By Nikolaos Kyriakou, firstname.lastname@example.org
As Buncombe County’s waiting list for the COVID-19 vaccine reaches over 54,000 hopeful recipients (and growing), many local health care professionals can skip the line and receive the two-shot series through their employers. Yet despite their elevated risk of contracting the coronavirus, many of those workers have not taken the first dose.
Area hospitals and care facilities report that a sizable percentage of their workforces are holding off or refusing the vaccine, citing concerns that include the short timeline for the futuristic drug’s development, possible adverse reactions, specific medical conditions including allergies and other autoimmune diseases and a lack of data on the long-term effects of the shots.
Xpress reached out to learn more about those workers’ concerns, as well as the thoughts of those who had chosen to go ahead with the shots.
“I feel like I don’t want to be a guinea pig,” says Charlie Dewberry, a certified nursing assistant with over 15 years of experience who works at AdventHealth Home Care in Asheville.
Dewberry says she refused the vaccine primarily due to the lightning-speed approval process. “Normally it takes years to produce a vaccine, and they came up with this one in less than a year.”
Tonya Blackwell, a registered nurse in a physician’s office affiliated with Mission Health, agrees.
“There’s still too much of an unknown, and people need to discuss it with their physician to know whether or not the ingredients are safe,” says Blackwell; she adds that her neurologist advised her not to get the vaccine due to regular migraines.
Both nurses estimate that half or more of the people they work with also refused the vaccine.
A federal Centers for Disease Control and Prevention study released last month found that only 38% of staff members at 11,000 long-term care facilities nationwide had received the COVID vaccine.
Natasha Clabern, an X-ray technician who works for a Mission Health contractor, says that half of the 35 or so people in her office said “no way” to the vaccine. Their primary concern was the lack of studies on the jab, she says: “It may not be safe. We don’t know the long-term effects of any of this.”
Clabern has received both doses but she says she was “scared” to get the vaccine.
“There is definitely a divide in our workspace. The people who decided not to get it definitely had strong feelings about not getting it, which I respect 100%. It’s your choice right now,” Clabern notes.
In December, the U.S. Food and Drug Administration granted the Pfizer-BioNTech and Moderna vaccines emergency use authorization, making the vaccines widely available. And on Feb. 27, the administration granted the same authorization to the single-shot Janssen COVID-19 (Johnson & Johnson) vaccine for people 18 and older. The drugs, however, remain in an experimental or trial phase and have not yet been proven to stop COVID infection or transmission, though they have demonstrated effectiveness in reducing the severity of symptoms.
In one of the first real-world studies to look at the impact of COVID-19 immunizations across an entire nation, an analysis of Scotland’s program released on Feb. 22 showed that receiving one dose of the Pfizer vaccine was associated with an 85% decrease in the risk of hospitalization from the illness. Those results have not yet gone through the peer-review process. A study released Feb. 26 on the use of the Pfizer vaccine in Israel, which had vaccinated over 84% of its population aged 70 and older, showed a significant decline in the severity of COVID-19 cases post-vaccination compared to the months prior to the vaccine’s availability.
The drugs use messenger RNA technology, which has been studied for decades but hasn’t yet been licensed to protect against an infectious disease. According to the CDC, “Interest has grown in these vaccines because they can be developed in a laboratory using readily available materials. This means the process can be standardized and scaled up, making vaccine development faster than traditional methods of making vaccines.”
Nationwide, hesitance to take the vaccine has receded in recent months, but a January survey by Kaiser Family Foundation found that 51% of Americans still want to see more proof the vaccines are effective before rolling up their sleeves.
As of late February, over 45 million people, representing about 13% of the total United States population, had received at least one dose of the COVID vaccine. About 20 million, or 6% of the population, had received both doses, according to the CDC. As of Feb. 25, over 2.3 million doses had been administered in North Carolina, according to the state Department of Health and Human Services, while nearly 13% of Buncombe County’s population had received at least one dose of the vaccine by Feb. 26.
Rusty Ginn, an RN and owner of Asheville Home Health, a small in-home care provider, says about half of his employees have received the first vaccine. Ginn says he wants his employees vaccinated but doesn’t tell them the vaccine is safe because “we don’t know if the vaccine is safe or not; we just have to trust that it is.”
Ginn says some of his employees were deterred from receiving the shot after one of their co-workers, a woman in her 20s, went into seizures and was hospitalized post-vaccination.
“We have our own horror story, which shakes people up, so I’m not telling people one way or another. I feel we’re all in the same boat with this,” Ginn says, adding that the woman has recovered and returned to work.
“There are nurses that believe coronavirus is man-made and that the vaccine is going to be maybe even more harmful than good, which is a strange thing to hear from a health care worker. Those people are not going to take the vaccine,” he muses. “I don’t think health care workers are different than anyone else insofar as their fears go.”
Another reason staff members resist the vaccine is that “they themselves are young and healthy so they might not have that personal concern that someone in another age group may have and they see their peers getting coronavirus and surviving,” Ginn adds.
Vickie White, physical therapist in a local hospital neighboring Buncombe County (she declined to say which one), was initially reluctant to get the vaccine due to allergies and asthma. And the newness of the drug made her nervous as well. “I’ve never been one to do anything new. When you change model of cars, you wait a couple years and wait for them to get the kinks worked out,” she notes.
