Why Isn’t My Mother’s Assisted Living Facility Staff Forced to Get Vaccinated?

In the March 21, 2021 issue of The New York Times, several readers responded to issues raised about the impact of COVID-19 vaccinations in a local assisted living facility.  One such reader wrote, “Both my mother and I have been fully vaccinated. All staff members at the facility were offered the vaccine. I was told that half declined. Recently, the facility closed to visitors because one staff member tested positive. I am having great difficulty understanding policies that allow unvaccinated employees to have daily contact with residents while barring fully vaccinated family members and essential caregivers from access when there is a positive COVID test result for an employee at the facility.” 

This is an increasingly problematic issue for facility administrators, long-term care facility staff, and visitors.  Some nursing homes have implemented a bonus system—carrots—to encourage vaccinations, while others are utilizing more stringent methods with threats of termination to decrease vaccine hesitancy. While many health care organizations mandate that their staff receive the influenza vaccine each year, which is FDA approved, the COVID-19 vaccines produced by Moderna, Pfizer and Johnson & Johnson have only received Emergency Use Authorization.  There has been a great deal of reluctance among minority employees based on a history of racial inequality, inappropriate experimentation, exploitation, and a general mistrust of both the health care system and government. 

We have lost so much due to COVID-19. Many of our facilities have lost numerous resident. Our staff has been decimated by illness, death and fear. Rather than dismissing the fears and concerns of our staff, we need to find ways of addressing the staff where they are. These concerns cannot be mandated away but must be addressed with empathy, education, and support.

Ilene Warner-Maron, PhD, RN-BC, CWCN, CALA, NHA, FCPP, is an assistant professor in the Department of Geriatrics and Palliative Medicine at the Philadelphia College of Osteopathic Medicine. Dr Warner-Maron is also the executive director of the Eastern Pennsylvania Geriatric Society. 

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