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Health Workers Refusing COVID Vaccines in Sluggish Rollout

About half of hospital workers in Riverside County, Calif., are passing on the vaccine for now, county spokeswoman Brooke Federico said. In Orange County, health providers report that 30% of workers are holding back.

by Teri Sforza, The Orange County Register / January 6, 2021
TNS
(TNS) - Jan. 6—Frontline health care workers are about as skeptical of COVID-19 vaccination as the population at large, surveys have found, but the reluctance of some to roll up their sleeves has surprised nonetheless.
 
About half of hospital workers in Riverside County are passing on the vaccine for now, county spokeswoman Brooke Federico said. In Orange County, health providers report that some 30% of workers are holding back, said Dr. Clayton Chau, O.C. Health Care Agency director. Other health care systems have reported that a quarter or more of their staffers are hesitant, and these concerns may play a role in the slower-than-expected rollout of the largest mass vaccination campaign in history.
 
"I'm worried about fertility side effects for myself and wife, who is also a nurse," said a man who works in Los Angeles and hopes to have kids.
 
While many dark and flatly incorrect rumors swirl in cyberspace — that the Pfizer and Moderna vaccines can give you COVID, that they alter your DNA — the primary concern among health care workers is identical to the primary concern of the general public, surveys have found: Are the vaccines really safe?
 
That half of Riverside County's hospital workers didn't get the vaccine on this "first-round pass" is not surprising, said Kim Saruwatari, the county's public health director. "People may have been on vacation. They may be waiting to see what happens, in terms of side effects. There may be a variety of reasons."
 
The county fully expects to boost the number of hospital workers who get shots, but, in the meantime, vaccines aren't going to waste. The health department directed hospitals to administer them to firefighters, paramedics, emergency medical technicians and other first responders, so as not to squander precious vaccine with a limited shelf life, Saruwatari said.
 
"That move has been successful," she said. "They're using vaccines that would otherwise expire to inoculate these groups so no doses would be wasted."
 
Slow going
 
Federal officials had high hopes that 20 million people would be vaccinated by the end of 2020. As of Jan. 5, though, fewer than 5 million Americans had received shots, according to data from the U.S. Centers for Disease Control.
 
In California, nearly 1.3 million doses of vaccine have landed, with another 611,000 expected this week. Just a fraction of that — 456,980 doses — have been injected into people's arms as of Jan. 5, according to the CDC and Gov. Gavin Newsom.
 
Orange County has used about one-third of the vaccine it has received so far, Chau said.
 
"It's gone too slowly for many of us," Newsom said at a briefing on Monday, Jan. 4. "We are working aggressively to accelerate the pace. ... We want to see 100% of what's administered immediately in people's arms."
 
Challenges include the most basic kind of logistics — having enough dry ice to keep vaccines at ultra-cold temperatures during transport, and enough cold storage at the destinations — and the absence of a national public education campaign is hurting as well, Newsom said.
 
On the local front, "We don't know how much vaccine will come in and the frequency with which it'll come in," said Riverside's Saruwatari. "The other challenge is resources, because we have a lot of public health workers who are already busy doing contact tracing and testing."
 
And in Orange County and elsewhere, hospitals and first responder agencies must strike a balance between mobilizing staff for vaccinations while sick patients pour into hospitals at all-time pandemic highs.
 
Local health departments are pulling support from fire departments, medical associations, nursing schools, physician assistant schools and paramedic programs, Saruwatari said. The state is working to increase the number of distribution sites and broaden the kinds of workers who can administer vaccines, with an eye on dental offices, pharmacies and even the National Guard.
 
Ramping up
 
Officials expect the pace of vaccinations to pick up rapidly over the coming weeks, and President-elect Joe Biden has set a goal of 100 million vaccinated in his first 100 days. The federal government has contracted with pharmacy giants CVS and Walgreens to bring vaccines to the elderly, and that's already happening.
 
" CVS Health has partnered with approximately 15,000 skilled-nursing facilities and assisted-living facilities in the state of California to provide COVID-19 vaccinations to nearly 700,000 residents and staff," said Monica Prinzing, a CVS spokeswoman. "After week one, our rollout is going according to plan."
 
