Efforts to keep healthcare workers safe from COVID-19 should emphasize risk mitigation in and outside the workplace, a new study confirms. Race and community factors far outweigh occupation as risk factors for contracting COVID-19, Emory University investigators say.
In an analysis of antibody levels among 10,000 Atlanta healthcare workers from April to June 2020, Black workers had almost double the risk of COVID-19 infection when compared with their white peers, reported lead author James P. Steinberg, M.D. In addition, contact with potential COVID-19 cases outside the workplace and disease prevalence in the communities where workers lived also were linked to higher infection risk.
In contrast, occupational exposure to other healthcare workers or patients with confirmed COVID-19 did not as strongly predict infection, the authors found.
What’s more, racial disparities that are well-documented in the general population persisted after the researchers accounted for other risk factors such as job role. This underscores the fundamental racial inequities that have become a hallmark of the COVID-19 pandemic, Steinberg and colleagues wrote.
Reducing worker COVID-19 risk may be a complex undertaking when it comes to vaccination. New data from the Centers for Disease Control and Prevention appear to show that despite a higher risk profile for transmission and severe COVID-19, the percentage of Black COVID-19 vaccine recipients may not match representation in the workforce.
Nationally, Blacks were found to make up 16% of healthcare workers (and 14% of nursing home residents), yet received only 5.4% of the shots during the first month of the vaccine rollout, the CDC found.
Interpretations of this data are difficult, investigators said. Half of vaccination reports during this time did not include race and/or ethnicity. Yet among the vaccinations that did include demographic characteristics, racial and ethnic data showed that recipients were 60% non-Hispanic white, 14% multiple or other race/ethnicity, 12% Hispanic and/or Latino, 6% Asian, 5.4% Black, and 2% American Indian/Alaska Native. In addition, 63% of recipients were women, and 55% were aged 50 or more years. This “likely reflects the overall demographic characteristics of healthcare personnel and long-term care facility residents recommended for vaccination in the Phase 1a priority group,” agency investigators noted.
Still, barriers to access among people of color along with wariness about the new vaccines may continue to dog the vaccination effort.
New findings highlight gulf between resident and staff vaccinations
Meanwhile, additional new data confirm the gulf between the number of LTC residents and staff members getting COVID-19 shots.
Among the 11,460 skilled nursing facilities that conducted at least one vaccination clinic in the first month of the CDC Pharmacy Partnership for Long-Term Care Program, a median of 78% of residents and 38% of staff members received one or more vaccine doses, reported Ruth Link-Gelles, Ph.D., of the CDC’s COVID-19 response team.
A November 2020 survey found that only 45% of long-term care staff members were willing to immediately receive a COVID-19 vaccine, with an additional 24% willing to consider it in the future, reported Link-Gelles and colleagues.
Concern about side effects was the respondents’ top concern. Other factors likely include high staff member turnover, staff members who work in multiple facilities, and limited resources for outreach and education in these settings, the researchers wrote.
“Barriers to SNF staff member vaccination need to be overcome with continued development and implementation of focused communication and outreach strategies to improve vaccination coverage,” they concluded.
