Issue: March 2021
Disclosures: Kliger, Fortune, Watnick, Scott, and Smith report no relevant financial disclosures.
March 18, 2021
3 min read

Health care workers, including dialysis staff, holding out on COVID-19 vaccine

Issue: March 2021
Disclosures: Kliger, Fortune, Watnick, Scott, and Smith report no relevant financial disclosures.
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Last month, Rochelle P. Walensky, MD, MPH, director of the CDC, signed off on her agency’s recommendation endorsing the safety and effectiveness of the Janssen, a Johnson & Johnson company, COVID-19 vaccine.

“The Janssen vaccine has been shown to be safe and effective in preventing severe COVID-19 illness, hospitalization and death,” Walensky said in a press release. “I know that many Americans look forward to rolling up their sleeves with confidence as soon as a COVID-19 vaccine is available to them.”

Mark E. Neumann

However, some professionals who are at a high risk for exposure to the virus and have priority status to receive the vaccine (such as emergency medical technicians and dialysis clinic staff) have declined to take it for a variety of reasons.

“We have seen a 50/50 split among staff in my unit among those who are taking the vaccine and those who are not,” Elizabeth Fortune, a patient on dialysis, said during a recent webinar.

“Yes, we have had some staff members who have been hesitant to get vaccinated,” Suzanne Watnick, MD, chief medical officer for Northwest Kidney Centers, told Nephrology News & Issues. “Currently, all staff have access, but before that happened, we polled our staff. Seventy-nine percent stated that they were either willing to take the vaccine or they would possibly get vaccinated.”

Watnick said the dialysis provider launched an education campaign to help staff understand the risks of the virus. “We see vaccination as one light at the end of the COVID tunnel, and it cannot come too soon,” she said.

Nancy Colobong Smith, MN, ARNP, CNN, a renal and transplant clinical nurse specialist at the University of Washington Medical Center, said staff hesitancy about taking the vaccine could send the wrong message to patients. “Even among health care workers, there are misunderstandings or misconceptions about vaccines,” Smith told Nephrology News & Issues. “I am concerned that patients are going to get mixed messages, and this will deter them from getting the vaccine.”

Adds nephrology nurse Tanya Scott, MSN, RN, CNN, director of patient care at Baylor St. Luke’s Medical Center in Houston, “I believe many factors contribute to the reluctance to take the vaccine, such as uncertainty regarding efficacy, the potential for adverse effects, and distrust in the health care system.”

The short time for the development of the Moderna and Pfizer vaccines has dialysis staff at the University of Virginia Health System dialysis clinics concerned about the potential for adverse events, Debbie Cote, MSN, RN, CNN, NE-BC, administrator for the clinics, told Nephrology News & Issues. “There is a lot of apprehension in general from staff and patients about the vaccine because of the limited time on the market.” Cote said.

However, Alan S. Kliger, MD, who is co-chair of the American Society of Nephrology’s COVID-19 Response Team, said the vaccines have gone through more rigorous testing than other treatments for infectious disease. “To date, millions of people in the U.S. have received the vaccine, and there have been very few reports of serious side effects – a track record so far, better than many other medications and vaccines that have been used in the past for other diseases.”

In January, the CDC released a video aimed at health care workers who were reluctant to take the vaccine.

“My primary message to health care workers is to get vaccinated,” CDC virus expert Anthony Fauci, PhD, said in the video. “It’s important for yourself, it is important for your family but symbolically as health care providers, it is important to show confidence in the vaccine so that other people in this country follow suit and get vaccinated.”

Scott took the vaccine because as a Black woman, she said she feels she is at a greater risk to contract the virus. “My mother has a medical history significant for [chronic obstructive pulmonary disease] COPD, and my mother-in-law suffers from chronic kidney disease, which requires her to receive hemodialysis,” Scott said. “Both suffer from diabetes and heart disease. I want to ensure that I do everything I can to prevent them from being exposed to COVID-19.”