In the last couple of months, scientists have achieved nothing short of a scientific miracle.
COVID-19 vaccines were developed, authorized for emergency use, and shipped across the country about three years faster than the record-holding mumps vaccine. Still, there is a question gnawing at the minds of public health officials – how many people will actually take the vaccine?
New Hampshire is now undergoing its first test of vaccine compliance in hospitals and nursing homes across the state, as the first recipients decide whether to get the shot.
According to a December poll from the University of New Hampshire, 61% of Granite Staters will almost certainly or probably get the vaccine when it becomes available to them. This poll was more optimistic than previous polls from UNH, which found only 40% planned on receiving the vaccine, but still left a sizable portion of the state’s population who would probably not or certainly not get vaccinated.
At Concord Hospital, most employees have jumped at the opportunity to receive some of the first doses in the state. A quiet minority has harbored hesitations. So far, about 67% of employees who have been offered the opportunity to get vaccinated have signed up for an appointment.
Michael McLeod, the associate chief clinical officer at Concord Hospital, said that statistic doesn’t necessarily mean a third of his staff don’t want the vaccine. McLeod said there are a number of factors that can explain why some aren’t signing up for vaccine appointments. Some might be dually employed at a nursing home or ambulance service that will provide their vaccines instead. Others might be on vacation or simply missed the notification.
McLeod said it’s also possible there are hesitancies about receiving the vaccines so early in the distribution process. To handle the latter, he said the hospital is working to answer staff’s questions and fill in any knowledge gaps about the vaccine.
Some, he admitted, will be a lost cause.
“If we look at the flu shot as a marker, there are always folks who have never gotten a flu shot and don’t plan on getting them,” he said. “We’ll likely see the same with COVID.”
However, he expects that as hesitant staff members watch their friends and family become vaccinated, many will change their minds.
As long as the vaccines are authorized by the FDA for emergency use, a classification that requires less evidence than is typically required for full approval, Concord Hospital will not make it mandatory for staff, McLeod said. If they are fully approved later on, McLeod said there is likely a path for mandatory vaccination.
The Equal Employment Opportunity Commission has signaled employers can legally require staff to take the COVID-19 vaccine, with some notable exceptions – those with certain medical conditions or religious beliefs may be granted an exception.
Brendan Williams, the president of the New Hampshire Health Care Association, prefers a gentler approach to vaccination.
“We really want people to come to the vaccine,” he said.
Lynda Goldthwaite, the administrator at Pleasant View Center in Concord, fears mandating the vaccine would politicize the decision and stoke resistance. So far, her staff and residents have been excited about getting a shot.
After watching nursing homes across the state experience devastating outbreaks, she said she thinks her staff understands the gravity of what’s at stake. Residents understand their decision could be the difference between life and death.
Other nursing homes have had a harder time convincing their staff. Based on conversations Williams had with nursing home administrators, he estimates about a third of staff eligible for the vaccine have declined the opportunity.
U.S health officials have warned that as the virus becomes more contagious, 70% to 90% of the population might need to be vaccinated in order to achieve herd immunity.
“I think we’ll get there,” he said. “There’s just a weariness because it’s unknown and there’s stuff on social media that’s misleading. There’s just a lot of static that’s not helpful.”
This is, at least in part, because the federal government hasn’t done enough to promote education and acceptance of the vaccine, Williams said. This type of messaging is crucial during the first phase of distribution while the public is watching health care providers for reassurance, he said.
“The general public is going to take its cues from what happens in the first stage,” he said. “If they see even healthcare providers aren’t trusting the vaccine, that’s going to be a problem.”
Williams thinks vaccination of nursing homes will likely have to happen in multiple phases, as staff and residents become more confident in the shots. He suspects nursing homes will handle those who still opt-out of the COVID-19 vaccine the same way they handled those who opted out of the flu shot in past years — those without shots will be required to wear additional personal protective equipment while in the facility.
Finding people to vaccinate at Concord Hospital is far from a problem right now, McLeod said. More than a thousand doses were allocated to the hospital – by the end of the week, all of them will have been administered.
The shots can’t come soon enough for many who work at the hospital, which has recently been inundated with COVID-19 patients. On one day in late December, the hospital saw more than 40 COVID-19 patients and McLeod isn’t optimistic about the hospital’s post-Christmas future. By some estimates, the hospital’s intensive care unit is at 84% capacity.
“For somebody who doesn’t want it, that’s fine,” McLeod said. “I have so many people who want it right now.”