But after talking to her doctor, White decided to go ahead. She had a slight headache after the first shot.
“The second shot was a little worse,” White says. “There was a decent amount of fatigue, and I did have a migraine. And I haven’t had a migraine for 15 years, and it really threw me for a loop. It was two full days before I felt like myself again.”
Nevertheless, White is glad she got the vaccine, as now she feels she and her husband are better protected since she is regularly exposed to COVID-positive patients.
Clabern says she felt fatigue and headaches the day after getting the first dose. Having previously had a COVID infection, however, she found the illness far worse.
“Compared with having COVID, the vaccine was nothing. I got lucky. Half of my co-workers who had the vaccine got sick for 24 hours afterwards with fever, chills and other symptoms. They had to call out sick the next day because they were required to not have a fever after 24 hours, although not to the point of being hospitalized.”
Clabern has not seen severe reactions to the vaccine among her patients.
“Most of our patients have a lot of comorbidities, and I think they’re valid in being scared of [the vaccine]. But most of the elderly that have taken the vaccine have been fine so far. I haven’t heard of any horrible adverse reactions yet, but that could change.”
On Feb. 19, the CDC released results from its monitoring of the new vaccine Dec. 14 to Jan. 13. During that period, “There were 4.5 cases of anaphylaxis per 1 million doses given during this time — a rate similar to what we’ve seen in other commonly used vaccines,” said Dr. Rochelle Walensky, CDC director. She also noted that 34% of vaccine recipients reported fatigue and 30% a headache after receiving the shot.
Amy Waters, a pediatric intensive care unit nurse at Mission Hospital in Asheville and a leader in the newly formed local chapter of National Nurses United, has received both doses. Despite being down for a couple of days with flu-like symptoms, she remains an enthusiastic advocate for the vaccine.
“I’m a strong believer in vaccines,” Waters says. “If I can personally get a vaccine to keep a child from being critically ill or dying, I will take it.”
While initially she was concerned that the vaccine development had been rushed, “Not having spoken personally to any medical professional who is against the vaccine, I can’t see why people would be against it. I feel like people who have a strong science background would feel it’s a good thing.”
In recent weeks experts have recommended people continue to practice hand-washing, mask wearing and social distancing even after being vaccinated. Yet some nurses, Waters says, only got the vaccine because they wanted life to go back to normal.
Only 56% of staff at Mission Hospital in Asheville had been vaccinated as of mid-February, not including those who may have been vaccinated outside the hospital, according to Nancy Lindell, spokesperson for Mission Health and parent company HCA Healthcare.
Marty Bowser, a spokesperson for Rutherford Regional Health System in Rutherford County, says about 400 of 600 staff members have been vaccinated in-house. Bowser also could not provide data on whether the other 200 staff members had been vaccinated outside the hospital.
As of Feb. 4, Dr. David Ellis, chief medical officer at Hendersonville’s Pardee UNC Health Care, said, “Right at 70% of our employees have been vaccinated. You’ll never get 100%, and I don’t think any of us going into this exactly knew what we would get.” Dr. William McLean of Deerfield Episcopal Retirement Community attributes his organization’s success at achieving a similar 70% vaccination rate among its staff to “a coordinated, significant push through education and sitting down and talking with folks about their concerns.”
Jeff Horton, executive director of the N.C. Senior Living Association, points out that some of the language used by federal agencies may have contributed to concerns among health care staffers about the safety of the vaccine.
“There is caution in that it was fast-tracked and rushed through and there hasn’t been time to know all the side effects and long-term issues,” Horton says. “People with the state have even said the term ‘Operation Warp Speed’ had possibly not been conducive to take it because it gives the impression it was rushed through and may not be safe.”
Both Horton and Deerfield’s McLean add that some female employees — who make up a significant percentage of the direct-care industry’s workforce — are worried about potential effects on fertility or future pregnancies. “I think that’s understandable,” says Horton.
Finding the balance
While AdventHealth Hendersonville Chief Medical Officer Dr. Teresa Herbert didn’t provide specific numbers of vaccinated employees, she says that the process of answering staff members’ questions and reminding them of the availability of the vaccine is ongoing.
“We are now asking people who did not respond at all in the first round of emails to either accept or decline and then we’ll have a better idea of true decline versus ‘I might get it next week,’” she says. “The email says, ‘If you don’t want the vaccine, please decline,’ and I tell them on the regular calls, ‘Go ahead and decline if you don’t want it.’”
Until COVID-19 vaccines have received the full, nonemergency approval of federal regulators, health care institutions are unlikely to require their employees to take them. While opinions differ about whether employers can mandate an emergency-use medication as a condition of employment, few local companies seem inclined to force the issue.
In the long-term care industry, McLean and Horton point out, employers must balance the challenges of filling low-wage, difficult jobs with protecting residents from COVID-19. “If you only have 50% of your staff that will accept vaccination in these positions that are a labor of love as it is,” McLean explains, “they could be lured away by jobs that pay more or pay the same but are easier work.”
For now, a significant portion of area medical workers are opting to wait to take their shot or rejecting the coronavirus vaccination altogether.
With additional reporting by Kay West
Editor’s note: This story has been updated from the version that ran in our print edition to correct the spelling of Tonya Blackwell’s name.