Some Health Care Workers Are Hesitant About Getting COVID-19 Vaccines

Jan 1, 2021
Originally published on January 3, 2021 2:49 pm

Dr. Nikhila Juvvadi, the chief clinical officer at Chicago's Loretto Hospital, administered the first coronavirus vaccine doses in the city, inoculating frontline medical workers.

But while they have priority around the country, not every eligible health care worker actually wants to get the vaccine. A recent survey by Kaiser Family Foundation found that nearly a third probably or definitely would refuse vaccination.

Juvvadi says that, in her hospital, a lot of that hesitancy is based on minority groups' deep-rooted mistrust of vaccinations and other large-scale health care programs: "I've heard Tuskegee more times than I can count in the past month — and, you know, it's a valid, valid concern."

She spoke with All Things Considered's Ailsa Chang about the concerns among her colleagues and in her community, and the steps her hospital is taking to address them.


Interview Highlights

On the feelings of the staff at Loretto Hospital, in a majority-Black community on Chicago's West Side

We did a survey right before the vaccine came out ... basically as to where you work in the hospital, and would you or would you not get the vaccine when it is your turn? We came up with, 60 percent said yes, and 40 percent actually said no.

Why health care workers might refuse vaccination

There's a lot of different factors, but there's some things [that] are reasonable. ... Pregnant women or breastfeeding women can say that there's not enough research. So those type of things I tend to understand. But then there's a wider hesitancy that almost is not rooted in the available science. ...

In the African-American population and to some extent in the Latino population, there are reasons for this. ... There's no transparency between pharmaceutical companies or research companies — or the government sometimes — on how many people from those communities were actually involved in the research. So they have — they have an issue with that.

And then, they have also heard the word "guinea pig." ... That community was used, unfortunately, as guinea pigs — whether it was Tuskegee, whether it was Henrietta Lacks' cells being used without her permission. That caused them to have this mistrust. So what we want and need to do is figure out how to move forward with that.

How Loretto Hospital is trying to break through vaccine hesitancy among staff

We've had town halls answering questions of every kind, whether it's "what is an mRNA vaccine," "what is the difference between one [vaccine] and the other," "be honest about the side effects" ... "why did they get the vaccine out in nine months when otherwise it takes 15 years?" And I tell them the answers to those questions very honestly and very transparently.

But the one thing I will tell you that has really worked is one-on-one conversations. So it usually goes something like, "Hey, what are your concerns?" And the first thing you have to do is listen to those concerns — do not dismiss them. And then explain and answer those questions to the best of your ability.

The second thing that I've seen that works is to introduce them to somebody of their same race or gender or age group and say, "Look, this person took it a week ago, this person took it two days ago — why don't you both sit there for a minute and talk to each other, and maybe she had the same concerns as you."

On making the most of perishable vaccine doses when some patients decide not to take them

We need to have built in safety nets for that — meaning, OK, we are going to give somebody 100 doses of the vaccine. Let's say only 60 of their workers take it. Who would they partner with that if ... their staff don't take it, we give it immediately to those other people.

That takes so much logistics and planning that I can't even imagine how massive a task that is. But with the vaccine hesitancy that is going on right now, we are going to end up with wasted doses if we don't do that.

Concerns about the limited information available about future vaccine distribution

We've absolutely been able to get all the shots that we've requested so far, it's just that we're trying to play it slightly safe ... We think that the next doses will definitely come — the city reassures us that they will — but it's not the city we're worried about, it's kind of the national distribution when we see it across the country that we worry about, right? And so maybe do we have to save enough for the second dose? The city reassures us that we don't, but it's still something that plays in the back of our head.

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AILSA CHANG, HOST:

Loretto Hospital on Chicago's West Side is the first place where coronavirus vaccines were administered in that city. And Dr. Nikhila Juvvadi, the hospital's chief clinical officer, is one of the people who's been giving those shots to her hospital's frontline workers. But at Loretto, and at hospitals around the country, not every eligible health care worker actually wants the vaccine. Dr. Juvvadi joins me now to talk about how she's been addressing that.

Welcome.

NIKHILA JUVVADI: Thank you for having me.

CHANG: So there was this recent survey by the Kaiser Family Foundation that showed nearly a third of health care workers probably would not or definitely would not get the vaccine. I'm curious - are you seeing that same level of distress at your own hospital?

JUVVADI: Yes, we are, actually. We did a survey right before the vaccine came out in anticipation. It was a general survey just, asked a question basically as to where you work in the hospital and would you or would you not get the vaccine when it is your turn? We came up with 60% said yes, and 40% actually said no.

CHANG: Well, those numbers are surprising to me because we're talking about health care workers who, I guess, you would think would trust the available science. So what do you think is driving this hesitation to get these shots, at least among your own? staff?

JUVVADI: You know, there's a lot of different factors. But there's - some things are reasonable. Let's say that pregnant women or breastfeeding women can say that there's not enough research. But then there's a wider hesitancy that almost is not rooted in the available science, just like you said, especially among our staff, which reflects the wider community. I mean, I've heard Tuskegee more times than I can count in the past month. And you know, it's a valid, valid concern.

And in the African American population and, to some extent, in the Latino population, there are reasons for this, meaning there's no transparency between pharmaceutical companies or research companies or the government sometimes on how many people from those communities were actually involved in the research. So they have an issue with that. And then they have also heard the word guinea pig. And because that community was used, unfortunately, as guinea pigs - whether it was Tuskegee, whether it was Henrietta Lacks's cells being used without her permission - that caused them to have this mistrust. So what we want and need to do is figure out how to move forward with that.

CHANG: Well, I want to ask about how to move forward because, as you say, your hospital staff reflects the broader community that you are in. You are in a neighborhood called Austin, which is majority Black. And this Kaiser survey that I cited, it also showed that a third of Black Americans overall are hesitant to get COVID shots. So if some of your own health care workers are hesitant about the vaccine - are skeptical - how do you convince the broader community where you are that they should be getting vaccinated?

JUVVADI: So we've had town halls answering questions of every kind - whether it's what is an mRNA vaccine? What is the difference between one and the other? Be honest about the side effects. And I tell them the answers to those questions very honestly and very transparently. One thing I will tell you that has really worked is one-on-one conversations. So it usually goes something like, hey, what are your concerns? And the first thing you have to do is listen to those concerns. Do not dismiss them. And then explain and answer those questions to the best of your ability.

CHANG: Do you picture at some point, if people remain reluctant, that you're just going to have a bunch of vaccine sitting around, unused when these shots become more widely available?

JUVVADI: So we've seen that already to a certain extent. We need to have built-in safety nets for that, meaning, OK, we are going to give somebody a hundred doses of the vaccine. Let's say only 60 of their workers take it. Who would they partner with that if they don't - their staff don't take it - we give it immediately to those other people? That takes so much logistics and planning that I can't even imagine how massive a task that is.

CHANG: Yeah.

JUVVADI: But with the vaccine hesitancy that is going on right now, we are going to end up with wasted doses if we don't do that.

CHANG: Dr. Nikhila Juvvadi is the chief clinical officer at Loretto Hospital in Chicago's West Side neighborhood of Austin.

Thank you very much for joining us today.

JUVVADI: Thank you for having me. Transcript provided by NPR, Copyright NPR.