New survey reveals that Hawaii long-term care providers outpace mainland counterparts in COVID vaccinations

Thirteen facilities had more than 90% of staff vaccinated; more healthcare staff seek
vaccination as comfort levels with vaccines grow

Honolulu – Skilled nursing facilities and other long-term care facilities in Hawaii are vaccinating an average 78% of their staff against COVID-19, demonstrating rates far higher than the national average of 38%, and highlighting a growing acceptance of the COVID-19 vaccines as time goes on, according to a report by the Healthcare Association of Hawaii, an industry trade association.


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Three facilities got 100% of their staff vaccinated, and 13 facilities had staff vaccination rates of 90% or more. Most found that vaccination rates rose when they reached the second of the three clinics planned as part of the federal pharmacy partnership program to vaccinate long-term care residents and staff.

The average vaccination rate for facility residents in Hawaii was 90% compared to the national average for nursing homes of 78%, with some Hawaii facilities vaccinating 100% of their residents.

Hilton Raethel, the Association’s president and chief executive officer, said the results show how well Hawaii’s larger long-term providers are doing in getting their staff vaccinated.

“It’s a testament to their hard work in educating staff and working with our federal partners and the Hawaii Department of Health to vaccinate both staff and residents,” he said. “They have also found that vaccination rates rise over time, as more healthcare staff become comfortable with being vaccinated for COVID-19, and have opportunities to receive the vaccine at subsequent clinics.”

The Association’s members include hospitals, skilled nursing facilities, assisted living facilities, Type II adult residential care homes, home health agencies, and hospices. Survey responses were received from 41 of the state’s 45 nursing facilities, or approximately 91 percent of Hawaii’s licensed nursing facilities. Survey respondents also included 10 of the state’s 18 assisted living facilities, and five adult residential care homes. (The smaller community care homes are not represented by HAH.)

Facilities generally found that staff vaccination rates increased when the second vaccine clinic with CVS or Walgreens occurred. At the time of the survey between Feb. 4-10, some facilities had yet to have their second clinic. In addition, some of the long-term care staff may have been vaccinated at other venues such as a hospital-run point of dispensing (POD), so their vaccinations were not counted towards the facility’s total.

A report released Feb. 5 by the Centers for Disease Control and Prevention (CDC) showed the early vaccination rate in the nation’s nursing homes to be 37.5%, with a median of 77.8% of residents vaccinated.

In the HAH survey, the reasons cited for vaccine hesitancy include:
• Concerns about short term and long-term side effects.
• Concerns about vaccine safety due to underlying health conditions.
• Concerns that the vaccines’ development was rushed.
• Concerns about childbearing and pregnancy.
• Misinformation from social media.
• Cultural concerns about vaccines’ effects on racially diverse populations.
• Religious concerns.
• General vaccination concerns.
• Taking a ‘wait and see’ approach.

The long-term care facilities found that these tactics worked best to achieve higher vaccination rates:
• Frequent communication through written, verbal, one-on-one, and virtual networking meetings.
• Engage leadership to receive vaccine first, to inspire confidence in staff.
• Frequent education and sharing of resources with staff, residents, and families.
• Engage community cultural leadership to speak with racially diverse staff.
• Frequent Q&A sessions with public health leaders and medical leadership.
• Apparel providing recognition of a staff’s COVID vaccination.
• Incorporating communication strategies and educational resources from the CDC, Hawaii
Department of Health, and the American Health Care Association/National Center for Assisted
Living (HAH’s national affiliate for long-term care).
• Drawings and raffles for staff who received a vaccine.

This press release was provided by the Healthcare Association of Hawaii