Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

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trader32176
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Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

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Norway Warns of Vaccination Risks for Sick Patients Over 80

1/15/21


https://www.bloomberg.com/news/articles ... ts-over-80


Norway said Covid-19 vaccines may be too risky for the very old and terminally ill, the most cautious statement yet from a European health authority as countries assess the real-world side effects of the first shots to gain approval.

Norwegian officials said 23 people had died in the country a short time after receiving their first dose of the vaccine. Of those deaths, 13 have been autopsied, with the results suggesting that common side effects may have contributed to severe reactions in frail, elderly people, according to the Norwegian Medicines Agency.

“For those with the most severe frailty, even relatively mild vaccine side effects can have serious consequences,” the Norwegian Institute of Public Health said. “For those who have a very short remaining life span anyway, the benefit of the vaccine may be marginal or irrelevant.”

The recommendation does not mean younger, healthier people should avoid being vaccinated. But it’s an early indication of what to watch as countries begin to issue safety monitoring reports on the vaccines. Emer Cooke, the new head of the European Medicines Agency, has said tracking the safety of Covid vaccines, especially those relying on novel technologies such as messenger RNA, would be one of the biggest challenges once shots are rolled out widely.

Pfizer and BioNTech are working with the Norwegian regulator to investigate the deaths in Norway, Pfizer said in an e-mailed statement. The agency found that “the number of incidents so far is not alarming, and in line with expectations,” Pfizer said.

Allergic reactions have been uncommon so far. In the U.S., authorities reported 21 cases of severe allergic reactions from Dec. 14-23 after administration of about 1.9 million initial doses of the vaccine developed by Pfizer Inc. and BioNTech SE. That’s an incidence of 11.1 cases per million doses, according to the Centers for Disease Control and Prevention.

Though both Covid-19 vaccines approved so far in Europe were tested in tens of thousands of people -- including volunteers in their late 80s and 90s -- the average trial participant was in his or her early 50s. The first people to be immunized in many places have been older than that as countries rush to inoculate nursing-home residents at high risk from the virus.

Norway has given at least one dose to about 33,000 people, focusing on those considered to be most at risk if they contract the virus, including the elderly. The Pfizer-BioNTech vaccine approved late last year has been used most broadly, with a similar shot from Moderna Inc. approved earlier this month also now being administered.

Of 29 cases of potential side effects investigated by Norwegian authorities, almost three-quarters were in people age 80 or older, the regulator said in a Jan. 14 report.

In France, one frail patient died in a care home two hours after being vaccinated, but authorities said given the patient’s previous medical history there is no indication the death was linked to the vaccine. The French pharmaceutical safety agency on Thursday reported four cases of severe allergic reactions and two incidents of irregular heartbeat after vaccination.

The first Europe-wide safety report on the Pfizer-BioNTech vaccine will probably be published at the end of January, the regulator’s key medicines committee said Friday. Vaccine makers are required to submit data monthly.

In the U.K., which has carried out more immunizations per capita than anywhere else in Europe, authorities will assess safety data and plan to publish details of suspected reactions “on a regular basis,” the Medicines and Healthcare Products Regulatory Agency said, without giving a date.
trader32176
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Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

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Norway Raises Concern Over Vaccine Jabs for the Elderly

1/16/21


Death count raised, age threshold lowered from initial report

Country suggests vaccines may be too risky for the elderly



https://www.bloomberg.com/news/articles ... rise-to-29


Norway expressed increasing concern about the safety of the Pfizer Inc. vaccine on elderly people with serious underlying health conditions after raising an estimate of the number who died after receiving inoculations to 29.

The latest figure adds six to the number of known fatalities in Norway, and lowers the age group thought to be affected to 75 from 80. While it’s unclear exactly when the deaths occurred, Norway has given at least one dose to about 42,000 people and focused on those considered most at risk if they contract the virus, including the elderly.

