While many of these COVID-19 Success Stories pertain to the previously administered bivalent vaccine, the strategies and ideas to support and motivate up-to-date vaccinations still apply.

How to Overcome Vaccine Resistance in Long-Term Care

COVID-19 vaccine hesitancy is rampant in nursing homes, which is a problem because older adults are more likely to get very sick or die from COVID-19, especially Hispanics/Latinos. Like many nursing homes, Victoria Gardens of Frisco, a skilled nursing facility in a fast-growing Dallas–Fort Worth suburb in North Texas, struggled with vaccine hesitancy among its 70 residents, family and staff. Nobody wanted to get the bivalent vaccine.

However, with some perseverance and free technical assistance and education resources from TMF Quality Innovation Network-Quality Improvement Organization (QIN-QIO), Victoria Gardens succeeded in convincing 30 residents and family that the COVID-19 bivalent vaccine is necessary. Their vaccine rate went up from 13% to 57% in one clinic.

At first, only nine Victoria Gardens residents had the bivalent vaccination. “Our biggest solution was educating the responsible party,” said Tonya Watson, director of nursing. “Even though we sent information in the mail, made phone calls and spoke in passing, it was the one-on-one education that was the most effective. Most of the families of the residents did not have the correct knowledge about the bivalent vaccine. They didn't want Mom or Dad to receive it because they didn't believe in it.”

Watson, the assistant director of nursing, and Victoria Gardens’ administrator began calling and educating residents with high Brief Interview for Mental Status (BIMS) scores in June 2023. She found that offering snacks to the residents who were capable of making decisions helped. They also displayed posters and flyers to get staff attention. “I posted pictures due to the fact that most individuals are visual,” she said.

“After receiving information from TMF, I was able to learn more about the vaccination,” Watson said, so she made calls and educated family members on the importance of the vaccination. “It takes time. Some people are so busy, they just say no instead of stopping to listen. We learned that once we began speaking with the family member or resident and helped them feel as though we know what we are talking about, they are more willing to listen and give what you're selling a try,” she said.

“TMF worked hard to find interventions to get the residents and families to agree to get the vaccination,” said Watson. This included providing information that Victoria Gardens could send in the mail to family members and use for making phone calls. Emailing and hanging printed vaccine information in the break rooms helped, too.

“Our next focus is on getting the staff vaccinated,” Watson said. “I have observed a few staff members looking at the TMF resources. Maybe we will offer incentives such as gift cards, bonuses, etc.”

The TMF QIN-QIO offers free COVID-19 education and technical assistance to nursing homes and skilled nursing facilities in Arkansas, Mississippi, Nebraska, Puerto Rico, Texas and the U.S. Virgin Islands. For information on how a TMF QIN-QIO specialist can assist your nursing facility, please email QIInetwork@tmf.org.