Personal support workers are split; some are beating down the doors to get vaccinated against COVID-19 and others are afraid — and that hesitancy is just one stumbling block in the province's effort to protect its long-term care homes, experts say.
Miranda Ferrier, head of the Ontario Personal Support Workers Association, says that more than half of her members don't want to get vaccinated, at least right now.
"They feel like guinea pigs, a lot of them," she said. "But then we have another part of our membership, that is extremely gung-ho about the vaccination."
The fear centres around the fact that the vaccines are new and personal support workers have been told to go first, said Ferrier. There's been a lack of concrete information about the vaccines and misinformation has been filling that void, making it hard to determine what's real, she added. And Ferrier said she understands why some feel like guinea pigs — a year ago most people didn't know what a PSW was and now they're being featured getting the first shots on live TV.
Her association, which represents PSWs on a voluntary basis, has been relaying her members' concerns to the provincial government and explaining the "headspace" workers are in. She said the province, and the medical establishment, have been surprised and concerned by the high level of vaccine hesitancy among her members.
Another personal support worker in long-term care died on Dec. 31, Ferrier said, referring to Sheila Yakovishin.
Ferrier said the hesitancy might ease up over time as PSWs see more and more people get vaccinated. It also might help, she said, if one high-profile politician such as the premier or the minister of health or long-term care, gets vaccinated. While Ferrier said politicians generally shouldn't get doses reserved for front-line workers, making an example of just one would send a message.
"I won't force anybody. It's their decision. Do I think they should get it? Absolutely. I think that they should get vaccinated," she said. "But this at the end of the day, it's up to them."
The Service Employees International Union has also seen high levels of vaccine hesitancy among its 22,000 long-term care workers, but President Sharleen Stewart said she believes that will fade when more workers see their peers vaccinated safely, noting that the only reactions so far have been allergic and some flu-like symptoms, which her members are prepared to deal with.
However, the SEIU is calling on the province to ensure workers get paid for the time it takes to get the vaccine and paid time off if they have to stay at home in the event of a rare adverse reaction, as well as for organized transportation to the vaccination sites.
"The government needs to eliminate all of the barriers to them getting the vaccine," she said.
"I think you would see an enormous uptake if they started there."
Dr. Brian Hodges, an executive vice-president at the University Health Network, said another helpful step is bringing the vaccines right into long-term care homes.
UHN has been sending teams with the Moderna vaccine to long-term care and retirement homes at a rate of two facilities a day since Dec. 31, and should have completed clinics at all 15 long-term care homes and five retirement homes it has partnered with — and some others — by the end of the week. It will be moving on to other homes, and working with other hospitals, as time goes on.
They vaccinate residents first, followed by staff and residents' loved ones the homes deem to be essential caregivers after the home has completed the process of obtaining consent forms and organizing staff and families, he said, adding that there are special preparations made to deliver the vaccine on floors for residents with dementia and floors in an outbreak.
— Brian Hodges (@BDHodges1) January 4, 2021
When it comes to staff, some have gone to a central hospital clinic to be vaccinated, but many haven't, and some of them haven't made their decision until the UHN team comes to the home where they work, said Hodges.
"In fact, just 15 minutes ago, I have four PSWs asking questions in the lobby about the vaccine and how it works, and what does it mean, the side-effects and other things they've heard," he said, on the phone from Cedarvale Terrace while his team was going floor-by-floor doing vaccinations.
"And what we found is that, once they have questions, to chance to get answers to questions, and see colleagues and peers being vaccinated in our staff clinic, the numbers go up very quickly," he said. "So we're in the last four homes we've done, we've come in, and we've been told that there are four or five interested staff. And by the time we're finished, we're having 20 to 25 staff stepping forward to ask to be vaccinated."
In one case, they had to have extra doses couriered over to ensure that everyone who wanted one could get it, he said.
Dr. Nathan Stall, a geriatrician with the Mount Sinai, said that while hospitals like the University Health Network are doing amazing work in bringing the vaccine into long-term care homes, the province-wide rollout isn't going fast enough — and anything short of seeing all long-term care and retirement home residents offered the vaccine by the end of the month would be too slow.
One key problem, he said, is the province has yet to decide it will move the Pfizer vaccine into long-term care homes over concerns about transporting, while other jurisdictions, including other Canadian provinces, have, leaving most of them sitting in freezers, he said. As of Sunday, the province had administered 42,419 doses of Pfizer and Moderna, while 148,350 have been delivered to the province.
Administering those doses right away wouldn't have prevented some of the worst outbreaks in the province's long-term care homes right now — like the one at Tendercare in Scarborough that has killed 60 residents — but it would have prevented those that are just beginning now, said Stall.
Stall said he doesn't understand why the province doesn't seem to be treating the impact of COVID-19 on long-term care as the emergency it is.
"It's inexplicable to me that we've left these people vulnerable when we had a tool that could literally save their lives," he said. "And the fact that vaccine clinics took holidays and our leaders took holidays when we're at the greatest amount of crisis right now is very distressing to front-line health workers and to people who have loved ones in these congregate care settings, including myself."
A big part of ending the crisis in long-term care is vaccinating workers. The vaccines have been shown to be very good in preventing serious illness in those who receive them, which is extremely important considering the deaths of PSWs who work in long-term care. It has not yet been proven, but it's likely that being vaccinated will help stop people from transmitting COVID-19 as well, he said.
Stall said he understands why some workers are hesitant to get the vaccine and more should be done to build trust among those workers, including those from racialized communities that have been wronged by the health-care system in the past. Another way of encouraging it would be providing paid time off for workers to visit vaccination clinics, he said.
Stall said he was very moved to see that the first Ontarian to receive the vaccine was a personal support worker, but that that was naive.
"I said, 'It's wonderful that we prioritize this population,' but many of them don't see it that way," he said, referring to some workers' fear that they're being treated as guinea pigs. "I think it was quite naive to think that we'll just prioritize them first and of course they'll go get the vaccine."
The Ontario Long-Term Care Association, which represents about 70 per cent of the long-term care operators in Ontario, wants to see, ideally, all long-term care residents, staff and essential caregivers vaccinated by the end of the month, said CEO Donna Duncan.
While the current focus is on the logistics of making vaccines available to all homes and preparing all homes to receive them, that will mean addressing vaccine hesitancy as well, she said.
"We certainly have to educate our residents and our front-line staff on the fact that the benefits outweigh the risks. We've been living with the risk of no vaccine over the last 12 months and the consequences are terrible. We need to support them and making informed decisions, but understanding what the risks are of not taking a vaccine."
Asked if employers may bar workers from long-term care homes if they refused to be vaccinated, Duncan said it's too soon to say when the focus is getting as many vaccinated as possible, but that the issue could be complex because some workers, such as those with severe allergies, may never get to be vaccinated.
Duncan said strategies to reach out to the hesitant should reach beyond the health and long-term care system to institutions where people place their trust, including in faith communities.
"This is a time of hope," she said. "We need to support each other in making informed decisions, but knowing what we've been through over the last 10 months, we would really hope that people understand the cost of not getting vaccinated. But it's going to take all of us working together to support each other in those decisions. The villain in this is COVID and this is an important weapon against it."
(Photo by Steve Russell/Toronto Star)