Drive for 75: Resources from Week 26

Members | September 03, 2021 | by Dee Pekruhn, Jill Schumann

LeadingAge Coronavirus Update Calls feature brief segments called “Drive for 75” to promote the successful vaccination of at least 75% of our aging services providers’ workforce, and as needed, residents. We will cover developments in the news, research, and innovative practices that support our members in attaining high vaccination rates.

This Week’s Highlights:

Volume Sixty-Two: Air Date 8.30.21. “Flu and COVID Vaccine Hesitance: Connecting the Dots”

Today, through the lens of a very thoughtful Brookings Institute report, we explore the question of whether it’s politics – or something else – that drives hesitancy in nursing homes. Special thanks to Allision Ciborowski of LA MD, who sent this article over for inclusion in the Drive for 75 series.

This article offers us a genuine feel-good at the very beginning: a chart that shows the precipitous drop off of COVID deaths among the vulnerable elderly in nursing homes after COVID vaccines became available. And a victory statement for us: “the campaign to vaccinate nursing home residents brought the third wave to a dramatic end.”If nothing else from today’s segment, I invite you to at least take a long look at that sharp drop in February and give yourself and your hard working teams a moment to celebrate the immeasurable success of your vaccination efforts. You saved lives.

Now into the skinny on what else they found. This report first looked at the correlation between states’ COVID vaccinations and political leanings where nursing homes operate, and then at COVID vaccination and flu vaccination acceptance in nursing homes in each state. They found almost NO correlation between political leanings and COVID vaccinations in nursing home residents, but they found a STRONG correlation between COVID vaccination acceptance and pre-COVID flu vaccination acceptance among nursing home residents. Further, they found that the correlation between COVID and flu vaccination acceptance holds strong for nursing home staff as well.

I’ll quote straight from the article here:

“This suggests that the factors responsible for variation in flu vaccine uptake among nursing home residents likely play a more prominent role for COVID-19 vaccination uptake than political identity. Research on the behavioral factors underlying vaccine hesitancy among nursing home residents specifically is scarce, but studies of the community-dwelling elderly show that the most consistent predictors of vaccine hesitancy include perceptions that the vaccine is not effective or the flu is not severe, concern about side effects, and lower education and income. Elderly people who are Black or Hispanic, younger, unmarried, or not part of a high-risk group are also less likely to receive a flu vaccine”

The report goes on to categories nursing home facilities into low-, medium, and high-risk categories based on current vaccine acceptance. Another quote, “Compared with low-risk facilities, higher-risk facilities are larger, more likely to be for-profit, and have lower quality ratings. High-risk facilities were also disproportionately located in the Southern and Southwestern regions of the U.S., and in counties with lower vaccination rates.

An important acknowledgement that gives us some food for thought is that there is not really any systematic data or analyses out there on what nursing home residents or staff decline the COVID vaccine. The report concludes with the recommendation that ongoing education and outreach, especially to the most high-risk groups identified, would help get more folks vaccinated, along with mandating the vaccine as a condition of employment. They also note full approval by the FDA, along with paid time off for vaccine side effects and monetary bonuses may help, and 18 states have even offered large lottery winnings that collectively were valued at over $80 million.

As with fine wine, it may turn out that ‘just the right blend’ of incentives and mandates may be what finally gets us to 75 or now, 95 % vaccinated in aging services. Cheers to that!

Volume Sixty-Three: Air Date 9.01.21. “Vaccine Mandates: Liberty Inducers”

There have been articles recently suggesting that, as a country, we have failed to emphasize, teach about and invest in public health for many decades. There is also a relatively low level of scientific literacy which has proven a difficult combination during this pandemic.

Much of the emphasis on health in more recent years has been on individual health and personal health behaviors. We don’t talk much about PUBLIC health which is a shared goal.

When we focus on an individualistic notion of freedom, we think in terms of each person being free to make their own individual choices without constraint. However, when we consider something like an infectious disease, freedom actually lies in community. Individuals will only be free of the illness, hospitalization, death, restrictions, and uncertainties if we address the pandemic TOGETHER. Seen in this light, vaccines and widespread vaccination are the ticket to freedom from this coronavirus and all that it brings with it.

In fact, in a recent article Doctors Ferguson and Caplan of the Division for Medical Ethics at the NYU Grossman School of Medicine argue that vaccine mandates are actually “liberty inducers” rather than strong-arm tactics.

They say, “liberty inducers are ethically justified. True, they will have some negative effects. They won't move everyone, and for those unmoved there will be consequences. Rather than restricting liberty, these strategies are necessary to achieving it. COVID-19 vaccine passports and mandates are past due. They are not too coercive. They will produce quick results and save lives. Ethics falls on the side of creating liberty through freedom from plague. Dawdling around using failed strategies just means more misery and less freedom.”

Perhaps looking at freedom with a new lens will help us move toward true freedom from the worst effects of this virus.