Data Isn’t the Cure-All for Vaccine Hesitancy Among SNF Staff, Feedback Shows

For nursing home staff who are hesitant about taking a vaccine for COVID-19, data and information may not be the most effective way to address their concerns, according to a report published in the Journal of the American Geriatrics Society.

The report, published on March 25, used a series of 26 town hall meetings from December 30, 2020, to January 15, 2021, with 193 staff from 50 facilities participating. The study was funded by the National Institute on Aging.

“Misinformation about the COVID‐19 vaccine was widespread among SNF staff,” the report concluded. “Sharing positive emotions and stories may be more effective than sharing data when attempting to reduce vaccine hesitancy in SNF staff.”


Several operators have reported the importance of peer leadership when it comes to addressing staff questions. One nursing home administrator earlier this year told Skilled Nursing News that a powerful moment in vaccinations for her facility was when a staff member with underlying medical conditions became one of the first workers vaccinated against COVID-19.

“In addition to the vaccination station, we have pictures of staff during our first clinic, and one of the staff persons in particular had a history of underlying medical conditions, and it’s common knowledge throughout the facility; she’s very open with sharing her experiences,” Vernon Manor Health Care Center administrator Angela Perry told SNN’s Rethink podcast in February. “So for her to be the first staff person vaccinated, it really opened some eyes. … ‘Hey, this person can do it, let me consider it.’”

The authors of the new report include Sarah Berry and Laurie Herndon of the Hinda and Arthur Marcus Institute for Aging Research, Hebrew Senior Life & Harvard Medical School; Kimberly Johnson of Duke University School of Medicine; Lonnita Myles and David Gifford of the American Health Care Association (AHCA); Ana Montoya of the University of Michigan School of Medicine; and Shekinah Fashaw of Brown University School of Public Health.


Their findings come after a February 5 Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC). According to the report, a median of 37.5% of staff members at 11,460 SNFs with at least one vaccination clinic had gotten their first dose of the vaccine. The research was conducted during the first month of the CDC Pharmacy Partnership for Long-Term Care Program. The low uptake relative to SNF residents, who had a median participation of 77.8%, sparked a concerted campaign from two major nursing home trade groups, AHCA and LeadingAge, to bolster staff participation by June.

It is worth noting, however, that since that report, staff willingness to take a vaccine for COVID-19 has climbed dramatically, with about 62% of post-acute and senior living workers polled by software firm OnShift reporting they would be willing to receive a COVID-19 vaccine. That represents a 94% increase in positive sentiment, according to the company.

The town halls revealed that most nursing home staff members were getting information about the vaccine from friends or social media, and the most common concerns were related to the speed of the vaccines’ development and the side effects, particularly around pregnancy or infertility.

Of the 67.9% of staff attendees who reported their disciplines, about half came from dietary, housekeeping and other groups. But there was no difference in the concerns by discipline, and the study authors noted that misinformation about the COVID-19 vaccines on social media “is rampant and rapidly evolving.”

“We did not anticipate that concerns about infertility or presence of micro-chip were so prevalent, and we would not have been able to address without asking,” the authors wrote. “An important benefit of the town hall format was that it afforded staff the opportunity to ask about their specific concerns without having to sit through a lengthy, predetermined presentation.”

In addition, the town halls revealed how important it is to focus on returning to prior activities after being vaccinated, with many staff reporting that the benefits of vaccination for their friends and their family were what convinced them to take the shots.

The town halls also confirmed anecdotal reports that physicians are the preferred source of information about COVID-19 vaccines for those reluctant to take the vaccine, the authors said.

“Given the low initial uptake of vaccination among SNF staff, it is critical to develop and implement successful models to address vaccine hesitancy,” they wrote. “Based on our experience and hearing from others, physicians and other health care providers need to take the time to meet with staff and their patients.”

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