On Aug. 25, the Biden administration announced COVID-19 vaccinations would be required for all nursing home workers or facilities would risk the loss of federal funds supporting care. This was a welcome announcement to the families with loved ones in facilities. Unfortunately, this requirement is slow in coming. The promise of protection is no comfort to William Hughes of Pinehurst, who wrote in an op-ed that his wife, Anne, recently succumbed to this disease as a resident of a nursing home. While she was vaccinated, not all her facility caregivers were. Mr. Hughes question for all of us: “What will it take to convince healthcare workers to be vaccinated — and facility owners to require it?”
While most nursing home residents are vaccinated, many members of nursing home staffs still aren’t. Staff vaccination rates did increase noticeably after the Biden administration’s announcement, to just under 70 percent by October, but it varies greatly by facility. Some providers instituted their own mandatory policy and have achieved virtually complete coverage, while others are still waiting. According to AARP, the percentage of nursing homes meeting an industry target of at least three-fourths of staff fully vaccinated was (35%) in mid-September. It’s difficult to explain the wide variability in facility vaccinations, but this is, for the most part, a for-profit industry; we have always had owners with a corporate culture of doing nothing beyond minimum requirements they perceive affects their bottom line.
We know that vaccination in facilities saves lives. A recent North Carolina Department of Health and Human Services report indicates a decrease in cases and severe illness in facilities can be directly attributed to vaccinations for residents and staff. We also know the industry supports required staff vaccination. Adam Sholar, CEO of the North Carolina Health Care Facilities Association said, “We need to go further and faster with increasing our vaccination rates,” and issued a letter in support of facility vaccination requirements.
Staffing shortages and fear that vaccination requirements will promote even more difficulties in both recruitment and retention of direct care workers is generally cited as the reason facilities stop short of imposing their own restrictions. The experience of providers imposing their own mandates or states that already imposed a mandate for health care workers does not support this industry concern. Most workers comply with requirements, particularly in facilities that have a history of support and respect for their workers. And most workers want to keep working, particularly when the requirements they oppose apply equally to everyone.
North Carolina residents and their families are living in fear. Even though they may be fully vaccinated and take every possible precaution, they are likely surrounded by unvaccinated workers. It’s past time for us to step up and issue our own state mandatory vaccination policy for direct care staff including all settings of long-term care, not just nursing homes. Other states have done it.
It’s time we answered Mr. Hughes question and addressed those fears – no more deaths of their own patients should be needed to convince health care workers to be vaccinated. A state, enforceable mandate is what it will take. It won’t save Anne, but it may save the lives of many others currently in care.
William Lamb is board chair of Friends of Residents in Long Term Care in Raleigh.