Every day during the pandemic, Dr. Mark Lewis and fellow anesthesiologists at Tufts Medical Center insert breathing tubes for COVID-19 patients who need intensive care.
“We are in their mouths,” says Lewis, describing the close contact with a patient, “literally inches away from their face.”
Lewis wears a gown, gloves, mask and a face shield during these encounters, of course, but he wants the next level of protection: a coronavirus vaccine. And he wants it now.
“Sign me up,” says Lewis. “It’s a game changer.”
As 60,000 small, frozen vials of a coronavirus vaccine make their way to hospitals in Massachusetts, there’s a growing sense of excitement, confusion and trepidation among hospital workers. Some employees say their sleeves are rolled up, ready for an injection. Others say they are wary — if not deeply mistrustful — of what’s inside that syringe.
Dr. Michele Finkle, an OB/GYN in Cambridge, is among those who isn’t sure what she’ll do. Finkle is a strong vaccine advocate. But this moment is different: she's pregnant. Anyone who said they were pregnant was not allowed to enroll in the coronavirus vaccine trials. So Finkle has a lot of questions that aren’t answered in the trial results so far.
“Although I think the vaccine is likely safe and effective now, there’s no data regarding what happens if or when it crosses the placenta, and if there’s any danger to the unborn fetus in utero or after birth,” she says.
Hospital leaders in Massachusetts say many female employees in their child-bearing years are wondering if they should get vaccinated. Guidance in the United Kingdom says people who are not pregnant when they become eligible for the vaccine should wait two months after receiving the second shot before trying to conceive. The Centers for Disease Control says about 330,00 health care workers could be pregnant or breastfeeding while hospitals run coronavirus vaccination clinics.
Barbara Braccio, a nurse who cares for COVID patients in Worcester, says until a few weeks ago she was adamant — she would not get the shots.
“It was new, it was rushed through, and I just didn’t feel comfortable getting it,” she says.
But Braccio says her resistance has crumbled under the weight of another surge of COVID-19 patients.
“I’m just tired of the fight with the COVID,” she says. “I just want to see it go away and it’s not going to just go away so the best option is the vaccine.”
There are signs that many nursing assistants, medical technicians, lab workers and cleaning staff still share Braccio’s initial concerns. One of the state’s largest health care unions, 1199SEIU, has polled members, asking if they’re ready to get a coronavirus vaccine. Preliminary results show about half of respondents say no. Tim Foley, the union’s executive vice president, says many SEIU members are women of color who remember the Tuskegee syphilis study and the country’s history of unethical medical research.
“We know there are some barriers and obstacles,” Foley says. “We need to make sure that we’re doing all that we can now to make sure folks have the information they need to feel comfortable taking the vaccine.”
SEIU members also staff nursing homes, where vaccinations are expected to begin about a week after hospitals. Dr. Asif Merchant, a medical director at four Boston-area nursing homes, says he’s hearing similar vaccine hesitancy among about half of the nursing homes’ staff.
Merchant says a lot of the resistance is based on bad information about whether the vaccines include live virus — they don’t — and whether they cause serious side effects. There were very few adverse events during the Pfizer trials. Some common side effects reported by participants included fatigue, pain at the injection site, and headache or muscle aches.
Merchant is hosting Q&A sessions in his nursing homes and says people become more comfortable with the idea of vaccination when their questions or concerns are addressed.
“The more we do that, there will be a wider acceptance. I truly believe that,” Merchant says.
Some hospitals are reaching out to hesitant employees, especially staff of color who ask why they should volunteer to go first.
“We understand that could create concern and build on mistrust that exists,” says Dr. Joseph Betancourt in a video taped in both Spanish and English for employees of the Mass General Brigham network.
Betancourt, the chief equity officer at Massachusetts General Hospital, answers the “why us first” question with this: “If you are getting it first, it is because you are especially valued and because you are especially at risk.”
Betancourt says Mass General will reinforce that message by reserving vaccine appointments daily for employees from Chelsea, Revere and other communities with high infection rates. There’s concern that if white employees are more enthusiastic about the coronavirus vaccines than Black and Latino staff, then disparities during COVID may increase.
“That’s certainly possible,” says Betancourt. “We’re trying to avoid that at all costs.”
It’s unclear how much pressure hospital employees will be under to get vaccinated. The shots will not be mandatory. Tufts Medical Center’s chief medical officer, Dr. Saul Weingart, says if employees aren’t ready for the vaccine, he’ll take that into account when creating the hospital’s priority list.
“My hope is that we can make this as democratic as possible and get as much input from individuals as possible,” Weingart says.
With hospitals going first, they may set the tone and expectations for vaccine priority groups that follow. Dr. Kimberly Fisher, an associate professor of medicine at the University of Massachusetts Medical School, who ran a national coronavirus vaccine opinion study earlier this year, says there are a number of reasons the public will pay close attention to vaccine acceptance among health care providers — doctors in particular.
“Physician recommendations for a vaccine are very influential and one of the most, the strongest influences in a patient’s decision about whether or not to be vaccinated,” says Fisher.
This segment aired on December 14, 2020.