White Coat, Black Art

Some health-care workers still hesitant to get COVID-19 vaccine

Hesitancy among some health-care workers about getting the COVID-19 vaccine may sound surprising given the risk they've faced during the pandemic and their important role in preventing its spread. But it shouldn't be, says an infectious disease specialist.

A comprehensive information campaign geared toward front-line workers would've made a difference, experts say

A nurse gives a COVID-19 vaccine to respiratory therapist Sahra Kaahiye in Edmonton on Tuesday, December 15, 2020. Although it seems the majority of health-care workers are on board with getting the vaccine, some may have questions that make them hesitant, said Dr. Allison McGeer. (Jason Franson/The Canadian Press)

Lorna Bernier is a personal support worker who provides home care in Victoria Harbour, Ont., on the shores of Georgian Bay. And she has decided not to get the COVID-19 vaccine.

"I've never taken the flu shot, other than when I had to go to school to do my placements," she said. "I've never been a person who gets sick. I've been fairly healthy, knock on wood."

Bernier said she gets "a mixed response" when she tells people she's not not going to get the shot.

"I've seen some raised eyebrows, and if my employer were to enforce it, I would definitely choose to do it," she said. "I mean, my job is my passion. It's what I do. And I pray to God, if I have to take it, that I don't have any adverse effects from the vaccine, right?" 

The benefits of the vaccine outweigh any risks, say health authorities. According to Health Canada, which reports weekly on adverse reactions to the vaccine, there have been five reactions considered serious out of 115,072 doses administered as of Jan. 1.

'Not different from other people'

Hesitancy among some health-care workers about getting the COVID-19 vaccine may come as a surprise, given the risk they've faced during the pandemic and their important role in preventing the virus's spread. 

But it shouldn't, said an infectious disease specialist.

"I think the reluctance to get vaccines is the same across all sectors of society," said Dr. Allison McGeer, a microbiologist and infectious disease consultant at Sinai Health System in Toronto who has researched vaccine hesitancy.

"Health-care workers are not different from other people."

Francesca Paceri, a registered pharmacist technician, carefully fills the Pfizer-BioNTech COVID-19 mRNA vaccine at a vaccine clinic in Toronto on December 15, 2020. (Nathan Denette/The Canadian Press)

She said some health-care workers have questions they want answered before they agree to be among the first to roll up their sleeves.

It's hard to say how many health-care workers are feeling uneasy about getting immunized, she told Dr. Brian Goldman, who hosts CBC's radio documentary program White Coat, Black Art.

A December survey by Safecare B.C., a workplace safety association for long-term care homes, found just 57 per cent of those who took the survey intended to get the vaccine when it became available in that province. 

In the online survey of nearly 1,500 personal support workers, 15 per cent of respondents said they would not get the vaccine and 28 per cent said they were undecided.

Meanwhile, the Registered Nurses Association of Ontario "is aware of thousands of nurses that are anxiously awaiting the vaccine," and has not heard of any members who do not wish to participate, a spokesperson said in an email to CBC Radio.

Toronto registered nurse Sara Fung said she's concerned about some of what she's reading online in forums for nurses where some say they're opting not to get the COVID-19 vaccine. (Submitted by Amie Archibald-Varley)

However, Sara Fung, a registered nurse in Toronto and co-host of The Gritty Nurse podcast, said she's been concerned by some of the hesitancy she's reading about in online forums for nurses.

The most common concern is whether the vaccine is safe for those who are pregnant or breastfeeding, she said, since these groups are left out of clinical trials.

"I think, for the most part, nurses and [other] health-care workers are willing to get the vaccine, but we aren't all on the same page, unfortunately. And I think there's a lot of misinformation out there."

But Fung said she understands where some of the hesitancy comes from. 

"Throughout the whole pandemic, nurses have felt very disempowered," she said. "And what I mean by that is we've had to fight for PPE [personal protective equipment]. We've been put in situations that were unsafe.

"A lot of nurses have had to work on COVID units, [intensive care] units, that they're not even trained for."

Lack of trust a major factor in PSWs' uncertainty about COVID-19 vaccines

2 years ago
Duration 2:05
As Ontario vows to vaccinate all long-term care workers and residents in hot zones by Jan. 21, many personal support workers say they're reluctant to get the shot right now and it’s because of a lack of trust in how the government has treated them.

