Staff at facilities that don’t have high worker vaccination rates are feeling pressure.

Some families’ hopes of visiting loved ones inside their nursing homes are being dashed by ongoing COVID-19 outbreaks among staff, and they may be poised to turn their anger toward vaccine-hesitant workers, according to a scathing report published Wednesday by NPR and the Center for Public Integrity.

Just 37.5% of long-term care staff received a first dose of the Pfizer or Moderna vaccines during the earliest round of a federal partnership program designed to vaccinate residents and frontline workers.

Despite much-publicized celebrations of increasinging vaccine acceptance among staff since then — and an extensive campaign asking workers and others to GetVaccinated — the report revealed that some areas remain agonizingly far from achieving herd immunity.

“Nationwide, most of the elderly and vulnerable in long-term care facilities have taken the coronavirus vaccine, but many of the staff caring for them have refused it,” NPR reported. “The federal program responsible for bringing vaccines to the vast majority of nursing homes and similar settings inoculated roughly half of long-term-care workers in the nation, and in some states a much slimmer percentage.”

According to March 15 Centers for Disease Control and Prevention data provided to the Center for Public Integrity, the federal partnership program had vaccinated less than a third of staff members in seven states and the District of Columbia.

In Arkansas, for example, the Center for Public Integrity reported that just 10% of the state’s 3,121 long-term care workforce had received two doses through the federal partnership. Those figures represent doses provided to workers in skilled nursing and assisted living facilities. (Arkansas officials said less than a third of long-term care facilities there relied on the federal partnership, and “roughly half” of the workers are fully vaccinated now.)

But as long as unvaccinated staff continue to carry COVID-19 into nursing homes, families desperate to maintain in-person contact with their loved ones are getting angry.

CMS visitation guidance issued in mid-March dictates that facilities can continue indoor visits if testing determines an outbreak is limited. But if large numbers of staff have COVID-19 or those infected work in multiple units, facilities must close their doors once again.

Janet Caldwell told NPR she was looking forward to seeing her 87-year-old mother again, without dirty windows or an awkward outdoor booth between them. 

But a few days after reopening to indoor visits, the mother’s nursing home called Caldwell to cancel again due to a staff outbreak. Workers at the facility had already been offered the coronavirus vaccine twice, Caldwell said.

“I was angry,” Caldwell said. “I felt just totally hopeless that this was just going to continue and it was just never going to end.”

The American Health Care Association and LeadingAge are leading a campaign that aims to have 75% of all long-term care staff nationwide vaccinated by July 1. But even with that goal, pockets of unvaccinated workers may remain in many buildings, amping up pressure on providers to do something more.

So far, few skilled nursing companies have shown interest in mandating shots for workers.

The Center for Public Integrity acknowledged the challenge in that approach, citing the expertise of Harvard Medical School policy professor David Grabowski, Ph.D.

“It’s unlikely that most nursing homes can make vaccination mandatory for employees, as many facilities already struggle to recruit and retain staff to perform these low-paying jobs,” the article said. “Governments or employers could consider paying staff to be vaccinated, Grabowski said, but some may consider that unethical or exploitative.”