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Why some San Diego County healthcare workers declined the vaccine

Available data suggests low refusal rates
Posted at 4:43 PM, Jan 15, 2021
and last updated 2021-01-15 21:22:47-05

SAN DIEGO (KGTV) — In some pockets of the country, large numbers of healthcare workers have turned down the COVID-19 vaccine, raising concerns about the rollout and the prospect of vaccine hesitancy.

However, in San Diego County, the available data suggests low refusal rates among frontline healthcare workers, although in some cases healthcare providers are collecting their numbers in a way that make them difficult to assess.

Refusal rates among healthcare workers in some Southern California counties have generated significant attention in recent weeks. Orange County’s health agency director said about 30 percent of healthcare employees in that county had so far refused the vaccine. An estimated 50 percent of the healthcare workers in Riverside County had declined.

Since healthcare workers face the greatest risks from COVID-19 and are at the highest priority for vaccination, refusals at those rates might imply distrust with the vaccine. But health experts in San Diego County cautioned that refusal data is often more complex than it appears. The numbers can be inflated by staff who have delayed the vaccine rather than flatly denying it, or by employees who received a vaccination elsewhere.

In some cases healthcare workers delay the vaccine because they’ve already had COVID-19.

“We don’t need to direct vaccine to people who are already theoretically immune. So our policy has been, along with the CDC, that you can defer in those people for 90 days,” said Dr. Christian Ramers, assistant medical director of Family Health Centers of San Diego.

Among those who are hesitant, there's a spectrum. A national survey by the Kaiser Family Foundation last month found 15 percent of healthcare workers fell into the most skeptical category, saying they would “definitely not” get the vaccine.

“Hesitancy as a whole is not one thing. It’s not an anti-vax thing,” said Dr. Ramers.

Ramers said at his own clinic, virtually none of the frontline healthcare staff who interact with patients declined the vaccine. He said the number of refusals increased among back office staff and those who were working from home.

Some women voiced concern about the vaccine because they were pregnant or thinking of becoming pregnant, Dr. Ramers said. Pregnant women were not expressly enrolled in the Moderna or Pfizer trials, although a few participants did become pregnant during the study.

Ramers said after discussing the risks and benefits of the vaccine with staff on an individual basis, many pregnant women did opt to get the shot.

ABC 10News surveyed some of the largest healthcare providers in San Diego County.

Some providers, like Sharp Healthcare, said they don’t track the number of outright refusals. As of this week, Sharp said 75 percent of its health workers have been vaccinated. Sharp has vaccinated 16,200 workers out of 19,000 employees and 2,700 affiliated physicians.

Scripps Health said it had vaccinated 67 percent of its workers so far, or 14,449 of its 21,559 staff and employees. The other 33 percent had not yet responded.

“A non-response can mean a number of different things, such as getting the vaccine elsewhere, wanting more information, wanting to wait longer, or being pregnant,” said Scripps public relations manager Stephen Carpowich.

UC San Diego Health said of the roughly 13,000 healthcare employees offered the vaccine, 72 percent had received a first dose. Only four percent had declined. Another 6 percent postponed for various reasons, including vacation or pregnancy.

The remaining 18 percent were scheduled for a vaccination or had not yet responded.

Health experts suspect San Diego County’s declination rate among healthcare workers is in low single digits.

“That’s a 95, 98 percent acceptance rate from the initial healthcare workers offered the vaccine,” Dr. Ramers said. “And we’re the ones seeing these patients and we know how bad this disease can be.”

He said anyone who is reluctant to get the vaccine should speak with their doctor about their individual risk factors.