Despite a groundswell of support among professional associations and employer mandates, not all nurses are on board with receiving one of the COVID-19 vaccines. What’s causing vaccine hesitancy?
According to a survey by the American Nurses Association of more than 4,900 nurses, 11% of U.S. nurses say they will not get the COVID-19 vaccine or they remain undecided.
Among the 7% of nurses who said they will not get the COVID-19 vaccine, the most common reasons for their decision were a shortage of information about the vaccines’ long-term effects and safety, as well as mistrust about the vaccines’ development, trials, and approvals.
Rationales for Vaccine Hesitancy
According to ANA survey, 88% of nurses have been vaccinated. Yet, 29% of nurses surveyed were against employers requiring vaccination for employment.
“More than 100 staff members at Houston Methodist Hospital who were fired for refusing to get vaccinated for COVID-19 appealed a judge’s ruling that sided with the hospital’s right to terminate their employment,” according to Yahoo! News.
Jennifer Bridges, an RN and lead plaintiff in the lawsuit filed by Houston Methodists’ former employees, said in the article that she is “not anti-vax” and has had previously required vaccines.
Her vaccine hesitancy is based on her concerns that the COVID-19 vaccine was “rushed and it didn’t have the proper research,” according to the article.
Nurses Are People, Too
When last surveyed by the American Association of Nurse Practitioners (AANP), about 94% of U.S. nurse practitioners (NPs) who responded had taken steps to obtain the COVID-19 vaccination in March and April of 2021, according to April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of AANP.
“At that particular time, some of the barriers included that they didn’t have access to the vaccine because they were still rolling out the vaccine availability in groupings,” Kapu said.
The number of fully vaccinated NPs should be higher by now, according to Kapu, given the widespread availability of the vaccine.
But nurses are people, too, and have questions just like everyone else about the COVID-19 vaccine, according to Kapu.
“There might be concerns about wanting more information related to the actual vaccine development process,” she said. “They may want more information about the science, the efficacy. It might be something as simple as (and this would be big to them): ‘I don’t want to have any side effects because I have to come to work and I can’t take a day off.’”
Some, like their patients, have had reactions to vaccines in the past and are concerned about that.
The assumption is nurses already have all the information they need to make a sound decision about the vaccine, but maybe they don’t, according to Kapu. In fact, more than one-quarter of the nurses surveyed by ANA said they don’t have enough information about COVID-19 vaccines.
ANA President Ernest J. Grant, PhD, RN, FAAN, said some nurses cannot get the vaccine because of existing health conditions. But others might be basing their decision to refuse the COVID-19 vaccine on misinformation, with some of that coming from social media.
While 87% of nurses surveyed indicated they get information about the COVID-19 vaccine from government sources, like the U.S. Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH), 15% cited friends and family and 13% said Facebook.
According to Grant, a big concern among young nurses who express vaccine hesitancy is their concern that the COVID-19 vaccine might impact reproduction.
“No study has shown that, so once we are able to point that out, these nurses tend to make the decision to go ahead and get vaccinated,” Grant said. “I think it really comes down to education.”
As scientists, nurses should keep up with the latest science on COVID-19 and available vaccines, according to Grant. To help disperse scientific data, ANA offers the Health Nurse Healthy Nation campaign and collaborates with other organizations on the COVID Vaccine Facts for Nurses webpage.
“We provide information to our state nurse associations so that they too can help filter out bad information to the members by email or newsletters and things on their websites,” Grant said.
AANP announced August 2 that its board of directors passed a resolution to support the efforts of employers to create a safe environment and to stop the spread of COVID-19 in offices, healthcare settings, and other places where people gather. That includes employers’ mandating COVID-19 vaccinations.
Kapu said AANP leaders thought long and hard about supporting employer mandated vaccinations.
“We know how hard it has been to staff nurses in the hospitals to make sure that they are there caring for these patients 24/7, but we really felt it was very important when a healthcare system or any other type of employer steps forward and says ‘We’re going to mandate it for our employees.’ We support that,” Kapu said.
Kapu has seen for herself how effective COVID-19 vaccines are. “I work at a hospital and happen to know that the majority of patients who are coming in — and we have a lot of patients coming in now — are unvaccinated,” she said.
Politicizing the vaccine and mask wearing has had a negative effect on people’s decisions to take precautions, which are common practices in nursing, according to Kapu, who has had the COVID-19 vaccination. “All of that has become political,” she said. “That is very unfortunate because this is a healthcare crisis. We need to take advantage of the evidence and follow what our healthcare experts are saying, and that is to get vaccinated.”
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