CVS started vaccination visits in California on Dec. 28 — a date set by the CDC — and is hitting skilled nursing facilities first, then assisted-living facilities, as per California's vaccination prioritization guidelines.
 
"As a result, we will begin vaccinating at assisted-living facilities on January 11," Prinzing said.
 
Walgreens, meanwhile, began vaccinating residents and staff at nursing homes and assisted-living facilities on Dec. 21, and is working with the CDC and federal and state governments to accelerate the administration of COVID-19 vaccines, said a corporate spokesperson by email.
 
Tracking the progress of vaccine campaigns — key to reopening life as we once knew it — is of keen interest. In addition to the CDC and global data, local counties are moving, albeit slowly, to add that information to the COVID-19 dashboards that now track case numbers, tests and deaths. Riverside is one of the first in Southern California to make its vaccination data public.
 
As of Jan. 3, Riverside county had been allocated 74,300 vaccine doses; 25,310 had been received and 17,294 had been administered. The site also serves to inform people about the vaccines by posting answers to frequently asked questions and educational videos encouraging people to get vaccinated.
 
Hesitancy
 
During the safety drills on airplanes, parents are told to put their oxygen masks on before assisting children in the event of an emergency. Health care workers are at the front of the vaccine priority line for the same reason: If they're felled, they can't help to those who depend on them.
 
While 27% of the public is "vaccine hesitant" — saying they probably or definitely would not get a COVID-19 vaccine — 29% of health care workers said the same, according to a recent Kaiser Family Foundation survey.
 
Orange County recently surveyed more than 26,000 people on vaccination concerns, to better target messaging about those concerns. Confidence in the safety of the vaccine was by far the strongest predictor of willingness to be vaccinated across all demographic and occupational groups, it found.
 
Health care workers fell in the standard spectrum, with about 57% saying they'd definitely get the shots.
 
Kaiser Permanente has vaccinated nearly 80,000 employees and physicians in California, says an an emailed statement from the health care giant, and it's encouraged to see that a majority of frontline healthcare workers are choosing to be vaccinated, "a critical first step in the society-wide vaccination that will be required to control and eventually end this terrible pandemic."
 
"While most people are excited to receive the COVID-19 vaccine, some are hesitant, so it is clear to us that vaccine education will be important to the overall success of our vaccination efforts."
 
Los Angeles County Public Health Director Barbara Ferrer said her team is also working to understand why health care workers are snubbing vaccines, and whether they're simply planning to take them later. If 80% accept the vaccine, "that's pretty positive news for us," she said.
 
'Culture of doubt?'
 
Dr. Ying-Ying Goh, Pasadena's public health director, said she had not encountered any local health care workers who refused the vaccine, and is frustrated with media coverage that she said "creates a culture of doubt that's unwarranted."
 
In Pasadena, health officials have distributed several thousand doses of vaccine to the local Huntington Hospital for its staff, while the health department prepares to inoculate hundreds more over the coming days, largely staff from nursing homes and long-term care facilities.
 
Others share her doubts that hesitancy among health care workers is as large as Riverside's numbers — or even recent polling — suggests.
 
"I'm concerned about the numbers being cited — there's no real context to the data," said Richard Carpiano, a public health scientist and medical sociologist at UC Riverside. "So 50 percent of Riverside's hospital workers didn't get the vaccine. Does that mean people didn't show up to appointments? Was that because of the holidays? Were they on vacation? It's not clear how this is being measured. Those sound like really high numbers to be a bit skeptical about."
 
Sal Rosselli, president of the 15,000-member National Union of Healthcare Workers, agrees.
 
"We don't know of one single member who has rejected the vaccine," Rosselli said. "We're getting calls and emails from people who are so happy, so relieved, that it's happening. Virtually all our members have received the first dose and many are starting to get the second. They're feeling good."
 
Newsom said the state has surveyed health care workers to get a better handle on the issue, and results are due soon.
 
The campaign is only a few weeks old, UCR's Carpiano said. "I'm optimistic that things will get better," he said.
 
As Orange County's Chau bluntly put it: "We do know if we don't get enough people vaccinated, we won't be able to get out of this lockdown."
 
Staff writers Bradley Bermont, Ian Wheeler and Olga Grigoryants contributed to this report.
 
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