Until Friday, the vaccine produced by Pfizer and BioNTech SE was the only one available in Norway, and “all deaths are thus linked to this vaccine,” the Norwegian Medicines Agency said in a written response to Bloomberg on Saturday.

“There are 13 deaths that have been assessed, and we are aware of another 16 deaths that are currently being assessed,” the agency said. All the reported deaths related to “elderly people with serious basic disorders,” it said. “Most people have experienced the expected side effects of the vaccine, such as nausea and vomiting, fever, local reactions at the injection site, and worsening of their underlying condition.”

Official reports of allergic reactions have been rare as governments rush to roll out vaccines to try to contain the global pandemic. U.S. authorities reported 21 cases of severe allergic reactions from Dec. 14-23 after administration of about 1.9 million initial doses of the Pfizer vaccine. The first Europe-wide safety report on the Pfizer-BioNTech vaccine is due to be published at the end of January.

Australia’s Concern

Australia, which has an agreement for 10 million doses of the Pfizer vaccine, is seeking urgent information on the issue from the producer, health authorities and Norway’s government, Health Minister Greg Hunt told reporters in Melbourne on Sunday.

Australia’s Therapeutic Goods Administration will seek “additional information, both from the company, but also from the Norwegian medical regulator,” Hunt said. Australia’s foreign ministry will also contact its counterpart in Norway on the issue.

Norway’s experience doesn’t mean that younger, healthier people should avoid being vaccinated. But it’s an early indication of what to watch as countries begin to issue safety monitoring reports on the vaccines. Emer Cooke, the new head of the European Medicines Agency, has said tracking the safety of Covid vaccines, especially those relying on novel technologies such as messenger RNA, would be one of the biggest challenges once shots are rolled out widely.

Though the two Covid-19 vaccines approved so far in Europe were tested in tens of thousands of people -- including volunteers in their late 80s and 90s -- the average trial participant was in his or her early 50s. The first people to be immunized in many places have been older than that as countries rush to inoculate nursing-home residents at high risk from the virus.

Too Risky


The findings have prompted Norway to suggest that Covid-19 vaccines may be too risky for the very old and terminally ill, the most cautious statement yet from a European health authority.

The Norwegian Institute of Public Health judges that “for those with the most severe frailty, even relatively mild vaccine side effects can have serious consequences. For those who have a very short remaining life span anyway, the benefit of the vaccine may be marginal or irrelevant.”

Pfizer and BioNTech are working with the Norwegian regulator to investigate the deaths in Norway, Pfizer said in an e-mailed statement. The agency found that “the number of incidents so far is not alarming, and in line with expectations,” Pfizer said.

“We are aware that deaths have also been reported in other countries, but do not have full details of this yet,” Norway’s medicines agency said. “There are also differences between countries in who is prioritized for vaccination, and this could also affect the reporting of side effects, including death.”

“The Norwegian Medicines Agency has communicated, prior to the vaccination, that when vaccinating the oldest and sickest, it is expected that deaths will occur in a time-related context with vaccination. This does not mean that there is a causal link between vaccination and death. We have also, in connection with the reported deaths, conveyed that it is possible that common and known side effects of the vaccines may have been a contributing factor to a serious course or fatal outcome,” the agency said.
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TimGDixon
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Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

Post by TimGDixon »

This isn't exactly good news... it sends a very bad message to the public. Yes it could have an impact on QuadraMune sales and i am sure we would all like that but to be honest i'm torn. I don't want anyone dying of covid-19 and want as many to be immunized (its not vaccination) against it as possible. If you are healthy its actually better to just get infected and have your own "self-immunity" rather than "non-self" from a synthetic drug. Personally i have zero concern about moderna or pfizer as i hav said before - i'm 62 years old... so they say... im pretty healthy but i don't want to get it naturally because of my age and so of course i take everything i make including QM. When it becomes available to me i will get it and i will still take QM every day. No one knows how long this "non-self" immunity will last and you will likely need it every year or other year once you've been immunized by the synthetic. If you catch it naturally you don't need a vaccine - you have self-immunity and tolerogenic memory of b and t cells and can produce new neutralizing antibodies from that. But even so i would take QM every day anyways.

