One-to-one conversations

Administrators at several of the lowest-ranked nursing homes said they are working diligently to boost vaccination rates among staff.

But concerns about the vaccine, including possible side effects, political influence and a lack of information about the long-term effects, have created challenges at some buildings.

Christina Fleming, chief marketing officer for National Health Care Associates, of which the Bloomfield Health Care Center is an affiliate, said some employees across their facilities are hesitant because of fears about infertility, even though the claim has been widely debunked.

“One of the biggest concerns we’re hearing is about pregnancy, fertility and lactation. That being a very big concern,” she said. “And then, of course, the [U.S. Food and Drug Administration] full approval, which we were able to share some updated fact sheets today, now that the Pfizer vaccine has been FDA approved.”

Fleming said nursing home managers are trying to put those fears to rest by conducting one-on-one conversations and educating staff.

“Where we’re seeing a big difference is in the hands-on, one-to-one discussions for questions and concerns,” she said. “That’s a positive thing that’s going to help us.”

Karen Donorfio, a spokeswoman for Apple Rehab, which owns Ledgecrest and Chesterfields, said the company has updated its reporting on vaccination rates and that the two facilities have recorded much higher rates recently. Two days before the state announced its immunization mandate for nursing home workers, Apple Rehab imposed one of its own for staff.

“Apple Health Care and its facilities are facing the same challenges on getting employees vaccinated as local communities throughout the country are having,” she said. “Employees are deciding not to get vaccinated due to medical exceptions, religious exceptions, non-fda approval, fear of long-term effects, personal beliefs, political influence, etc.

“While we have experienced vaccine hesitancy, Apple Rehab has made great strides in staff education and incentives. … We are confident that our staff vaccination percentages will continue to increase.”

Timothy Brown, a spokesman for Athena Health Care Systems, which owns Middlesex Health Care Center, said managers are still trying to increase worker inoculation rates. He estimated that the vaccination rate there has risen since the last data report to about 60%.

“Our medical director, Dr. Jessie Cohen, has been made available to speak with our unvaccinated and provided education and feedback to our staff,” Brown said. “We are working with our staff daily to verify their vaccination status and continue our vaccine education. The governor’s mandate had a significant impact on the uptick in our numbers and those in other centers.”

“We’ve gone to great lengths to educate and advocate for employee vaccinations and also have offered cash incentives and other giveaways,” he added.

Broadly, nursing homes that have struggled with improving their vaccination rates cite misinformation as a reason why they are straggling, health officials said.

“We’ve seen the exact same disparities when it comes to flu vaccinations before COVID. I was someone who pushed very hard to get flu mandates implemented in nursing homes because I knew that there were a lot of outlier facilities that just didn’t have very good flu vaccine” coverage, said Arthur Caplan, professor of bioethics at New York University Langone Health. “We’re seeing a repeat of the same vaccine hesitancy or vaccine hostility, and I think [it’s] because some of the workforce has a lot of misinformation.”

Mandates are effective at increasing vaccination rates but are most successful when they are complemented by an education program, Caplan said, so “it’s not either-or.”

Health officials are also hopeful that the full FDA authorization granted to the Pfizer vaccine this week will convince people on the fence to get vaccinated.

“The licensing is a big step,” Caplan said.