Why don't more health care workers take virus vaccines?

Front-line health care workers were the first in line when COVID-19 shots became available in December, but polling shows medical professionals can be vaccine-hesitant, too, leaving some with concerns about the vaccines to question whether health care professionals know something the rest of us don't.

As of early March, 52 percent of front-line health care workers reported having received at least one dose of a COVID-19 vaccine, and 42 percent said they had received both doses - meaning half of front-line health care staff remained unvaccinated at the time, according to a survey of front-line health care workers conducted by the Washington Post and Kaiser Family Foundation in April.

A separate survey of 160 rural hospital leaders conducted by the Chartis Center for Rural Health between March 12 and April 15 found nearly half of the respondents reported 21-50 percent of their staff had decided not to get a COVID-19 vaccine.

"When asked why health care personnel are declining a COVID vaccine, a majority of respondents - 44 percent - cited 'Matter of Personal Choice,'" according to the survey, which was reported in the industry publication Fierce Healthcare.

"Another 31 percent reported a lack of trust in vaccines," according to the article in Fierce Healthcare.

The sentiments are shared by some health care professionals locally, as hospitals in Jefferson City continue efforts to vaccinate staffs against COVID-19.

"Across the SSM Health system, SSM Health currently has 72.5 percent of its employees fully vaccinated," said Jessica Royston, St. Mary's Hospital spokeswoman. "We have also received a few hundred medical/religious waiver submissions, which are being reviewed and evaluated now.

"We believe the vaccine is the best way to prevent serious illness or hospitalization from COVID-19 and strongly encourage everyone who is eligible to get a vaccination as soon as possible," Royston said.

"The concerns of health care workers to receive a COVID-19 vaccine mirror the concerns of many people outside of health care," said Lindsey Huhman, spokeswoman for Capital Region Medical Center. "As an organization, we are strongly encouraging everyone eligible, including our employees, to get the vaccine."

She said their approach to the situation is to provide evidence and education the vaccine is safe and effective.

"We are working with our health care workers who are hesitant to get the vaccine one on one to answer their questions and address their concerns," she said. "And our efforts are working. This week, we were able to get the vaccine into arms of more employees and efforts will continue."

If COVID-19 vaccines are so great, why don't more health care workers take them?

Health care workers can experience the same drivers of vaccine hesitancy as the general population, and many of the vaccination trends among medical staff mirror disparities found in vaccination rates across the country.

The type of setting where medical staff go to work, their education, political beliefs, religious beliefs, where they live and their race and ethnicity can all factor into their decision to get vaccinated.

An ongoing research project from the Kaiser Family Foundation tracks the evolving public attitudes toward COVID-19 vaccinations. According to the foundation's research, unvaccinated adults are usually younger, people of color, Republican-leaning and less-educated.

"But unvaccinated isn't an entirely uniform group, with significant differences by intention," the report states. "Adults who want to 'wait and see' before getting vaccinated are more likely to be young and people of color, while those in the 'definitely not' group are more significantly Republican-leaning and in rural areas."

Dr. Matthew Kodsi, vice president of medical affairs at CHI Memorial Hospital in Chattanooga, Tennessee, said like all people, health care workers are not immune from what's happening in the community at large.

"We've (CHI Memorial) done a lot of the community vaccination events, and we've seen our numbers go down from when we did 2,000 in one day back in March. And now, if we can do 20 at a time, we're jumping up and down with excitement," Kodsi said. "So it's just everyone has these concerns that are unfortunately, in many cases, due to misinformation."

One of the biggest concerns he said he's heard among women - which comprise 76 percent of the health care workforce, according to the U.S. Census - is the fear vaccines will cause infertility, "which has no scientific foundation."

"People might say, 'Well, you don't know. We haven't followed it for 10 years,'" he said. "True, I'm not going to say that we have long data. But what we have is science that says there is no medical reason to expect that that would happen. And there is data looking at people who are pregnant - tens of thousands of people who are pregnant who've been vaccinated, or more - and it shows no increased risk of miscarriage. So, there's no reason to believe that that's a risk."

Dr. Rupali Limaye, who is an associate scientist at Johns Hopkins Bloomberg School of Public Health, said vaccine hesitancy in the African American community is "not only due to historical perception of medical experimentation but also current racism and discrimination. And then there's also issues related to the vaccine product itself. Is the vaccine safe for Black people? Is it safe for individuals that might have diabetes, et cetera?"

In the poll by the Washington Post and Kaiser Family Foundation, 39 percent of Black front-line health care workers and 44 percent of Hispanic front-line health care workers reported receiving a COVID-19 vaccine as of early March, compared to 57 percent of white health care workers.

In the general population and in health care, education is one of the strongest predictors of vaccine acceptance.

Workers involved in diagnosing and treating patients, such as doctors and nurses, were the most likely to be vaccinated, according to the poll, with 68 percent reporting having received at least one shot compared to those who assist with patient care, such as bathing, eating, cleaning, exercising and housekeeping. In the pool, 37 percent of people who assisted in care were vaccinated.

Staff working in hospitals and outpatient clinics reported the highest rates of vaccination as of early March, with 66 percent and 64 percent, respectively, saying they'd received a shot. But rates were lower among doctors' office staff (52 percent) and nursing homes or assisted care facilities (50 percent).

One in four (26 percent) home health care workers - a job that requires no formal educational credential and pays around $10-$12 per hour - reported getting a vaccine.

Kodsi said the hospital is continuing to educate staff and the public about vaccine safety, and often the best tool to overcome hesitancy is an individual conversation with a person. He recalled talking to a group of people at a recent vaccine event who were debating whether to get vaccinated.

"We had a really good conversation. It took us about 10 or 15 minutes, and they then felt comfortable getting the vaccine and did," Kodsi said. "The most important thing we as a system and a community and health care workers can do is to make sure that everyone who makes the decision about whether or not to receive the vaccine is making that decision with as much accurate information.

"We don't want people to feel like we're just going to tell them they've got to get it," he said. "We want to respect their concerns, address their concerns, make sure they've got the information they need so that they can make the decision that really is the best for them."

Elizabeth Fite with the Chattanooga Times Free Press and News Tribune staff members contributed to this report.