Tim
trader32176
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Joined: Fri Jun 26, 2020 5:22 am

Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

Post by trader32176 »

I can say this much in response .
I am an expert now having gone through it before a year ago , and am now currently . So - Nobody said anything about it for months the first time it came around . If you go back in time , it wasn't really mentioned that it started until months later. now it's been said that it could have started in december 2019 , to to january 2020.

there have been many studies on how long the antibodies last . In my case , i would say that the antibodies do not last a year , since it was a year ago i got it the first time . The first time I ran a high temperature , the second time , no raise in temp.

this time around I had the same symptoms . Abdominal cramps , diarrhea, then sneezing and runny nose along with hot flashes and cold chills .
you can be in bed , and feel really cold , blanket up and then you are sweating and cooking from it .
Then the headaches , and nausea w/ , and no wanting to eat.

the first time this happened there was an eventual stage of congestion in the lungs , which was turning green , but i kept dosing it with QM , and my lungs cleared up in a couple of days .

The first time I took QM , NS and Projuvenol in rotation every day , and it took me 2 1/2 weeks to get over it , due to the heavier viral load from kissing my girlfriend , and my immuno - comprimised system . It took her 1-2 weeks to get over it .

This time around , someone else around me got it , and I believe the viral load was lower because of the distance of contact.
This time I used the same products again .
Only this time when it started into the dry cough and irritated throat stage , I took a couple of eyedroppers of NS and dropped those drops into my throat while inhaling lightly . that seemed to stop the advance of any green congestion into the lungs.

It was a battle the first day with my abdominal cramps vs. the QM . a very heavy painful battle . But the QM won the battle . - imo
trader32176
Posts: 1755
Joined: Fri Jun 26, 2020 5:22 am

Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

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51 adverse reactions reported & 1 person hospitalized in Delhi as India begins world’s largest Covid-19 vaccination program

1/17/21


https://www.rt.com/news/512774-india-ad ... d-vaccine/


Dozens of health workers in Delhi who were the first in line to be inoculated against Covid-19 have experienced side effects from the jab, with one admitted to the ICU, as India begins its nationwide immunization drive.

At least 51 healthcare workers in India’s capital suffered minor adverse reactions after receiving the jab on Saturday. Health authorities said the most common side effects were dizziness and headache.

Several people reported tightness in the chest and were administered medical treatment, while one individual experienced a serious health emergency after suffering from headache, rashes, respiratory distress, and tachycardia after taking the vaccine. The patient was administered adrenaline and rushed to an intensive care unit, India Today reported, adding that his symptoms worsened for at least 30 minutes after being hospitalized. The case has been classified by health authorities as a serious instance of AEFI (adverse events following immunization). However, his vitals are now said to be stable.

India granted emergency approval to two variants of the Covid-19 vaccine earlier this month: Bharat Biotech's Covaxin, and Covishield, a jab based on the AstraZeneca/Oxford formula and manufactured by the Serum Institute of India. Both shots are being used in India’s capital.

In total, 4,319 health workers were vaccinated in Delhi on the first day of the immunization drive, although officials had hoped that more than 8,000 personnel would receive the jab.

India hopes to vaccinate more than one billion people, starting with 30 million doctors, nurses, and other frontline workers. The government says it plans to immunize 300 million people by August.

Prime Minister Narendra Modi has hailed the massive public health initiative as a clear demonstration of India’s “capability,” but his government has been accused of rushing approval for the two jabs.

Covaxin had not yet completed phase three trials at the time it was given the green light, and there have been similar concerns raised about lack of transparency regarding Covishield.

A representative from a health watchdog group, the All India Drug Action Network (AIDAN), told RT shortly after the two drugs received emergency approval that the “expedited” roll out of the jabs has raised questions about their review process.

