It was a devastating autumn for residents and staff of Oak Meadows Senior Living. Over a two-week period in November, 10 residents of the assisted-living complex in Oakdale died suddenly from COVID-19 and 31 residents and workers fell ill from the virus.
After witnessing the horror of people gasping for air and dying, administrator Deborah Veit expected front-line workers to leap at the opportunity to be inoculated against the deadly virus when vaccines finally arrived at the facility this week. Instead, nearly half the 75 staff members who care for residents at Oak Meadows are refusing the shots out of fear of side effects and distrust in the vaccine's efficacy. "After all that we've been through, I was blown away that staff wouldn't want [the vaccine]," said Veit, executive director of Oak Meadows, which no longer has active coronavirus infections. "There's too much fear of the unknown."
Across Minnesota, senior homes and public health officials are facing an unexpected obstacle in their efforts to roll out the coronavirus vaccines and stem the relentless tide of infections: resistance from front-line workers who have witnessed the virus' deadly toll.
Long-term care facilities are reporting that 30 to 60% of their employees are refusing to take the initial doses of vaccines that were developed at record speed. Many workers are reluctant to be vaccinated until they see more evidence that people aren't suffering serious side effects and the shots are working, say the providers.
Senior home administrators said some front-line workers are convinced that the vaccines were rushed without rigorous testing. Many have read news reports of rare incidents in which people have suffered dangerous reactions, administrators say. Others are reacting to misinformation online, including unsubstantiated reports that the vaccines cause fertility problems or alter a person's genetic makeup.
Alarmed by the skepticism, some long-term care providers have started to turn up the pressure on employees by requiring them to accept the vaccinations as a condition of their employment or by screening out job candidates who aren't willing to take the shots. Other senior care facilities have begun offering gift cards, free meals and other incentives to get workers to roll up their sleeves, according to Care Providers of Minnesota, a long-term care industry group.
The surprising pushback threatens to disrupt state efforts to vaccinate 500,000 health care workers and long-term care residents by month's end. Front-line staff in long-term care facilities are a top priority because of their exposure to the virus and their critical role of preventing more infections among older adults, who are especially susceptible to dying from the respiratory illness. So far, 64% of the 5,817 COVID-19 deaths in Minnesota have occurred in long-term care communities, including 23 of the 43 fatalities reported Wednesday, state records show.
The phenomenon of elderly residents enthusiastically embracing the vaccines — while their younger and often healthier caregivers are apprehensive — has played out across the state.
Michelle Smith, a registered nurse from Rochester who works at a skilled nursing home, said she is refusing to get the shots until she sees how the vaccines perform and whether people suffer severe reactions. She was troubled by a widely publicized report of a Florida doctor who died from a severe blood disorder after receiving the vaccine, and by online reports of people suffering strokes after getting the shots, she said.
"I feel like health care workers are being used as guinea pigs for a vaccine that was rushed to pacify a scared public," she said. "It didn't seem to go through the proper vetting."
The speedy authorization of the vaccines made by Moderna and Pfizer, which were granted emergency approval by the federal government last month, has fueled worker fears, say facility administrators. Early on, the scientific community was concerned that the massive vaccine development program, dubbed "Operation Warp Speed," was being pushed along for political reasons.
"I heard one staff [member] say to me, 'Other vaccines have taken four years to develop and this took 10 months, so how can this possibly be OK?' " Veit said.
To counter misinformation online and persuade more workers to embrace the vaccines, nursing home and assisted-living administrators are posting photos on social media of workers getting the shots, as well as handing out fliers highlighting the safety of the vaccines and the low rate of serious side effects. Federal health authorities last week reported just 29 cases of a severe allergic reaction, known as anaphylaxis; and none of those cases were fatal.
Dustin Lee, president and CEO of Prairie Senior Cottages, which operates seven memory care and assisted-living homes in Minnesota, said that 58 of his 141 front-line staff refused to take initial shots of the vaccine when it arrived this week. Lee said Prairie Senior Cottages has begun asking every new applicant their views on being vaccinated as part of the hiring process. Those opposed to getting the shots are not hired.
"From my perspective, we are failing," Lee said of the low acceptance rate. "Until we get to 85% [acceptance], we won't be able to get our lives back ... We won't be able to go to concerts and hop on airplanes and return to living without fear."
Facility administrators noted that many workers who were hesitant to get shots during the first round of vaccinations are likely to embrace shots in coming weeks as they see that people are not suffering side effects.
Both the Pfizer and Moderna vaccines come in two doses that are administered three to four weeks apart. Many workers who passed on the first shots have already indicated they would get the vaccine later, administrators said.
In Minnesota, vaccinations of the 83,000 residents in the state's 2,100 senior care facilities were largely relegated to the large pharmacy chains, CVS Health and Walgreens, and the effort has gotten off to a slower start than many had hoped.
Senior communities across the state have been escalating their campaigns to persuade workers to accept the vaccines.
Volunteers of America, a nonprofit that owns and operates 14 long-term care facilities in Minnesota, has been erecting posters of workers who have gotten the shots along with simple descriptions of why — such as, "My mom told me to!"
The nonprofit also has been holding educational webinars on the vaccines and posting images on Facebook of workers getting the shots. So far, about half of Volunteer of America's roughly 900 senior care staff in Minnesota have agreed to the vaccinations, while the acceptance rate has been far higher, 85%, among its senior residents.
There have been no serious side effects among Volunteer of America's staff who have gotten the shots. Even so, concern about health effects is the predominant reason why some workers have been reluctant to participate, said Jacci Nickell, senior vice president health care operations at Volunteers of America.
"It was so frequently in the media and the message was loud and clear, that there are side effects to the medication — and it's just such an unknown," she said.
Despite worker apprehension, the mood was celebratory when residents at the Oak Meadows senior home began receiving their first shots early Thursday. A 101-year-old male resident let out a loud, "Whoop-whoop!" as he was wheeled up to get the vaccine.
Veit said years of misinformation about vaccines — as well as differences in attitudes between generations — could explain the disparate reactions. Unlike younger caregivers, many older residents of senior communities have lived through infectious disease outbreaks and are more comfortable with vaccines, she noted. So far, all 130 seniors who live at Oak Meadows have agreed to be vaccinated, she said.
"I wonder if age and maturity and longevity have given them wisdom," Veit said of the older residents. "A lot of our tenants are in their 80s and 90s and they've been through other vaccinations and other wars. ... They saw the benefits in vaccinations and so they don't question it as much whereas younger people haven't been through something like this."
Chris Serres • 612-673-4308