Shunda Whitfield saw the effects of the coronavirus pandemic firsthand. As a certified nurse’s assistant at a long-term care facility in Spanish Lake, she was among the first people in the region to get sick with COVID-19, in April 2020.
Whitfield has a compromised immune system and was severely sick for months. But when the federal government shipped the first doses of COVID-19 vaccine across the country for workers like her, she didn’t sign up for a shot.
“It’s like a tug of war,” she said. “The first thought that I had was that this is happening too fast!”
Hesitancy among health care workers is a huge concern as a new wave of coronavirus cases and hospitalizations sweeps across Missouri. People who work in hospitals and clinics are at higher risk of catching the coronavirus and spreading it to other people. But some area hospitals report as much as one-third of their workforce is still unvaccinated.
Health officials want workers like Whitfield to get the vaccine to keep the virus from spreading.
But Whitfield still had unanswered questions. She was worried the shot would make her sick again.
“Some people are like, there are diseases out here and no cure for them, so how did they come up with one so fast, for this?” she said. “Then you had other people [who said] ‘How do we not know that two years down the line there won’t be a recall?’ You know, we have serious health issues!”
Clinical trials and months of data have shown that the vaccines are safe, effective and important, even for young people and those who have already caught COVID.
But that hasn’t convinced some health care workers. Katreva Hart, a nurse at a St. Louis community health clinic, didn’t think she needed to be vaccinated because she wasn’t directly seeing patients.
“I'm not in the hospital, I do triage nursing,” Hart said. “So most of my personal contact is over the phone. So I just didn't feel like I was in a high-risk population.”
Hart isn’t against all vaccines. She gets the flu shot every year.
“I’m just not convinced at this point,” she said. “I still don’t 100% think it’s something I necessarily need.”
One mind at a time
Hart and Whitfield are among nearly 350,000 health care workers in Missouri. Those workers include nurses and doctors, and also home health aides, assistants, lab techs, phlebotomists and pharmacy workers.
Like many other Missourians, their reasons for not wanting to get vaccinated are all over the map.
A four-state study of 3,500 health care workers published late last year in the journal Vaccines found they were mostly concerned that the vaccine was developed too quickly, that it may be unsafe and that they can’t trust the government entities behind it.
The study found that people who made more money and had higher education levels, like doctors, were more likely to want the vaccine. White people and older people also had higher rates of vaccine buy-in.
“Health care workers is a really broad term,” said Dr. Shephali Wulff, the system director of infectious disease at SSM Health. As of the beginning of July, the hospital chain had vaccinated about 70% of its employees, she said.
“Just like we see vaccine hesitancy in the community, the same is true in health care,” she said. “You really can't isolate people from their social and political thinking, even though they work in the health care field.”
Persuading workers comes down to changing one mind at a time, Wulff said. Enlisting lots of different people to address questions — such as having OB-GYNs talk about whether the vaccine is safe for pregnant women — is key.
“As we go into these hospital systems … it really doesn’t matter if 100% of the MDs, the family nurse practitioners and the docs have the vaccine if 20% of those people who are bringing food to each and every room every day to make sure that patients have nutrition are not vaccinated,” Tori Bayless, the CEO of Maryland-based Luminis Health, told the American College of Healthcare Executives this week.
Hospital officials and public health experts shouldn’t bully or judge workers who are afraid to get the shot, she said. They have to address their concerns directly and without judgment.
“It’s not enough to say, ‘We did six webinars, and we send out 400 emails, and how could anyone not know at this point?’” Bayless said. “There’s a reason and if it's your reason, it's a real reason, even if it may not coincide with science or data.”
But Bayless said vaccinations are critical to make sure the virus doesn’t spread more.
Often, people need to hear that their peers and people they trust have been vaccinated before they change their mind, she said.
‘OK, I’m going’
There’s one easy way to get health workers vaccinated: In St. Louis, the four largest health systems announced they would mandate all workers be vaccinated by fall.
Katreva Hart figured her clinic might do so, and that led her to get the Moderna vaccine earlier this summer.
“I just kind of broke and went ahead and got it because we had some extra doses that day,” she said. “And so it was just kind of like a last-minute decision.”
Even though her workplace didn’t mandate it, Shunda Whitfield got the Pfizer vaccine. She decided to do so after talking to lots of people she trusted: the doctors who help her manage her lupus, her friends and even experts her union brought in during telephone conferences.
“I started to research just a little bit more,” she said.
She jotted her questions down and took them to her doctor.
“I said: ‘Look, I don’t understand this. I don’t understand this. You know me, you know what I’m faced with. What’s going on with me and my body?’”
She changed her mind a few times. She made an appointment, then canceled it.
But in late May, something clicked while she was driving past the local library and saw a sign.
“I looked and it said VACCINATION,” Whitfield said. “And it was like, today is the day from 2 to 6. And when I was coming back past, I was like, ‘OK, I’m going.’”
Everything finally came together. Whitfield had the facts she needed, and when she was ready, the opportunity was there in front of her. She went inside, asked more questions to a worker at the vaccination site, who told her that the Moderna and Pfizer vaccines are more than 90% effective but that nothing was guaranteed. She appreciated the honesty. (Moderna and Pfizer vaccines have shown to be up to 95% effective at preventing severe illness due to the coronavirus.)
“I was scared to death, but, but it actually went well,” she said. “I didn't have any side effects.”
Many people in her family, including some who work in health care, still don't want to be vaccinated.
Whitfield thinks they could still change their minds. But it just might take a while.
Follow Sarah on Twitter: @petit_smudge