Indian officials have labored to dispel rumors about the vaccines, including the belief echoed by some politicians that they can cause impotence. But in some cases these efforts appear to have only exacerbated doubts about the drugs.

Dr. Venugopal G. Somani, the drugs controller general of India, told local media that the jabs are “110 percent safe,” in an attempt to quash public fears. Later, the country’s minister of petroleum and natural gas, Dharmendra Pradhan, said that people who question the safety and efficacy of India’s Covid-19 vaccines are “mentally challenged.”
User avatar
TimGDixon
Posts: 708
Joined: Fri Jun 26, 2020 4:36 am

Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

Post by TimGDixon »

Excellent - thank. you for that. Indeed i don't think any of us wants anyone to suffer for any reason or why do you invest in bio - you can make a lot of money in lots of other sectors - its because deep down each and eveyr one of you are humans who care about humans.
trader32176 wrote: Sun Jan 17, 2021 6:49 am I can say this much in response .
I am an expert now having gone through it before a year ago , and am now currently . So - Nobody said anything about it for months the first time it came around . If you go back in time , it wasn't really mentioned that it started until months later. now it's been said that it could have started in december 2019 , to to january 2020.

there have been many studies on how long the antibodies last . In my case , i would say that the antibodies do not last a year , since it was a year ago i got it the first time . The first time I ran a high temperature , the second time , no raise in temp.

this time around I had the same symptoms . Abdominal cramps , diarrhea, then sneezing and runny nose along with hot flashes and cold chills .
you can be in bed , and feel really cold , blanket up and then you are sweating and cooking from it .
Then the headaches , and nausea w/ , and no wanting to eat.

the first time this happened there was an eventual stage of congestion in the lungs , which was turning green , but i kept dosing it with QM , and my lungs cleared up in a couple of days .

The first time I took QM , NS and Projuvenol in rotation every day , and it took me 2 1/2 weeks to get over it , due to the heavier viral load from kissing my girlfriend , and my immuno - comprimised system . It took her 1-2 weeks to get over it .

This time around , someone else around me got it , and I believe the viral load was lower because of the distance of contact.
This time I used the same products again .
Only this time when it started into the dry cough and irritated throat stage , I took a couple of eyedroppers of NS and dropped those drops into my throat while inhaling lightly . that seemed to stop the advance of any green congestion into the lungs.

It was a battle the first day with my abdominal cramps vs. the QM . a very heavy painful battle . But the QM won the battle .-imo
trader32176
Posts: 1755
Joined: Fri Jun 26, 2020 5:22 am

Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

Post by trader32176 »

Coronavirus: California calls for pause, investigation after allergic reactions to Moderna vaccine batch

A cluster of allergic reactions prompted state officials to call for a pause of Moderna batch 041L20A


1/18/21

https://www.mercurynews.com/2021/01/18/ ... ine-batch/


In the latest pitfall of California’s COVID-19 vaccine rollout, the state’s top epidemiologist recommended Sunday night that clinics put hundreds of thousands of doses on hold after a series of allergic reactions in Southern California.

An abnormally high number of people experienced anaphylactic shock, a severe allergic reaction that requires immediate medical attention, after receiving a shot of the Moderna vaccine at one San Diego vaccination site, Dr. Erica Pan said in statement Sunday night. While the number was fewer than 10, the cluster of negative reactions prompted the California Department of Public Health to pause the administration of some 330,000 doses from the batch, which had been distributed throughout the state, until an investigation was complete.

“Our goal is to provide the COVID vaccine safely, swiftly and equitably,” Pan said in the statement. “A higher-than-usual number of possible allergic reactions were reported with a specific lot of Moderna vaccine administered at one community vaccination clinic. … Out of an extreme abundance of caution and also recognizing the extremely limited supply of vaccine, we are recommending that providers use other available vaccine inventory and pause the administration of vaccines from Moderna Lot 041L20A until the investigation by the CDC, FDA, Moderna and the state is complete. We will provide an update as we learn more.”

