The pandemic has taken a deadly toll on A.G. Rhodes Cobb, a nursing home on the outskirts of Atlanta. Twelve residents have died after contracting Covid-19. Forty-four staff members have fallen ill.
But despite their up-close look at the virus's impact, most workers at the facility have been reluctant to get vaccinated. At the three clinics held last month at A.G. Rhodes Cobb and two other facilities in Georgia run by the same company, about 30 percent of staff members chose to get vaccinated, while 57 percent of residents opted in, according to management.
"Some people think if you get the vaccine, you'll get sick. And some are afraid and distrusting of the government," said Sonya Williams, the activities director at A.G. Rhodes Cobb, who was vaccinated in late December. Williams, 42, is now encouraging her hesitant colleagues to do the same — pointing to her own experience as proof that the vaccine is safe. "The faster we can all get it, the faster we'll be able to move forward," she said.
This week, her unvaccinated co-workers will have another chance: When CVS comes back to administer the second shots needed for full protection, vaccinations will also be available for staff members who declined them the first time around.
Nursing homes across the country are facing the same struggle, as workers have been more reluctant than residents to be vaccinated. Though rates vary widely, the American Health Care Association, which represents for-profit nursing homes, estimates that about 50 percent of long-term care staff members have been hesitant to get vaccinated. The majority of direct-care workers in nursing homes are people of color, who have generally been more hesitant to get vaccinated, based in part on their distrust of the federal government and the United States' history of medical racism.
In Utah, 57 percent of long-term care workers have accepted the first dose, compared to 86 percent of residents, according to the state health department. As of early January, only 40 percent of nursing home workers in Ohio had elected to get vaccinated, according to figures cited by Gov. Mike DeWine.
Ahead of the next round of vaccinations, facilities have been brainstorming ways to convince wary staff members — a campaign that's grown urgent as the pandemic has continued to spread unchecked and long-term care residents remain among those most likely to die from the virus.
Last Monday, A.G. Rhodes announced it would offer raffle prizes including bonuses up to $500, TV sets and paid time off to staff members who receive the vaccination. The company is encouraging staff members who have already been inoculated to wear custom T-shirts advertising the fact. The administration has also held employee town halls to address questions, encouraging staff members to be vaccinated while stressing that it is not mandatory.
"We know those concerns come from a legitimate place and support them in that position," said Mary Newton, a spokeswoman for A.G. Rhodes, who says a number of previously skeptical staff members are now planning to get vaccinated in the second round. "We're trying to dispel some of the myths about the vaccine — it isn't something that just got cobbled together and has really been in the works for a long time."
While they have witnessed the devastation of the virus firsthand, some long-term care workers say their experience on the front lines of the pandemic has only made them skeptical about the vaccine. Every day before she walks into work, Monique Collins, a certified nursing aide in Pennsylvania, has prayed in her car for God to keep her safe. As a contract worker, she is dispatched to nursing homes that are short-staffed — often because there are rampant Covid-19 outbreaks.
She contracted the virus in late December, and it's taken her weeks to recover. Even so, she does not plan to get the vaccination any time soon: She's suspicious of how quickly it was rolled out and how poorly officials and leaders have handled other vital parts of the pandemic response.
"I did not feel that we were treated worthy enough as front-line workers," said Collins, who scrambled to purchase N-95 masks when facilities did not provide them. "Where was the government? Where was everyone? How would it be in my best interest now to listen to them and follow their leadership?"
Nursing homes across the country are enlisting their own staff to help encourage reluctant colleagues and others in the community. In Wisconsin, a nurse who has stage 4 breast cancer was among the first to receive the vaccination during the first clinic at St. Paul Elder Services. "I'm hoping that my story influences other people to receive it and get it, and not be scared to get it," Amanda Metzner, the assistant director of nursing, told a local news station.
The facility is also offering financial incentives: Staff members who receive the full course of vaccination will receive $150, the equivalent of about eight hours' pay on average.
"People responded pretty well to that. I think it helped convince a handful more people at the last minute to say, 'I'm going to do this,'" said Sondra Norder, the president and CEO of St. Paul Elder Services. About 66 percent of the staff and 86 percent of residents were vaccinated in the first round, she said — rates that were higher than in many other facilities.
But there have been unexpected challenges to the facility's vaccination effort as well. Shortly after Norder was vaccinated on Jan. 4, she received test results showing she had contracted the virus — and had to explain to staff that the two events were unrelated. "I think people understand there was no positive link there, but I was a little worried," Norder said.
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Jovonne Harvey, the admissions director at A.G. Rhodes Atlanta, said she was among the skeptics at first.
"I was very unsure about a vaccine that was rolled out so quickly. This is just the eyes of a normal American, not a scientist," she said. "It's hard to make a sound decision when there are all these unknowns."
Harvey, 43, then spoke to doctors who stressed the importance of getting vaccinated — not just to protect themselves, but their families and others around them. "They said, 'If we don't take control over that, we're going to be part of the problem.'"
Harvey, who has three children, also weighed the pros and cons with her husband. "What would our kids do if they lost both of their parents? You're going to take a risk one way or the other." Once she had made up her mind, she wanted to get the vaccination as soon as possible and help convince her colleagues, too. "Our residents aren't going to contract the virus unless it's from us," she said.
She put on the T-shirt that the facility was handing out — emblazoned with "I took the Covid-19 vaccine" — and immediately started fielding questions from her co-workers. Harvey said some staff members were quick to bring up the Tuskegee syphilis study from the mid-20th century, in which poor Black men were experimented on without their consent and left untreated.
Harvey, who is Black, has tried to reassure her colleagues: She pointed out that the same vaccine was given to all staff members and residents, regardless of their race, and the only side effect she experienced was a sore arm. (Side effects like aches, chills and fever are more common after the second dose.)
But she also tried to be open about her initial fears."I wanted to be honest," Harvey said. "And I think it helped to see someone who was just as nervous as they were."
CORRECTION (Jan. 21, 2021, 9:16 a.m. ET): A previous version of this article incorrectly described the bonuses A.G. Rhodes is raffling off to staff members who get vaccinated. The bonuses are paid through employees’ paychecks, not in cash.