Does COVID-19 Vaccine Hesitancy Start with Healthcare Workers?
By Adeevah Goldstein
December 23rd, 2020 marked the monumental day I received the first dose of the Pfizer COVID-19 vaccine. As a nurse who worked on the front lines during the height of the COVID-19 pandemic, this day was a harbinger of hope. However, this day, for many nurses, was also met with some hesitancy.
The hesitancy shared by the nurses, is the same hesitancy met by many in the general public. Issues include hasty rollout, fear of unknown effects of the vaccine, and general government mistrust. If the very people whom patients turn to for advice, healthcare professionals, are themselves skeptical of the vaccine, they may influence their patientsâ€™ behavior.
To vaccinate high-risk populations, the CDC launched the Partnership for Long-Term Care Program to vaccinate residents and staff members in Long-Term Care Facilities (LTCFs). Within the first month of the rollout, Pfizer distributed 1 million vaccines across 49 states; however, there was a noticeable dip in the percentage of staff members vs. residents vaccinated.
â€œAccording to a survey conducted in October 2020, 37% of nurses stated that they were not confident that a COVID-19 vaccine would be safe and effective.â€ In December 2020, and then again in January 2021, survey updates expressed 28% to 29% hesitancy among healthcare workers to get vaccinated. In November 2020, only 45% of healthcare workers expressed receiving the vaccine with no hesitation, leaving 20% vacillating between the two extremes.
These numbers are abysmal! One would think that first-hand knowledge of the devastation of the COVID-19 disease progression would be enough to convince anyone to receive the vaccine incontrovertibly. Nurses are privileged because they have access to COVID-19 vaccine information and understand the medical jargon regarding the vaccine process and efficacy, making them potential influencers in promoting vaccine coverage.
In an attempt to reveal key influencers in promoting widespread COVID-19 vaccination, CVS health conducted a survey asking different racial and ethnic groups to choose their top influencer from a predetermined list. Influencers included personal doctors, Dr. Anthony Fauci, CDC, FDA, Joe Biden, and celebrity crushes. One’s doctor ranked the highest among all racial and ethnic groups, being the single most critical factor in influencing vaccine adoption. Although nurses are not doctors, nurses are quintessential patient educators. Doctors, especially in a hospital setting, spend little face-to-face time with their patients. Itâ€™s the nurseâ€™s job not just to carry out the doctorâ€™s orders but to educate the patient on the reason behind the prescribed course of treatment. It is interesting that nurses are meeting the mistrust of patients instead of assuaging it.
The CVShealth survey also listed the top reasons individuals, including nurses, are hesitant to receive the vaccine. These reasons include: the vaccine seemed too rushed, unsure of its efficacy, and afraid of the side effects. I will address each concern in the following paragraphs.
Firstly, the vaccine was rolled-out in a short period. Generally, research and development (R&D) is a much longer, more arduous process. There are five stages of R&D. These stages include: researching the most effective antigen, determining the dosage, testing the vaccineâ€™s effectiveness, gaining approval and licensure, and continuous monitoring during distribution. Even though this process can take decades to actualize, the vaccine took only one year. This can be explained because R&D timelines are directly linked to the funding and resources available. In the case of COVID-19, the federal government pumped billions of dollars into vaccine R&D, shortening the timeline of bringing the vaccine to market without compromising safety.
Also, according to the CDC, â€œmRNA vaccines are new, but not unknown.â€ mRNA is naturally found in every cell in your body; itâ€™s job is to produce proteins which serve as an instruction manual for the cell. In the case of the COVID-19 vaccine, each person is injected with an mRNA sequence; this sequence produces spike proteins, which are sent to the surface of the cell. The body sees these proteins as foreign, and creates an immune response against them. Researchers have spent decades studying mRNA vaccines, and have found that mRNA vaccines effectively prevent cross-species disease transmissions, such as Zika and Rabies. Therefore, COVID-19, a disease thought to be transmitted by bats, is a perfect candidate for an mRNA vaccine.
To quell the second fear, the Mayo Clinic, backed by Israeli research reveals that the first dose of Pfizer vaccine alone has 75% efficacy within the first two weeks, an 85% efficacy after four weeks, and with the second dose, boosts immunity to 90% or more. Remarkably, the phase III Study of the Pfizer COVID-19 vaccine boasted a 95% efficacy rate!
The third fear baffles me. As someone who has seen the ravages of COVID-19 on the human body, and as someone who has been fully vaccinated, I can say that this argument seems illogical. Would one rather be sick with a life-threatening illness and be crippled with possible long-term effects of the disease, or spend 24 hours with general flu-like symptoms? We all have weathered chills, low-grade fever, and body aches; just reach for some Tylenol.
As a nurse, my intention is not to force people to get vaccinated; it is debunking fallacies and shedding light on this vaccineâ€™s science. For healthcare providers, the facts are valuable, not our personal opinions. Letâ€™s not be partially responsible for the misrepresentation of the effect of the COVID-19 vaccine; instead, letâ€™s bridge the gap and let patients make the final decision with proper education.
Adeevah Goldstein graduated from NYU Rory Meyers College of Nursing in 2016, and has since served as a nurse at NYU Langone Medical Center on various adult cardiac units. She is also a graduate of Yeshiva University (YU) and was a participant in the YU-NYU Joint Nursing program. While a full time nurse, she is studying part time at NYU Wagner, working towards a degree in Health Policy and Management (HPAM). Adeevah enjoys running, hiking, swimming, and reading in her spare time.