The reactions reported at the San Diego clinic were similar to rare occurrences that the Centers for Disease Control and Prevention had warned of and cautioned to be on the lookout for. In California, vaccination sites monitor recipients on-site for 15 minutes for adverse reactions. The cluster in Southern California was the first in the nation concerning enough to pause usage altogether.

The 330,000 doses in the batch from Moderna amount to just below 10% of all the vaccine doses allocated to California thus far. But of the 3.5 million doses the state has received, according to CDC data, it had administered fewer than one-third, just over 1 million doses. On a per-capita basis, only five states have inoculated fewer of its residents than California, according to the CDC data.

Severe allergic reactions, while possible, are believed to be exceedingly rare in the Moderna and Pfizer vaccines. The rate of anaphylaxis in the Moderna vaccine was expected to be about one in every 100,000, officials said. Multiple federal and state agencies had opened an investigation into the cases and said they would have more information later this week.
trader32176
Posts: 1755
Joined: Fri Jun 26, 2020 5:22 am

Re: Up to 60% of US health workers are refusing to get COVID-19 vaccines over fears of side effects

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Why Are So Many Health-Care Workers Resisting the COVID Vaccine?

2/2/21


https://www.newyorker.com/science/medic ... id-vaccine


Tiffany Chance has worked as a certified nursing assistant since 2005. As an African-American woman in her mid-thirties, Chance typifies the demographics of her profession: most C.N.A.s are young, over a third are Black, ninety per cent are women. She was born and raised in Ohio, and for years worked at a single nursing facility. When the pandemic started and nursing homes faced dire personnel shortages, as many employees contracted the virus or quit in fear of it, Chance started picking up scattered shifts through IntelyCare, a staffing agency that allows health-care workers to choose jobs the way that Uber drivers accept riders. She often works six shifts a week, eight or twelve hours each, across several nursing homes.

When considering a shift, Chance, who has asthma, tries to choose nursing homes without active coronavirus spread. This information, however, is self-reported, and there’s often a delay. “I’d pick a place that said they don’t have the virus, then I’d show up and they’d say, ‘Actually, some of these people have COVID,’ ” Chance told me. In early October, she scheduled a shift at a new facility, which, she was told, had no coronavirus-positive residents; she was given a surgical mask, not an N95 respirator. A week later, as she started to develop a runny nose, she received a call: a resident had tested positive. Soon, her breathing worsened. “God, it was terrible,” she said. “It felt like an elephant was sitting on my chest. I couldn’t walk an inch without getting out of breath.” Chance couldn’t work for weeks; during that time, she received no sick pay. She tried to sign up for food stamps and unemployment benefits, but “I had to jump through so many hoops. They wanted my medical records, my test result, my pay stub, my last employer. I’m thinking, What does my last employer have to do with this? I need help right now!” She tried to e-mail the paperwork, but was told it would take longer to process than if she dropped it off. “I’m, like, I can’t drop it off, I have COVID.” As the weeks wore on, she turned to family for help with food and money for rent. “I kept thinking, You work this hard, you care for so many people. And when you get sick, this is how you’re treated.”

While navigating these bureaucratic hurdles, Chance’s symptoms worsened; during one especially rough night, she considered going to the hospital. But the following morning her breathing eased, and slowly it returned to normal. Chance is convinced that her illness didn’t get worse only because, a few years ago, she’d received the pneumonia vaccine. “I really think it helped,” she said. “That vaccine saved me.”

