She advocates reimbursement of time and costs to employees. However, she noted, “There is good evidence from behavioral economics that offering money signals is risky. These vaccines are really safe and effective, so we don’t want to perpetuate people’s fears. “

Although Covid-19 cases and deaths in long-term facilities are declining, those with high vaccination rates also need to remain on guard. New residents are constantly arriving and the employees are leaving. The turnover of nursing staff in nursing homes is extraordinarily high and, according to a new study, averages 128 percent over the year. This means that after one year all original caregivers and 28 percent of their replacements have left.

Perhaps the most delicate issue is vaccinating most of the country’s direct caregivers, the roughly 2.3 million people who work in private homes.

“It’s going pretty bad,” said Vicki Hoak, executive director of the Home Care Association of America, which represents 3,200 home care agencies. Although home care workers have priority over vaccinations in every state, they struggle to get them, she said.

Like the rest of the direct caregivers, the home carers are primarily black women, including many immigrants. Averaging $ 12.12 an hour in 2019, they are the worst-paid group, according to the PHI research and advocacy group. Almost half depend on public support such as Medicaid or nutrition programs.

Without a central workplace, they are more difficult to reach, educate and vaccinate than helpers in nursing homes and assisted living centers. (Some, privately hired by individuals and families through what is known as the gray market, do not work for agencies at all.)

“Reluctance to vaccinate is absolutely a factor, but most importantly, the lack of readily available vaccination options,” said April Verrett, president of SEIU Local 2015, the union that represents nearly 400,000 domestic workers in California.