The COVID-19 pandemic has presented the world with many challenges; arguably, the impact has been greatest on those who reside and provide care in our long-term care settings. Vaccinations give us hope that we can turn the page and no longer fear COVID-19 and it’s devastating impact on quality and loss of life.

The COVID-19 vaccines have been available to essential workers for nearly six months; science and medicine have proven the vaccines are safe and effective. So, why are we not seeing higher rates of vaccination among healthcare workers? April Peyer, Infection Preventionist with Missouri Slope Lutheran Care Center in Bismarck, ND, shared some of the struggles and concerns she has in her attempts to increase vaccine confidence. Missouri Slope is the largest long-term care facility in North Dakota; employing 470 individuals. As of the time of this article, Missouri Slope is sitting at a 51% vaccination rate of their staff.

April Peyer“COVID has been devastating for us; we lost many residents this past year. We lost married couples, individuals who had a lot to live for – every death was a painful loss for our staff. We also had residents diagnosed with COVID and then recovered; however, these residents still experience many lasting effects from the disease,” Peyer stated.

“The majority of team members who wanted to get vaccinated did so in the beginning. We have provided a staff inquiry to identify reasons for hesitancy of those who have opted to not get vaccinated. The concerns are common to what we are hearing elsewhere; the belief that the vaccines were produced too quickly, not FDA approved, potential side effects and some fear the vaccine is unsafe. We provided trainings, education and resources to help alleviate concerns with fact-based answers, but making little impact,” Peyer added.

Missouri Slope had invested much time and effort into addressing the lower-than-desired vaccination rate of its staff. Leadership led by example and were the first to be vaccinated back in December. The Medical Director, Dr. Bruce Hetland, addressed vaccine efficacy and safety during several vaccination clinics. In addition, vaccinated staff are allowed removal of some Personal Protective Equipment (PPE). Written and video testimonials of staff who have been vaccinated have been shared and informational brochures are posted throughout the building and in the facility restrooms.

Access a video of employee testimonials prepared by the Missouri Slope team.

“It is disheartening. We recently had to discontinue visitors in the facility due to a few COVID cases. As you can imagine, this is especially hard for family members. I could just cry thinking about it. We have done so much to offer education and training. I keep a running file of our activity and the rate of vaccination and we are only seeing a small uptick in vaccinations at this point; I wish there was more I could do.” Peyer said.

Missouri Slope has considered a mandate for all its employees even though that may be unpopular. Peyer added, “I will continue to advocate for a vaccine mandate amongst all of LTC. We have not experienced a flu outbreak in our facility in eight years; since we implemented an influenza vaccine mandate. I have done a lot of research on the COVID-19 vaccine options. When asked my opinion on what vaccine to choose, I indicate to get whatever option is available to you. They are safe and effective. I believe strongly in the vaccine; I would administer it to my 6 year-old if an option.”

Peyer is looking for assistance or tools to help alleviate concerns among staff. Their leadership team meets weekly seeking input for a Performance Improvement Plan to improve employee vaccination numbers. She is currently in the process of developing a video where she offers answers to common questions; offering fact-based responses to questions.

“I feel most did not see the worst of COVID. In North Dakota, we were not impacted like other cities in the country. Unless you were personally affected or cared for a patient or resident that lost his/her life, it does not seem as scary. However, it is real and we lost lives; many lives that were worth living. We need to do our part, as healthcare workers, to protect one other and those we provide care for; without exception,” Peyer concluded.

COVID Vaccination Ambassador ProgramGreat Plains Quality Innovation Network’s COVID-19 Vaccination Ambassador Program

The hesitation and low staff vaccination rate is not unique to Missouri Slope Lutheran Home. Vaccination is the key to ending this pandemic. A vaccine protects the individual vaccinated, but also protects those we provide care for; particularly individuals at increased risk for severe illness. Great Plains QIN is celebrating and recognizing organizations with high staff COVID-19 vaccination rates throughout North Dakota and South Dakota through the COVID-19 Staff Vaccination Ambassador Program.

The Nursing Home Staff Vaccination Ambassador page was recently launched. Congratulations to the nursing homes who have reached the 75% vaccination mark. We know this is not easy and your efforts are to be celebrated. *The site will be updated weekly

This effort began with nursing homes and was recently extended to community healthcare partners and service organizations. All responses are self-reported and voluntary. Organizations with a 75% or greater staff vaccination rate will be recognized as COVID-19 Staff Vaccination Ambassadors. Ambassadors will be highlighted on the Great Plains QIN Web site, provided a certificate and a template press release recognizing this accomplishment. There is also great value in responses sharing what has worked well and barriers encountered; best practices and resources will assist those seeking assistance in increasing their staff vaccination rates.