For most of the winter, Meryl Gordon worried about people caring for her 95-year-old mother, who was recovering in a Manhattan nursing home after a free fracture.
“Each week, they sent a note to the families of how many employees had positive COVID tests,” said Professor Gordon, a biologist at New York University. “It was a source of great concern.”
Gordon is relieved that his mother is fully vaccinated and has returned to his care. But what about two home care assistants helping his 98-year-old father, David, in his Upper West Side apartment?
Both did not agree to be vaccinated. David Gordon’s doctor advised him to postpone the COVID vaccine due to previous allergic reactions.
Meryl Gordon did not insist that the guardians be vaccinated. “You avoid doing something that could make you lose the people you rely on,” he said. But he remains anxious.
The problem is that many long-term care employers, from individual families to large national companies, are struggling as vaccines become more affordable, though not affordable enough. In the event of an epidemic, can they require vaccination for those caring for very vulnerable older adults? Required:
Some employers do not wait. Atria Senior Living, one of the largest live support chains in the country, has announced that all staff members must be fully vaccinated by May 1.
Silverado, a chain of small dementia care homes located mostly on the West Coast, was vaccinated until March 1. Juniper Communities, which operates in 22 institutions in four states, also received a mandate.
“We felt it was the best way to protect people, not just our residents, but our team members and their families,” said Lynnipper CEO Lynn Katzman. Of the company’s nearly 1,300 employees, “about 30 have withdrawn” because of vaccination claims, he said.
Jun Uniper’s experience supports what public health professionals have been saying for years. Vaccine mandates, like many others created by health organizations for the flu vaccine, remain controversial, but they do increase vaccination rates. As of February 25, 97.7% of Jun Uniper residents had received two doses of the vaccine, as had 96% of its staff.
This is in stark contrast to staff vaccinations in many institutions. According to the Centers for Disease Control and Prevention, only 37.5% of staff in nursing home clinics received their first shot in the first month, along with 77.8% of residents.
The results of opinion polls vary depending on who is being asked and when. An analysis by the Kaiser Family Foundation in January found that 29% of health care workers had doubts about vaccinations.
The national recruiting platform of healthcare companies, myCNAjobs.com, last month surveyed 250 companions, assistants հաստատ nursing assistants հաստատ in-home’s institutions. It conducts daily interviews with thousands of people. It estimates that 35% plan to vaccinate, 20% do not, and more than 40% remain unsure.
These workers can not stay away from the elderly people whom they help with such things as bathing, dressing և toilet. When they enter և out of institutions հաճախ private homes, who often work in many jobs, these workers can spread the coronavirus և they և their families are also vulnerable to its dangers.
Experts say it is probably legal for employers to make vaccination a working condition. The Federal Commission for Equal Employment has agreed as long as the mandates allow for religious-religious exceptions. An analysis by the University of Pennsylvania last fall found that about half of American adults nationally consider employer mandates acceptable.
“It is unwise to vaccinate a vaccine while it is under emergency use,” said Lawrence Gostin, a law professor at the University of Orjtown. As mandates during the YPC can pose legal challenges, he advised to wait for the full approval of the Food and Drug Administration.
That may come next month for Pfizer-BioNTech և Moderna vaccines. After that, “I expected state or local governments to force vaccinations on people working in health care,” said Gostin, who heads the World Health Organization’s Center for Health Law. “They would have the right to do that.”
Ethically, he added, “it is completely justified. “People have the right to risk their own health, but they have absolutely no right to endanger others.”
Other health professionals claim that carrots should be used instead of wood. Working with chronic long-term care. “I do not think we want to do anything right now to get people out of that environment,” said David Grabowski, a health policy researcher at Harvard Medical School.
He offers much more rewarding than gift cards or free meals offered by some institutions, such as paid leave to vaccinate employees and allow them to skip work for a day or two if they respond.
“There are worse things than putting $ 500 to $ 1,000 in the pockets of workers who were the backbone of long-term care before the epidemic and had a terrible time with it,” he said. “It’s the most dangerous thing in America right now.”
Paying employees for vaccinations is ethical, however, says Emily Largent, a bioethicist at the University of Pennsylvania who recently became the editor of JAMA.
He approves the reimbursement of time և staff costs. But he mentioned. “There is good evidence from behavioral economics that offering money signals is risky. “These vaccines are really safe and effective, so we do not want to reinforce people’s fears.”
Although COVID-19 cases and deaths are long overdue in institutions, even those with high vaccination rates need to be vigilant. New residents are constantly arriving, և employees are leaving. The turnover of nursing staff in study rooms is extraordinarily high. The annual average is 128%. This means that after one year, all the initial members of the nursing staff will remain, as well as 28% of their replacements.
Probably the most pressing issue is the vaccination of the nation’s largest segment of primary care workers – approximately 2.3 million people working in private homes.
“It ‘s pretty bad,” said Vicky Joachim, executive director of the American Home Care Association, which represents 3,200 home care agencies. Although home care workers have priority vaccinations in every state, they struggle to get them, he says.
Like the rest of the caregiver workforce, the domestic workers are mostly women of color, many of them immigrants. According to 2019 According to the research և advocacy group, they are the lowest paid group in 2019, averaging $ 12.12 per hour. Nearly half rely on a public aid horse, such as Medicaid or food programs.
Without a central workplace, it will be more difficult for them to reach, educate, and vaccinate them than in nursing homes, assisted care assistants. (Some, privately hired individuals և through the so-called gray market, do not work in agencies at all).
“Vaccine fluctuations are an absolute factor, but moreover, the lack of easily available vaccination options,” said April Verrett, president of SEIU Local 2015 in California, a union of nearly 400,000 home care workers.
“People working with several jobs can’t wait in long lines,” he said. They may not have cars to navigate through websites, or have Internet access to Internet portals. “I do not think the mandates will do anything to create the kind of trust needed to vaccinate people,” Verrett said.
Some individuals who hire home care assistants, including Gordon, say they will require future candidates to be vaccinated.
So far, most employers seem to be in favor of a voluntary approach. Answering staff questions, combating misinformation, helping employees get vaccines through mobile և pop-up clinics, perhaps providing transportation. Local 2015 has adopted an updated Rosie the Riveter icon with a scroll bar as part of its campaign to promote member vaccination.
“We need to listen to people’s concerns, talk about what we know,” Largent said. “I think we will continue to see fluctuations when they see people like them being vaccinated.”