Hannah Miller, a nursing student and staff member at a long-term care facility in Eau Claire, Wisconsin, received her first dose of the COVID-19 vaccine on August 23 — not voluntarily.
“It (the vaccine) hasn’t been out long enough to see the long-term effects,” Miller told Wisconsin Watch. “We don’t know if it could cause bigger health problems in the future or cause problems, such as fertility.”
Miller said she has been asked to receive the vaccine by the hospital as she completes her clinics for the school. She said she wouldn’t be able to graduate without getting it. Miller requested that her school and workplace not be disclosed in this article.
Increasingly, health care facilities in Wisconsin and around the country are requiring their employees to be vaccinated. However, in long-term care facilities such as nursing homes – where residents are at high risk of severe illness and death from COVID-19 – some workers refuse the injection.
As of late August, the Wisconsin rate for fully vaccinated nursing home employees was about 60%. The overall rate of fully vaccinated individuals in Wisconsin between the ages of 18 and 64 is about 58.4%. By contrast, among the population aged 65 and over, the proportion is around 95%.
In mid-August, President Joe Biden ordered long-term facilities that receive federal Medicare or Medicaid funding to order their workers vaccinated, citing studies showing that having highly vaccinated nursing home staff is associated with a 30% decrease in COVID-19 cases. Of the 355 nursing homes in Wisconsin, 353 are both Medicare and Medicaid-accredited. However, some nursing homes in Wisconsin do not require employees to be vaccinated, a spot examination of facilities by Wisconsin Watch showed.
On Thursday, Biden upped the ante, ordering all hospitals, home health care companies and other medical facilities that receive Medicare or Medicaid to vaccinate their employees. The move will affect an estimated 17 million workers at 50,000 sites across the country.
Nationwide, more than 134,000 residents of long-term care facilities have died from COVID-19. In Wisconsin, 3,220 people have died in such facilities as of September 3 — or 42% of all COVID-19 deaths in the state, the Wisconsin Department of Health Services reports. In one of the worst outbreaks in Wisconsin, the Department of Homeland Security found that 191 residents and workers were infected at one unnamed nursing home.
The president’s decision to issue the authorization came based on a Centers for Disease Control and Prevention study that found the effectiveness of Pfizer and Moderne’s vaccines waning among nursing home residents — among the first to be vaccinated in early 2021.
The researchers said that reduced immunity caused by the vaccine and the emergence of a highly contagious delta type may be to blame.
The study recommended that, “Because nursing home residents may still be at risk of infection despite vaccination, many COVID-19 prevention strategies, including infection control, testing, and vaccination of nursing home staff, residents, and visitors, are critical. “.
The US Food and Drug Administration doesn’t erase the concern
As a health care worker, Miller said she will continue to do her part to keep the people around her safe by wearing a mask and washing her hands. However, Miller noted, vaccines “did not eliminate the disease,” and she could still catch it even if she was vaccinated.
She thinks it’s too early to delegate. Miller said she has family members working in health care who quit their jobs instead of getting the needed shot.
The CDC found in a new report that unvaccinated people are 29 times more likely to be hospitalized with COVID-19 than vaccinated people. As for Miller’s concern about her ability to conceive, the CDC advises that “there is currently no evidence to show that any vaccines, including COVID-19 vaccines, cause fertility problems (problems while trying to conceive) in women or men.”
“I totally encourage vaccines once they have been tested and approved by the Food and Drug Administration,” Miller said. “Vaccines are valuable and needed, but I don’t want to be a guinea pig. I still believe that everyone should be free as to whether or not to be vaccinated.”
Days after Miller spoke with the Wisconsin Watch, the Pfizer vaccine received full approval by the Food and Drug Association. However, I hesitated to accept it.
“I feel better now that they’ve agreed to it, but I’m still nervous about what could happen in the future,” Miller said of the change. “It usually takes years for the Food and Drug Administration to approve a vaccine, and that vaccine has been done so quickly that I feel like maybe more people have been rushed into getting it and I feel there is still information missing.”
Controversy continues over vaccine mandates
Miller isn’t the only staff member at the long-term care facility concerned with vaccine mandates. In recent weeks, health care workers have protested at the Capitol and outside their workplaces.
The nation’s leading nursing home association fears that the acute labor shortage in long-term care will only grow with a vaccine mandate. In Wisconsin, nearly one in four jobs are still vacant, according to the Wisconsin Health Care Association and the Wisconsin Center for Assisted Living.
The Rock Haven nursing home in Rock County, Janesville is one example of a facility that has attempted such a policy. In December, the county-run nursing home mandated employee vaccination, prompting some employees to take legal action. They claimed the rule was a violation of their rights to “decide whether to accept or refuse to give COVID-19 vaccines.” In response to the legal challenge, the Rock County Council rescinded the mandate in late May.
Marilyn Burns, an infection prevention specialist at Rock Haven, issued a statement confirming that there is no vaccine mandate in the nursing home — which is currently battling the COVID-19 outbreak.
“We understand that some members of the Rock Haven community are dissatisfied with Rock Haven’s hiring of vulnerable employees,” the statement said, adding, “We’re not sure how this (Biden) mandate will affect our facility.”
Wisconsin vaccination rate 32
In late August, the Wisconsin rate for fully vaccinated nursing home employees was about 62%. The state ranks 32 out of the 50 states, Puerto Rico, Guam, and the District of Columbia.
Hawaii leads the country with a long-term care facility employee vaccination rate of about 88%. Louisiana last time was 49%.
The Wisconsin Department of Homeland Security said vaccines are the “most important tool” to protect people from COVID-19 and that it is “extremely important” that staff of long-term care facilities are vaccinated.
As of September 5, the agency has conducted 2,678 public health investigations related to COVID-19 at long-term care facilities around Wisconsin. It found that the average number of confirmed cases per investigation is three, and the average is 11, with one unnamed facility reporting 191 confirmed cases of COVID-19.
In Wisconsin, a long-term care facility investigation is automatically run whenever a case of COVID-19 is detected, including examining how a person became infected, Elizabeth Goodsett, a communications specialist with the Department of Homeland Security said.
Although the total number of active investigations has decreased over the past year, DHS has reported a steady rise over the summer.
Fear of labor shortage
Concerns are also growing in the long-term care industry about Biden’s mandate for a vaccine. In a statement, Mark Parkinson, president and CEO of the American Health Care Association and the National Center for Assisted Living, objected to Biden’s selection of one group of health care providers.
“Focusing solely on nursing homes will result in reluctant workers fleeing to other health care providers and leaving many centers without sufficient staff to care for residents,” the statement read. “It will make the already difficult shortage of manpower worse. The net effect of this measure will be the opposite of what is intended and will affect the ability to provide quality care to our residents.”
Ultimately, Miller said she believes all people — including health care workers — should be allowed to control their own health care, not the government.
“In nursing school, we’re constantly learning that the patient has rights,” Miller told the Wisconsin Watch. “They can choose not to take medications, refuse treatment, or refuse tests. We are sick in our own way, so why don’t we have the same rights to refuse?”
Madeleine Furstenberg’s work on this story was sponsored by the Anne Defroy Fellowship at the University of Wisconsin-Eau Claire. The nonprofit Wisconsin Watch (wisconsinwatch.org) collaborates with Wisconsin Public Radio, PBS Wisconsin, other news media, and the School of Journalism and Mass Communication at the University of Wisconsin-Madison. All work created, published, published, or published by Wisconsin Watch does not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.