Chance doesn’t want a coronavirus vaccine. (Because it’s not known how long naturally acquired immunity lasts, the C.D.C. recommends that people who have already had the virus still get vaccinated.) I asked her how she has come to believe that one vaccine saved her life but another threatens her health. The vaccine “came out too fast,” she said. “I think they removed a lot of barriers to get it done faster.” She continued, “It’s not that I don’t believe they’re trying to do a good job. I think they have awesome scientists working really hard. I applaud them for doing what they’re doing. I just don’t believe there’s been enough research yet. There’s no way they’ve been studying it for long enough.” Beyond the speed of development, Chance has questions—about how long vaccine-generated immunity lasts, about how serious the long-term side effects might be, and about what could happen if the virus mutates further. Until these questions are answered to her satisfaction, she has no plans to get immunized. “I’m not saying never,” Chance told me. “I’m just saying not now.”

Like Chance, Kia Cooper has been a certified nursing assistant for nearly two decades. She works in and around Philadelphia; early in the pandemic, she would split her time between traditional nursing homes and assisted-living facilities. She prefers the latter. “Nursing homes give you too many patients, and they are much more dependent on you for everything—dressing, bathing, feeding, transport,” she said. “It’s backbreaking work.” In Cooper’s experience, it’s not unusual for a single C.N.A. to care for twenty nursing-home residents at a time. One evening in the spring, she arrived for an overnight shift to find that the other C.N.A.s scheduled to work hadn’t shown up. “It was me and two nurses for fifty residents,” she said. “The charge nurse kept calling people to try to get them to come in, but no one responded.”

Cooper now prefers to work in home care and assisted-living facilities, where the residents require less support; she’s found four assisted-living facilities on the outskirts of Philadelphia that she likes. Recently, a previous employer offered her a chance to get vaccinated. She passed. “I’m not totally against it,” she said. “But it was so rushed. I want to wait and see how others do.” Her experience with a health-care industry that seems to put profits over the interests of patients and staff—that denies hazard pay, that fails to provide adequate protective equipment—also contributes to her hesitancy. “I do wonder if it’s a money thing,” she told me. “These are big companies trying to force these products on everyone. You have to wonder, Are they doing it for us or are they just trying to make money?”

Destiny Hankins, a licensed practical nurse from Tennessee, currently working in Ohio, shares these concerns. “Sometimes, it feels like no one cares about us,” she said. “I’ve worked in places where pretty much the whole staff walked out because the facility lied to us. They said there was no COVID when there was. They didn’t give us P.P.E. They didn’t have the decency to be straight with us.” During the pandemic, Hankins has been sleeping in her garage to avoid infecting her twelve-year-old daughter, who has epilepsy, and her fiancé, who has an autoimmune condition. She told me that she’s managed to stay safe by adhering to a mantra she’s dubbed the “three ‘P’s”: prayer, precautions, and P.P.E. When the vaccines first became available, she decided that she didn’t want to get immunized. She thought that the vaccines might contain live virus, which would pose a threat to her family; she saw a video of a woman who, after receiving the vaccine, claimed that she was unable to move properly. She heard from some colleagues and acquaintances that the vaccine contained microchips. Eventually, she learned more, and decided that she wanted the shot. But because she works part time at several facilities, and full time at none, she hasn’t been able to get one.

Despite confronting the damage of COVID-19 firsthand—and doing work that puts them and their families at high risk—health-care workers express similar levels of vaccine hesitancy as people in the general population. Recent surveys suggest that, over all, around a third of health-care workers are reluctant to get vaccinated against COVID-19. (Around one in five Americans say they probably or definitely won’t get vaccinated; nationwide, hesitancy is more common among Republicans, rural residents, and people of color.) The rates are higher in certain regions, professions, and racial groups. Black health-care workers, for instance, are more likely to have tested positive for the virus, but less likely to want a vaccine. (Thirty-five per cent turned down a first dose.) Compared with doctors and nurses, other health professionals—E.M.T.s, home health aides, therapists—are generally less likely to say that they’ll get immunized, and a recent survey of C.N.A.s found that nearly three-quarters were hesitant to get the vaccine.

