John Eaglin Jr. works with some of the most vulnerable Oregonians, but when he learned he could get a shot of the vaccine against the coronavirus, he wasn’t sure if he wanted to do it.
He combed the internet to learn how the vaccine was produced, what corners may have been cut to get it approved so fast and whether clinical studies had actually proved it was safe.
“It’s an important decision to make,” said Eaglin, who supervises dining staff in the Portland senior care facility Rose Villa. “And it’s worth putting in the effort.”
Eaglin is one of tens of thousands of senior care workers in Oregon who must decide if they want to get a shot of new coronavirus vaccines that federal officials approved last month after a break-neck scientific effort to fight the pandemic.
Senior care home residents have faced the brunt of the pandemic’s death toll, with about half of Oregon’s 1,700 coronavirus fatalities connected to nursing, memory care, assisted living and independent living homes, despite accounting for only a fraction of the state’s total cases.
While thousands of workers in these facilities are choosing to go ahead with a shot to protect themselves and residents, Oregon has found that, like in other states, plenty are deciding to wait and see, if not refuse to get the vaccine altogether.
If not enough people get vaccinated, facilities could see continued spread of disease along with “serious outcomes,” state health officials said. And if further spread and deaths continue due to an insufficient number of people signing up for a shot, it will take longer for the state to pull back restrictive measures, such as physical distancing and mask-wearing.
In Ohio, only 40% of nursing home workers agreed to get a shot, Gov. Mike DeWine has told The Associated Press, and a top North Carolina health official estimated more than half were refusing.
It’s unclear if vaccine hesitancy among care home staff is a problem in Oregon. Multiple administrators told the newsroom about 65% to 80% of their workers got vaccinated, around the same rate the state says is necessary to achieve herd immunity in the general population.
But those examples are anecdotal. Oregon health officials don’t track how many workers were offered a vaccine and how many declined, and the pharmaceutical companies who do the work aren’t required to report that information to the state.
But state officials said they haven’t seen significant vaccine hesitancy among staff, though there have been “examples of resistance.” Some workers – particularly younger ones – have said they’ll purposefully skip the first of multiple clinics to see how their colleagues fare after getting a shot.
State officials also did not say what percent of staff should be vaccinated to prevent continued spread of disease inside senior care homes. But residents might be more willing than workers to be vaccinated, numbers provided by some facility managers show, which would help ensure the most vulnerable protect themselves.
Of the approximately 4,700 doses one pharmaceutical company offered long-term care workers, around 30% refused, according to data provided by the state. Health officials were not able to provide a breakdown for the other two companies vaccinating residents and staff, Walgreens and CVS.
Both the Pfizer-BioNTech and Moderna vaccines are thought to be about 95% effective, leaving only about 5% of people who get a shot vulnerable to an infection.
“The most important thing right now is to get as many people vaccinated as possible,” the Oregon Health Authority, the state’s public health agency, said in an emailed response to questions. “We can make progress even without having everyone immunized.”
All of Oregon’s 21,300 nursing home residents and staff should have had a chance to get their first shot by this time next week, the Department of Human Services said, and workers will have multiple opportunities if they initially decline.
Several nursing home administrators told the newsroom they’ve had to work hard to allay their workers’ concerns and make sure their questions are answered so they feel comfortable getting a shot.
About seven in 10 workers at one small facility in eastern Oregon agreed to be vaccinated, the facility’s administrator said, compared to every one of the residents. Staff are worried that the Pfizer-BioNTech vaccine was simply too rushed to be entirely trustworthy.
“The joke going around is, ‘How long is it going to take before there’s an attorney on television asking if you got the initial COVID vaccine,'” said Christopher Monroe, administrator of Pioneer Place, a facility in Vale.
Meanwhile, only 45% of the workers at the veterans’ home in The Dalles agreed to get a shot, compared to 97% of the residents. At the veterans’ home in Lebanon, 60% of staff got a shot, compared to 90% of residents. The Oregon Department of Veterans’ Affairs, which owns both homes, declined interview requests.
The Oregon Health Authority said facility managers should be proactive about telling staff the vaccine is safe, lead facility-wide conversations about it, have discussions that are “honest and safe” and hear out workers’ concerns.
The issue is particularly important because the state is moving into the second phase of the federal pharmacy partnership, with plans to vaccinate workers and residents in thousands of other settings.
Those include hundreds of assisted living facilities and thousands of smaller facilities and adult foster homes for the elderly, people with mental illness and people with intellectual and developmental disabilities.
Krista Mattox runs the Robison Health & Rehabilitation nursing facility, in Southwest Portland. About 90% of the residents have so far gotten a shot, compared to 65% of staff.
Among the people she’s talked to, side effects were the biggest concern. Since the first round, around five people have gone from saying they were on the fence to being absolutely certain that they would get a shot.
Mattox said she respects workers’ decisions about whether to get vaccinated against the coronavirus.
“We wanted everybody to be making informed decisions,” Mattox said.
The sooner more workers and residents get vaccinated the sooner it will be possible for staff to take off their masks and allow themselves to get closer to vulnerable residents.
“Human beings need human contact,” Mattox said.
If Rose Villa’s experience is any indicator, listening to employees’ concerns could prove key to driving up vaccine rates.
The facility’s director of health services, Erin Cornell, said managers expected some caution about the vaccine among staff at the Southeast Portland facility, but they didn’t know how much or what workers’ specific concerns might be.
So, a week before vaccines were first available, every Rose Villa employee received a survey with questions such as whether they were going to get a vaccine and what additional information could help them make a decision.
Cornell and her colleagues used those results to answer questions about side effects, the vaccine approval process and even to connect some workers with doctors.
In one case, a worker had health conditions and she wanted to talk to a doctor but didn’t have one, so the facility helped her find a physician. Cornell said that employee has since decided to get the vaccine.
“You can’t address a need without fully understanding what the need is,” Cornell said.
Of the 178 employees who work in both the nursing and independent living sections of Rose Villa, 128 got vaccines on the first day shots were available. By the end of the second clinic Monday, more than 20 additional staff got their first shots, according to numbers provided by a Rose Villa spokeswoman.
For Eaglin, the Rose Villa server, the final decision to get the shot at the first vaccination event came down to the safety of the elderly residents he interacts with.
“Because of my situation, where I work and people that I interact with, I decided – and my research of the vaccine itself – I decided to go ahead and opt in and get the vaccine,” he said.
Eaglin said his heart started to race when he got the text message saying he was in line to get a shot in Rose Villa’s performing arts room. By the time he rolled up his shirt sleeve, he said he had no doubts he was doing the right thing.