Many long-term care staffers refused the vaccine. Now they have more infections than residents

FORT LAUDERDALE, Fla. — At Florida’s long-term care facilities, more workers are now infected with COVID-19 than elderly residents, a dramatic shift from earlier in the pandemic.

Despite state and federal attempts to offer vaccinations at all nursing homes and assisted-living centers in the state, 62% of staffers have declined — posing the single biggest threat to the more than 25,000 elderly people in those facilities who are also unvaccinated.

“These are the folks from the beginning that were bringing it in,” said Mary Daniel of Jacksonville, a caregiver and advocate for families of residents. “It’s frustrating. Staff members are choosing not to get the vaccine and it’s the residents who are getting punished because their families are getting locked out again.”

As of April 9, 344 of Florida’s long-term care workers tested positive for COVID, compared to 276 residents. The good news is overall cases are down — only a tenth of what they were in January, according to state data.

But while infections in residents continue to decline, cases among workers have plateaued, or in some instances, begun to tick upward in recent days. These are mostly low-paid workers who are in close contact with elderly residents.

Nursing homes are mandated to test their workers regularly for COVID-19 but assisted living facilities are not. So it’s possible not all cases are reported. Most homes continue to require masks and check the temperatures of staff daily to spot symptomatic workers with COVID before they expose others.

But mandating vaccination is highly controversial.

“Some workers are totally against it,” said Pascal Bergeron, chairman of North Lake Assisted Living in Hollywood and CEO of ALF BOSS, an assisting living resource agency. “They are scared to death of it, and forcing it on them would probably cause some to quit.”

The low vaccination rate is worrisome in workers who care for the group most vulnerable to COVID-19, particularly when some residents did not get vaccinated either. The Agency for Health Care Administration reports that 82% of residents are vaccinated.

Kristen Knapp, communications director for the Florida Health Care Association, which represents nursing homes, said a combination of factors exists for why some of these vulnerable residents still aren’t fully vaccinated: Some are new admissions, others declined as a personal choice or their family declined for them. And some have underlying conditions that put them at risk.

But the effort to inoculate both residents and staff isn’t over, Knapp said.

Industry leaders have set a national goal of getting 75% of the 1.5 million nursing home staffers vaccinated by June 30. In Florida, facility operators say that goal is way too lofty.

Because of staffing shortages, Bergeron said operators face a dilemma: They don’t want to lose workers by mandating the vaccine, nor do they want staffers with COVID in their buildings.

At his Hollywood facility, Bergeron said all but two staff members were vaccinated during federally run clinics in January. Those two staffers ended up getting COVID.

“Before, I would pay staff if they were out sick with COVID. But the ones who got it and were out sick now didn’t get paid. It was their choice not to get vaccinated,” he said.

Some facilities are offering incentives to staffers to get vaccinated.

Southern HealthCare Management, which operates 26 skilled nursing and rehabilitation facilities across Florida, first offered $25 gift cards to persuade workers to get vaccinated, said Thomas O’Neill, vice president of program development. A week ago, in a new “Second Chance At The Shot” campaign, the company also offered two hours of pay if workers got vaccinated on their own time. And it offered prizes of $1,000 to $3,000 to improve employee break rooms at the facilities that hit vaccination goals of at least 65%.

“There was a lot of apprehension in the beginning,” O’Neill said. “But now that they see several weeks have passed … and they see that (vaccinated) people are just normal, there’s more willingness. I think we’re well on our way to reaching our target.”

Darell Butler, 36, a Daytona Beach certified nursing assistant and dietary cook at a pair of nursing homes, said he originally declined the vaccine after months of changing guidance from his employers, the government and the media.

“It seemed like a rush job,” he said.

But in late January, Butler changed his mind — mostly because he didn’t want to risk infecting his family. Now he shares his vaccination experience with co-workers, some of whom have relented and followed his lead. But he doesn’t push those who are against getting the shot after watching many of his peers leave the profession during the pandemic.

“I get it,” he said. “We feel like nobody really cares about us and how we’re doing.”

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