At Yale-New Haven hospital, ninety per cent of medical residents chose to get the vaccine immediately, but only forty-two per cent of workers in environmental services and thirty-three per cent of food-service workers did. The problem may be most pressing in nursing homes. In December, the governor of Ohio, Mike DeWine, said that sixty per cent of the state’s nursing-home staff had declined the vaccine; in North Carolina, the number is estimated to be more than fifty per cent. According to the C.E.O. of PruittHealth—an organization that runs about a hundred long-term-care facilities across the South—seventy per cent of employees in those facilities declined the first dose.

This hesitancy is less outright rejection than cautious skepticism. It’s driven by suspicions about the evidence supporting the new vaccines and about the motives of those endorsing them. The astonishing speed of vaccine development has made science a victim of its own success: after being told that it takes years, if not decades, to develop vaccines, many health-care workers are reluctant to accept one that sprinted from conception to injection in less than eleven months. They simply want to wait—to see longer-term safety data, or at least to find out how their colleagues fare after inoculation.

Another major hurdle is mistrust of both the political and the health-care systems. The problem is most acute in historically marginalized communities, which already live with racial disparities in life expectancy, maternal mortality, access to medical care, representation in clinical trials, informed consent, the physician workforce, and COVID-19 outcomes. And it’s exacerbated among health-care workers who are underappreciated and poorly paid. “In many cases, vaccine hesitancy is not a lack-of-information problem. It’s a lack-of-trust problem,” David Grabowski, a professor of health-care policy at Harvard, told me. “Staff doesn’t trust leadership. They have a real skepticism of government. They haven’t gotten hazard pay. They haven’t gotten P.P.E. They haven’t gotten respect. Should we be surprised that they’re skeptical of something that feels like it’s being forced on them?”

Health-care leaders have resorted to various carrots and sticks to get their employees vaccinated. Given the newness of the vaccines and the lack of long-term safety data, most employers have opted to encourage—not mandate—vaccination; some have offered cash bonuses, days off, even Waffle House gift certificates. (“If that doesn’t get you in line, I don’t know what will,” the governor of Georgia, Brian Kemp, said.) But officials at some organizations have started mandating vaccination. (The law generally allows companies to pursue compulsory vaccination, and recently the U.S. Equal Employment Opportunity Commission signalled that employers might begin requiring it for the coronavirus.) “I have very mixed feelings about mandates,” Grabowski said. “I see this a lot on Twitter: just mandate the vaccine and good riddance. Putting the ethical issues aside, the people who say that have no understanding of the labor market here. It’s a very fluid workforce. A number of employees would just say, ‘No, thanks,’ and nursing homes would be even more understaffed than they already are. That’s a very dangerous place to be.”

Relative to the staff, nursing-home residents have very high levels of vaccine acceptance—above ninety per cent in many places. This is good news, considering the devastation that COVID-19 has visited upon these facilities. So far, nursing homes and long-term-care facilities have accounted for some hundred and forty thousand COVID-19 deaths—forty per cent of the total U.S. death toll, though these facilities represent only five per cent of the country’s cases. But, even in nursing homes, vaccination efforts have not proceeded with the requisite urgency. In the month after the vaccines were released, less than a quarter of the doses made available for nursing homes were administered; even today, nearly a quarter of residents of long-term-care facilities have not received their first dose of a vaccine, according to the C.D.C.

In most states, CVS and Walgreens, in partnership with the federal government, are responsible for vaccinating people in long-term-care facilities. The federal government sends vaccines to the states, which allocate doses to nursing homes; teams from the pharmacy giants then visit the facilities on pre-specified days. In mid-December, Alex Azar, the head of Health and Human Services in the Trump Administration, suggested that all nursing-home residents could have their first dose by Christmas. But, even before Azar spoke, many states had informed the C.D.C. that their programs responsible for nursing-home vaccinations wouldn’t be active until at least December 28th. Four weeks later, some facilities are still waiting for their first appointment.

