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Barriers to Seasonal Vaccine Uptake among Vermont Skilled Nursing Facilities Staff
Cauley, Shane Curtis, Kylie Hess, Brian Loftis, Clara Rasheed, Amin Silverman, Andrew Velasquez, Olivia Zahran, Yusuf
Cauley, Shane
Curtis, Kylie
Hess, Brian
Loftis, Clara
Rasheed, Amin
Silverman, Andrew
Velasquez, Olivia
Zahran, Yusuf
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Abstract
Background: In Vermont, most long-term care (LTC) staff have completed the primary COVID-19 vaccine series. However, seasonal vaccination rates among LTC staff have been declining nationally. LTCs have employed methods to increase staff vaccination, though the prevalence of these interventions in Vermont skilled nursing facilities (SNFs) has not been explored.
Methods: Phone interviews were conducted with infection control personnel or administrators at 6 SNFs located throughout the state. Transcripts were coded for thematic analysis inductively, with related codes later being grouped into themes and sub-themes.
Results: Despite moderate-to-high vaccine importance at most SNFs and broad availability of on-site vaccination, staff vaccination rates remain low, particularly for COVID-19. Common vaccine promotion among SNFs included employer-provided vaccinations, on-site clinics, and sending direct reminders to staff. Only one of the 6 SNFs surveyed currently has a vaccine mandate in place (for influenza only). Financial barriers (i.e., high out of pocket costs) and fixed anti-vaccine sentiments among staff were cited as factors impeding vaccine uptake. Other factors included negative staff perception of seasonal vaccination efficacy/utility. 83% of the facilities expressed concern that staff beliefs were too fixed for further interventions to be effective.
Conclusion: Although this study is limited by a low response rate, the data does suggest that interventions targeted at fixed anti-vaccination beliefs may be effective. Other potential avenues for improving vaccine uptake include reducing the financial cost of seasonal vaccines, though these may be more effective at specific facilities. Further investigation is needed to characterize the impact of interventions that are already in use.
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2026-01-28
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Vermont Department of Health – Laboratory and ID Division