virtually the same as among the general population in non-pandemic times, that it recleared the vaccine for distribution.

And yet, there are those who will cling to those two side effects as an excuse to refuse vaccination. In no healthcare setting might that be more concerning than nursing homes, where the maker of another vaccine is warning of fresh outbreaks if more first-round vaccinations and boosters don’t happen in time.

More of the same won’t cut it

Campaigns have worked to convince, incentivize and otherwise promote vaccinations among long-term care workers since December. And yet, here we are: A dangerous, highly transmissible variant is raging in many areas, especially those where vaccination rates are low in the community and among healthcare workers.

Just three states met the nursing home industry’s goal of vaccinating 75% of staff, while 13 still hadn’t even hit the 50% mark as of the latest data reported July 8.

Providers would surely like to employ more Tom Gormans — willing to be vaccinated to protect others, with a scientifically backed understanding of the risks — but they have an equally powerful alternative.

Previous research shows that vaccine mandates raise compliance rates significantly, even when they include provisions for health and religious exemptions. Healthcare employers that instituted policies of influenza vaccination as a condition of employment got 94.4% of workers vaccinated, compared to 69.6% in organizations without a requirement.

That’s according to the Society for Healthcare Epidemiology of America, which joined AMDA, the Association for Professionals in Infection Control and Epidemiology and four other groups in calling for wider mandates Tuesday.

The stakes may feel higher with labor shortages, but increased mortality from COVID vs. flu make this vaccination effort even more critical. Employers may be asking, “What if my workers quit?” The question should be, “What if more of my workers or my residents die from COVID?”

Reconsider bravery

Nearly 160 million Americans have completed their vaccinations, and that number is now 1 billion strong globally. As one industry insider and Twitter regular opined, “What more do we need to know?”

Vaccines approved in the U.S. are overwhelmingly safe, and federal oversight continues to work to alert the public to potential concerns. Better yet, science has delivered us multiple vaccines, giving healthcare workers the power of choice as they protect themselves and their charges from COVID. 

We all know nursing home workers walked into fire this year and last, putting aside their fears or working through them to do what they could on behalf of their vulnerable patients.

But now that the fire’s hottest flames have been extinguished, a significant number of workers are letting fear, misinformation or a combination of both keep them in danger.

This phase of the battle requires a different kind of bravery, the kind where reluctant shot-takers and non-mandaters reconsider their initial reactions. It’s time to abandon the wait-and-see mentality and move toward full vaccination coverage for our nursing homes.

Kimberly Marselas is senior editor at McKnight’s Long-Term Care News.