Federal health officials have released a comprehensive new guide and toolkit aimed at helping nursing home administrators tackle issues of vaccine hesitancy among certified nursing assistants, as well as barriers to vaccination.

Invest in Trust: A Guide for Building COVID-19 Vaccine Trust Among Certified Nursing Assistants,” published by the Department of Health and Human Services, is based in part on interviews with CNAs. The authors explain key reasons why CNAs do not get vaccinated, detail research-based insights on the kind of conversations and messages that work to build vaccine trust, and offer practical ideas on how to help reduce barriers to vaccination. A toolkit includes posters and information cards on vaccine scheduling.

Vaccine hesitancy among CNAs is significant and worrisome, given the essential role they play in caring for residents at high risk of COVID-19, according to the authors. But there is no single solution to increasing vaccination rates among these staff members, they said. Reasons for concern about the shots are “varied, complex and not specific to any one demographic,” the authors wrote. “Even those willing or eager to get the vaccines may face logistical barriers.”

Summarized recommendations include: 

  • Establish trust in yourself as the employer by communicating transparently and frequently about the vaccine, organizational policies about vaccination and vaccination rates within your facility.
  • Remove barriers to make it easy for staff members to find and access vaccines, and consider hosting vaccine drives so that employees can access them where they already are.
  • Make time to listen and create opportunities for CNAs to get their questions answered by trusted, local experts, managers and staff members who already have gotten vaccinated. (The toolkit includes some suggested language for those conversations.)
  • Offer meaningful incentives such as paid time off to get vaccinated or recover from short-term side effects.
  • Activate trusted messengers who may not be part of your organization’s management or leadership.
  • Use effective messages such as “more and more CNAs here are choosing to get the vaccine,” or cite critical milestones for those who want to wait and see, such as the fact that more than 120 million Americans are fully vaccinated.
  • Appeal to CNAs’ expertise and the role they play as caregivers for residents and their family members.
  • Celebrate as a community, but address fears at the individual level.

The full guide is available as a downloadable PDF.