Debbie Ford, Chief Nursing Officer at Ochsner Medical Center in Jefferson, was the first Ochsner Health employee to receive the COVID-19 vaccine at 9:07 a.m. on Monday, December 14, 2020. (Photo provided by Ochsner Health)
In spite of overwhelming evidence that the COVID-19 vaccine protects against death and serious illness, one-third of health care workers surveyed across Louisiana are not convinced vaccines are necessary to end the COVID-19 pandemic, according to the preliminary results of a Louisiana Department of Health survey of roughly 10,000 medical workers.
The survey, which began June 29 and ended Aug. 5, asked a series of questions designed to gauge the opinions of medical professionals regarding the novel coronavirus and its vaccines. A consultant hired to complete the project, Dr. Paulette Riveria, shared some of the findings with the Louisiana Illuminator.
The health department has not published the survey yet. Spokesperson Aly Neel said the findings are pending an internal review by state health officials.
While some of the preliminary findings might be concerning, Neel pointed out that the survey shows a majority of providers have recommended and continue to recommend the vaccine. She said the health department expect to publish the entire survey by the end of September.
“We look forward to sharing the findings of our statewide survey on healthcare providers’ perceptions of the pandemic very soon,” Neel said. “There’s a lot to unpack but one major finding is that the majority of providers have not only personally gotten the COVID vaccine but also have recommended and will continue to recommend the vaccine to their patients. That is in line with what national data have found. It doesn’t mean there isn’t misinformation — and it remains critical that we continue to lead with empathy, answer questions, and connect people to reliable sources of information.”
More than 10,000 medical workers participated to some degree, and 9,384 submitted complete responses, Riveria said. Nurses, by far, participated the most, accounting for 6,547 complete responses. That included registered nurses, licensed practical nurses and advanced practice nurses, but the survey also went out to doctors, physician assistants, pharmacists, dentists, respiratory therapists, podiatrists, and medical students. Doctors accounted for 1,444 of those who completed it.
One of the questions asked participants to rate on a 0-10 scale how strongly they agreed that vaccines are necessary to ending the pandemic. Overall, 48% responded with a rating of 8-10 in strong agreement, 17% responded with a rating of 6-7, and 35% responded with a rating of 0-5.
Riveria said the responses to that question were particularly “heavily nurse-skewed.” Most of the doctors, roughly 70%, gave the highest rating, meaning they agreed that vaccines are necessary to ending the pandemic, she said.
Another finding indicated that about 15% of respondents admitted to advising someone against getting vaccinated at some point in the past. More than 10,000 people responded to that question.
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“We asked this because it’s not just prescribers and those in the room giving advice to patients,” Riveria said. “If they express any sentiment positively or negatively about vaccinations, it might influence a patient. So we were interested to see…how they advised people, whether it was family members or patients.”
The health department distributed the survey by email using the state regulatory boards for doctors, nurses and other healthcare professions, as well as medical schools, Riveria said. Participants completed the questionnaire anonymously through an online portal.
Riveria said the survey does not represent the opinions of every health care provider in the state, but it is the first of its kind employed by the state that has collected a significant number of opinions from medical personnel.
When told of the findings in the survey, Dr. Susan Hassig said she was not surprised. Hassig, an epidemiology professor and infectious disease researcher at Tulane University, said the findings appear to reflect Louisiana’s political climate, fueled by a Republican base that has embraced the anti-vaccine movement.
“That doesn’t surprise me — not here,” Hassig said. “It’s also a reminder that nurses aren’t necessarily trained in all of the things we are. They’re not necessarily who I’d go to for advice in a pandemic.”
In the first 10 months of the pandemic, more Americans died from COVID-19 than from combat in all four years of World War II. That number has since more than doubled to 676,000 on Monday — eclipsing, for the first time, the death toll of the 1918-1919 Great Influenza pandemic. Of the coronavirus deaths, 13,473 have occurred in Louisiana.
In July, when the survey got underway, Louisiana had one of the worst vaccination rates in the country with less than one-third of residents fully vaccinated. The state was also in the middle of its fourth — and most severe — COVID-19 surge.
That surge peaked Aug. 17 with a record 3,022 people hospitalized across the state before the new mask mandate and increased vaccinations started slowing the infection rate. As of Tuesday, Louisiana’s vaccination rate had climbed to about 44% and hospitalizations were down to 1,239.
The situation remains largely a pandemic of the unvaccinated. People who aren’t vaccinated account for 88% of new cases, 85% of deaths and 88% of hospitalizations in Louisiana.
Despite the evidence, vaccine resistance seems to be holding firm in some segments of the population. Louisiana Attorney General Jeff Landry, a Republican, has advised people on how to circumvent mask mandates, joined a lawsuit against a medical school that required its students to get vaccinated and issued legal opinions that undermined the governor’s efforts to fight the pandemic.
On Monday the Advocate reported that a group of nurses and other non-physician staff from two hospitals in Acadiana filed lawsuits against their employers in an attempt to stop mandates requiring employees to take a COVID-19 vaccine. They are represented by Jimmy Faircloth, who also represented bar owners in an unsuccessful lawsuit against Edwards to try to reverse statewide pandemic restrictions on bars last year.
Hassig said it makes sense that it’s mostly nurses who are vaccine-resistant because most are not educated on the scientific side of medicine. Typically, nurses are educated and trained in how to apply medicine, which includes things such as bedside manner and the proper use of medical tools and equipment, she said.
“Nurses are trained to deal with the patients at the bedside,” Hassig said. “It’s very narrowly focused…They learn the how and not necessarily the why.”
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This can leave nurses and other non-physicians just as susceptible to misinformation as the general public, Hassig said.
Riveria, the doctor who led the health department survey, said physicians also can fall victim to misinformation since they tend to prefer easily-accessible information and don’t always have the time to thoroughly vet sources. Some of the vaccine-hesitancy is due to general misconceptions rather than politics.
For example, a common misconception is that the Pfizer and Moderna vaccines use a technology that was invented just last year. In fact, the mRNA technology that delivers those vaccines has been studied by scientists for more than 30 years.
Riveria said the survey measured some conversion of medical professionals who indicated they were initially skeptical about the vaccine but now trust the science. Still, about one-third of the 15% who had admitted to advising someone against getting vaccinated in the past indicated they would continue to advise against it no matter what, Riveria said.
She said the health department hopes to use the findings to better understand how public health information, particularly regarding the COVID-19 vaccine, is received by the medical community and to help identify the best candidates for vaccine ambassadors — “points of contact who aid LDH in distributing vital information to people, populations, and communities.”
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