Saturday, January 02, 2021

Why are so many healthcare workers refusing the COVID vaccine?

I've read so many articles about vaccine hesitancy and, even more specifically, the outright refusal of some healthcare and frontline workers to take advantage of the COVID-19 vaccines.

For example, only 40% of Ohio nursing home staff are planning to get the vaccine, more than half of the staff of a large Houston hospital  are going to refuse it, 55% of New York firefighters are planning on refusing it, over half of staff at a Riverside, California, hospital will be refusing it, as will over 40% of Chicago hospital workers, and 20-40% of LA County frontline workers. These are large numbers in areas where the pandemic is running rampant, and areas where Black and Hispanic people have been disproportionately affected by the virus (65% of fatalities, according to one study). 

In more general terms, a December poll in the US showed that vaccine hesitancy is more pronounced among healthcare workers (29%) than among the general publc (27%), which is a strange turn-up.

These are all American studies (and I can only hope that these people have re-thought it since), but the situation in Canada is probably similar. For example, one BC study found that only 57% of long-term care workers were keen to get the vaccine.

Part of the issue seems to be that healthcare and frontline workers in North America tend to be Black or Asian, and people of colour in general are much more reticent to get the vaccine. In one large survey, less than 43% of Black people say they are definitely or probably going to be vaccinated. Among some of the stated reasons for this in America are a perceived lack of Black and Latino involvement in research and testing of the drugs, a distrust of Donald Trump and his accelerated rush of the vaccines (as though he was the only person looking to expedite the process!), and in some cases a belief that Trump and his administration is actively trying to harm certain segments of society in some way. Most of this is firmly in the realm of conspiracy theories, but nonetheless firmly believed.

Often, in America at least, the Tuskagee Syphilis Study is referenced as an example of the "culture of medical exploitation, abuse and neglect of Black Americans". Why people would assume that the same thing is going to happen with the COVID vaccine as happened in that particular egregious case of unethical and racist surgeries, I have no idea. Be that as it may, some see the push to get healthcare workers first as evidence of a negarious experiment on people of colour, not a commonsense protection of those most at risk. There is very little that can be done in the face of this kind of suspicion and mistrust.

Interestingly, some studies suggest that vaccine hesitancy among healthcare workers is often a temporary thing: they are not refusing it outright, but would like to see si months or a year of results in the general public before they get rhe shot themselves. There is also some evidence that education (or lack of it) plays into the decision: most healthcare workers who say they will definitely get the vaccine have at least a college education, and over half of those who say they will definitely not get the vaccine have not been educated beyond high school.

Even in Canada, healthcare workers seem to have an innate distrust of governments. But it's not just governments that are making the assurances here: do they also distrust the pharmacare compamies that have spent months testing their vaccines, and the federal agencies throughout the world that have re-tested and approved them. Do these people distrust everyone? And anyway, what viable choices do they really have? Do they want to continue laying themselves and their families open to the virus. After all, as one Canadian nurse laconically quipped about the vaccines, "it's safer than COVID".

But anti-vaccination sentiments are, almost by their very nature, not logical, not science-based. A straight comparison of the possible risks and benefits would leave no-one in any doubt about the best way to proceed. But risks and benefits are just two of the factors at play here. 

Be that as it may, if the general public sees healthcare workers refusing the vaccine, then you have to know that the already high rates of vaccine hesitancy will only get worse. Maybe it's not fair to ask even more of healthcare workers, but I do believe that they have a responsibility to lead on this - many of them have been quite outspoken in this regard - I'm not sure how we will get to herd immunity otherwise.

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