Nurses weren't informed about the vaccine development process as it went along, and lack a sense of agency around it, she said.

Systemic racism in health care plays role in hesitancy

When sharing information about vaccines, it's important for public health leaders to acknowledge and appreciate that different life experiences among people can affect confidence in health authorities, said McGeer.

She noted many people working in long-term care homes are new immigrants to Canada who "aren't necessarily going to trust our public health system the way some of us who have lived here all our lives will."

Amie Archibald-Varley, a registered nurse for Niagara Health, said systemic racism plays a key role in vaccine hesitancy among health-care workers of colour. (Submitted by Amie Archibald-Varley)

Registered nurse Amie Archibald Varley, a quality and patient safety specialist for Niagara Health in the Niagara region, and Fung's podcast co-host, said that's a significant factor in reluctance around this vaccine. 

"So there are racialized workers in long-term care and also in various other areas that have high scientific literacy," said Archibald Varley.

People in that group are generally on board with getting the vaccine, but she said she's concerned about others whose decision may, understandably, hinge on "systemic racial issues, disparities or a history of negative experiences" in health care. 

"The individual and historical experiences that many racialized communities, especially in First Nations and Black communities, have faced directly correlate to the mistrust we see today," she said. "Racialized groups were experimented on with no pain medication, and they were subjected to eugenic practices, including forced sterilization…. So it's not surprising that these groups have developed a culture of mistrust and skepticism." 

"And I think what we need to do for those groups is we really need to listen to them. We need to hear what they have to say…. Because I feel that, through powerful conversations, you can change minds."

Right now every person who decides to get vaccinated could be a life saved, whether it's them or whether it's someone they work with, their family members and others. ​​​​​​- Tara Moriarty, University of Toronto infectious disease research


Campaign for front-line workers should've started 'months ago'

University of Toronto infectious disease researcher and associate professor Tara Moriarty has been having a lot of those conversations. Her mother lives in the memory unit of a long-term care home, and Moriarty has been so concerned about vaccine uptake among personal support workers that she has started spending her evenings holding Zoom sessions to answer their questions in a non-judgmental way.

"Right now every person who decides to get vaccinated could be a life saved, whether it's them or whether it's someone they work with, their family members and others," she said. 

Moriarty, who has a PhD in anatomy and cell biology, and is part of a national coalition that's responding to COVID-19 vaccine misinformation, said a public health campaign aimed at informing front-line workers about the vaccine should have been put together months ago in advance of Health Canada's approvals. 

Many have questions about vaccine safety and some are misinformed about how vaccines work and whether the decision has ramifications just for them, or for others as well.

Debbie Frier, registered nurse, left, injects Leah Sawatsky, an emergency room nurse, right, with the Pfizer-BioNTech COVID-19 vaccine at the Regina General Hospital in Regina on December 15, 2020. (Michael Bell/The Canadian Press)

Fung said she's seen nurses post comments online like "If I get it, I get it; it's my time that's at stake. I'm doing everything I can to stay healthy."

That's difficult for her to stomach, given she lost her 100-year-old grandmother to a COVID outbreak at her long-term care facility in April. "They're not really thinking about the greater good." 

"I just think that we need to really bring this back to who the most vulnerable people are and that they're the most affected."

Registered nurse Robin Trumble of Barrie, Ont., shows off the receipt she got after receiving her COVID-19 vaccine January, 8. (Submitted by Robin Trumble)

'Excited and relieved'

Robin Trumble, a Barrie, Ont., registered nurse who works for Simcoe Health, got her vaccine Jan. 8. "I was quite excited. I felt a relief. There was some guilt. I would have liked to have let my dad have my spot. He's 69 and he does have an underlying health history."

While Trumble said she's aware of some skepticism about the vaccine, she and her colleagues "crashed the site" in their enthusiasm to register for a shot.

"It was a stampede. You couldn't get through. The server was busy."

Trumble said she feels "very privileged" to be offered a chance to get the shot while supplies are still limited. "This has been going on for a long time. Everybody is done with the pandemic, no matter where you work. People want to go back to their lives and this is really the only way out of it."

Written by Brandie Weikle. Produced by Jeff Goodes, Sujata Berry, Willow Smith and Dawna Dingwall.

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