“It’s worth saying that this was never going to be easy,” Grabowski told me. “Given the number of facilities and the population you’re dealing with, it was always going to be an operations and logistics nightmare. You can’t just set up a drive-through or bring people to Dodger Stadium en masse. You have to go to every facility, make sure every resident has a chance to get vaccinated—that requires very high levels of management and coördination.” The speed of vaccinations has been further complicated by what some believe is unnecessary paperwork, including, for example, gaining written consent from residents, many of whom have dementia or other cognitive deficits. Large pharmacies also don’t have established relationships with care facilities and cannot use nursing-home staff to help administer the vaccines. “If you talk to them, I think they’d tell you that things are actually proceeding according to schedule,” Grabowski said. “It’s just a slow schedule.”

Some states have opted out of the program. West Virginia has relied on local pharmacies, in addition to the big chains, to administer vaccines; by the end of December, the state had the highest nursing-home-vaccination rate in the country—all two hundred and fourteen facilities had been offered the vaccine, and more than eighty per cent of residents in two hundred homes had received their first dose. Nationwide, each CVS or Walgreens is responsible for vaccinating around twenty-five nursing homes; in West Virginia, there are more pharmacies than nursing homes participating in the vaccination program. Many nursing-home residents in West Virginia received their second dose before those in other states got their first.

Kimberly Delbo has been the director of nursing services and innovation at an assisted-living facility in central Pennsylvania for three years. Delbo takes great pride in the culture that she’s helped create. “We’re a small, tight-knit family,” Delbo told me. “The most important thing we can do as an organization is make sure people know that we truly care about them.” In an industry where a fifty-per-cent annual staff-turnover rate is not uncommon, Delbo’s facility did not lose a single employee in 2019; last year, it had a ninety-per-cent retention rate. During the pandemic, employees have had access not only to adequate protective gear but also to what she calls the “health-care heroes’ room,” complete with a massage chair, aromatherapy, antioxidant drinks, and fresh fruits and vegetables. “They work hard,” she said. “They deserve a tranquil environment.

Around Thanksgiving, the facility had a coronavirus outbreak in which nearly one in seven residents and half of the staff were infected. One woman—a C.N.A. for more than forty years—contracted the coronavirus and lost her husband and her father within the same month. “She still came back to work,” Delbo said. “She said, ‘This is what I’m made for.’ When you see that kind of resilience, it’s truly humbling. You think, These are the real heroes.” To manage the staff shortage, Delbo lengthened shifts from eight to twelve hours, and reached out to contacts in the state’s health department to arrange emergency staffing. Her son, also a nurse, took time away from his regular job to help out. “It sounds bad—and it was—but, compared to some other facilities, we were relatively spared,” Delbo said.

In early December, Delbo was told that her facility would be vaccinated by the end of the month. As the New Year approached, however, the projected date was revised to mid-January. She sent some staff members to a local hospital to see if they could get immunized; it wasn’t until January 23rd that the pharmacy team finally delivered the first doses to her facility. “The vaccine-distribution process has been very discouraging,” she told me. “It was presented one way on paper but turned out to be completely different in reality.” The residents at her facility are aged seventy-eight to a hundred and eight. “You would think this is a priority population,” she said. “We were like sitting ducks, just praying we could dodge the bullet of another outbreak. We were watching as the general public started getting vaccines, and we were still waiting.”

Like staff at nursing homes across the country, those at Delbo’s facility are split on whether to get vaccinated. “I have a staff member who’s been with us for twenty years and said, ‘Can I be the first person to get it?’ ” Delbo said. “But others are very unsure about it. They ask me, ‘Kim, what do you think about this vaccine? Is it safe?’ ” Delbo has made educating residents and staff a central priority. “We’ve been very proactive about building confidence in it, about getting them the facts, about debunking conspiracy theories and social-media myths,” she said. “We can engage in this dialogue because they trust us. I think what’s important for people to understand is that you don’t build trust in a day and you don’t build it for a specific purpose. We’ve been investing in trust for years. We were doing this before the pandemic, and we’ll do it after.”
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