Lessons Learned From Frontline Skilled Nursing Facility Staff Regarding COVID-19 Vaccine Hesitancy

Sarah D. Berry MD MPH; Kimberly S. Johnson MD; Lonnita Myles BA, MBA; Laurie Herndon NP; Ana Montoya MD MPH; Shekinah Fashaw BS; David Gifford MD MPH


J Am Geriatr Soc. 2021;69(5):1140-1146. 

In This Article


Background: Presently a median of 37.5% of the U.S. skilled nursing facility (SNF) workforce has been vaccinated for COVID-19. It is essential to understand vaccine hesitancy among SNF workers to inform vaccine campaigns going forward.

Objective: To describe the concerns raised among healthcare workers and staff from SNFs during town hall meetings.

Design: Sixty-three SNFs from four corporations were invited to send Opinion Leaders, outspoken staff from nursing, nurse aid, dietary, housekeeping or recreational therapy, to attend a 1-h virtual town hall meeting. Meetings used a similar format where the moderator solicited concerns that the attendees themselves had or had heard from others in the facility about the COVID-19 vaccine. Physicians and moderators used personal stories to address concerns and reaffirmed positive emotions.

Setting: Twenty-six video town hall meetings with SNF staff.

Participants: Healthcare workers and staff, with physicians serving as content experts.

Measurement: Questions and comments about the COVID-19 vaccines noted by physicians.

Results: One hundred and ninety three staff from 50 facilities participated in 26 meetings between December 30, 2020 and January 15, 2021. Most staff reported getting information about the vaccine from friends or social media. Concerns about how rapidly the vaccines were developed and side effects, including infertility or pregnancy related concerns, were frequently raised. There were no differences in concerns raised by discipline. Questions about returning to prior activities after being vaccinated were common and offered the opportunity to build on positive emotions to reduce vaccine hesitancy.

Conclusions: Misinformation about the COVID-19 vaccine was widespread among SNF staff. Sharing positive emotions and stories may be more effective than sharing data when attempting to reduce vaccine hesitancy in SNF staff.