Just as predicted before the rollout began, vaccine hesitancy among nursing home workers stands as a serious barrier to widespread acceptance in long-term care — and, in turn, fully fostering group immunity among the most vulnerable.
Battered by COVID-19 and unwilling to trust the institutions that oversaw the deaths of their patients and colleagues, a significant percentage of frontline caregivers have said no to the coronavirus vaccine.
At Gurwin Jewish Nursing and Rehabilitation, CEO Stuart Almer and his team have tried to break through the fear and reluctance by highlighting the reasons why the staffers who have opted into the program eventually decided to roll up their sleeves.
Almer himself has a more direct connection than many of his peers at the executive level: His own father is a long-term resident at the non-profit Gurwin campus in Commack, N.Y., in the New York City suburbs of Long Island.
That shared experience forms a pillar of Gurwin’s vaccine outreach toward its workers.
“We both got vaccinated,” Almer told SNN. “We believe in it, and we feel fine.”
SNN spoke with Almer last week to hear how the vaccine rollout is proceeding in one of the areas hit hardest and earliest by the novel coronavirus, and how Gurwin is working to get as many of its staffers vaccinated as possible.
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Tell me what you’re seeing on the ground right now.
We were very pleased, as a skilled nursing facility, to be at the front of the line. We’ve been through so much on this end of the health care spectrum, so now for us to be in front of the line to get the vaccine, it felt like we deserved it, and we earned that right — so we can protect staff, protect our residents,
We had our first vaccination, and it was by Walgreens, two weeks ago, on a Monday. In fact, we understand we were the first facility, or among the first facilities on Long Island — certainly in Suffolk County — to get the vaccine.
Walgreens did a superb job in bringing enough vaccines and enough staff to do a very comprehensive vaccination here of residents and staff. We have our own pharmacy, and so we have the wherewithal — if we were permitted to — to provide vaccinations, but this is being done by the outside pharmacies as per CDC.
What was the calculus behind the Walgreens decision?
The options were limited, in that it was just a selection between CVS and Walgreens. There’s no science behind it.
But I mentioned having our own pharmacy because if we could have, we would have chosen to do it ourselves. We do our own flu vaccination every year. So for us, this is relatively easy. Because we have our own pharmacy, we can store vaccinations. We have pharmacists who can help administer, not just nursing staff. So we would have liked that opportunity, but we didn’t have it.
What’s the timeline for the second dose?
This coming Monday [January 11] is round two. Between staff and residents combined, we had about 350 individuals vaccinated. So those 350 will be given their second dose, the booster next Monday — myself included, by the way. My father’s a long-term resident here, and he’ll have his second dose as well.
We’re excited about it. We’re looking forward to it — to ultimately promote safety and get past the pandemic. But anyone else who elects to take it, residents and staff, will have that first vaccine opportunity on that same day next Monday.
Right now, we’re undergoing a very serious campaign at Gurwin to promote vaccinations so that we get everybody done next week. It’s a challenge but that’s our goal.
How have you been trying to combat vaccine hesitancy? In Ohio, for instance, up to 60% of nursing home workers have declined to receive the shots.
Those numbers that you are referencing are really what we are seeing and hearing as well in the industry. But we have a campaign. One piece of it is very heavy education. Right now we have an oversized video display in our main lobby — it’s an ongoing loop of videos of key staff, myself included, who are talking about the importance of vaccination.
It’s from a personal perspective. For example, myself and my father — I mentioned that we were both excited about it. We both got vaccinated, we believe in it, and we feel fine. We’ve had other staff — regular staff, or management staff, across the board — all on this video. One of [the featured staffers] is Spanish-speaking, and that was so that other Spanish-speaking staff can hear that message from one of their co-workers, encouraging them to take the vaccine.
There are staff who have had issues of cancer in their household, or they’ve had people who are at high risk otherwise, and so it’s important for them personally to get vaccinated to protect their family. — and some just speaking on behalf of our residents here.
On a 24/7 basis, this is running. In addition, we have a social media platform known as Beekeeper. All of our staff who wish to have the link on their cell phones get updates and policies and all types of Gurwin information live on this social media platform that’s only for employees. We put the video on there as well.
The goal is: Whether you’re here, whether you’re at home, wherever you are, you’ll see the staff appealing as part of this campaign. In fact, as soon as we finish this call this morning. I’m going to go live on the public address system here and again remind everyone: Walgreens is coming back on Monday. It’s so important that we vaccinate staff and residents, so we keep everybody safe.
Besides education — we think that’s the most powerful — but people will still make an individual decision. There are many people who are anxious with regard to the vaccine; they worry about side effects, they worry about their own future. So it is a process. It’s a process for the world, let alone for Gurwin.
How do you make sure everyone is on site for the vaccination clinic? Obviously there are multiple shifts of people working at the facility, and they all won’t be there at the same time.
We were proactive and offered any staff member — whether they were working or not on Monday, two weeks ago — to come in and be vaccinated. We had night staff who came in, and we had other staff — weekend staff, per-diem staff all came in. They had plenty of vaccine; Walgreens did a great job with the amounts.
We have to let them know a certain number of days in advance how many staff and residents we anticipate will be vaccinated. Certainly the first time demonstrated they were prepared. If we had even more staff and residents wanting the vaccine, they all would have had the first first dose on that day. So we’re confident in that.
The same thing will happen again on Monday, and then they will return again for the second dose — I believe it’s February 1. Beyond that, we don’t know yet what their schedule will be or what their plans are. Again, we would be hopeful that we could do it, but that remains to be seen.
How will the eventual vaccination inform things like visitation and communal activities?
We’re seeing a significant uptick in the region — we are across the country, and we’re seeing it in the region here. I believe that Suffolk County is now beyond 11% positivity rate — and that’s a concern because as that goes up, it affects us here.
[Editor’s note: As of January 10, the positivity rate in Suffolk County, N.Y. was 10.5%.]
It’s almost like two separate issues: The vaccine is key for the future, for ensuring people don’t get sick, but it’s happening as this significant uptick is happening. If the uptick happened later, we might have been protected in time. We’re starting to see an increase here, just following what’s happening in the community. That presses us even more to push the campaign harder: The better that we can do, the fewer people will hopefully get sick.
One big difference from earlier this year that we spoke about last time — comparing the situation of March, April, May, which seemed dire — is that testing now is being done so much better in terms of getting results much more quickly.
Right now, if we have a positive staff member, they’re very quickly off schedule; residents are more quickly isolated if they are positive. We have a greater advantage than we had earlier this year, so that puts us in a better position to deal with this.
In terms of visitation, the Department of Health in New York State determines visitation. The way in which the formula exists now — and has been for many months — as long as we have just one case, whether it be staff or resident, just one, the clock gets reset in terms of visitation. For a large facility like Gurwin, it’s mathematically very, very challenging to ever get to the goal that we can have someone visit.
If you may recall, originally, it was 28 days consecutively without one positive case. When you add our total staff size together in the nursing home, plus our residents, you’re talking about 1,200 lives. We knew when the mandate came out that it would be near impossible to [achieve]. Then it was relaxed to 14 days, and even then it became near impossible. And now with the uptick, we just don’t see it happening.
However, even though we don’t have inside and regular visitation, we are continuing a very robust program for drive-by visitation — but right now, the uptick is so significant, we’ve had to put a pause to drive-bys just to be safe.
This interview has been condensed and edited for clarity.