MHE's Associate Editor Briana Contreras spoke with Senior Vice President of healthcare services at SCAN Health Plan, Eve Gelb. The two discussed the issue of vaccine mistrust among family caregivers and how it can result in leaving vulnerable seniors at risk.
Below is a brief Q&A of the interview with Gelb that has been edited for clarity and length:
Q: It was found that 63% of family caregivers who do have doubts about the COVID-19 vaccine safety, say that they'll take their senior under their care to get vaccinated. So, although it's a good thing these family caregivers are having their seniors receive vaccinations, can you share why those who have doubts and aren't getting their vaccines are affecting their senior's care?
A: You know, it does concern me that those caregivers are not taking care of themselves. So, in order for this ecosystem to work, folks have to take care of their older adult or loved one, and they also have to take care of themselves. I'm heartened to hear that even though they might have hesitancy, they're interested, they're making sure that their loved ones get the get needed care, but I'm also disheartened that they might not be caring for themselves, and that some of that hesitancy might be also impacting the older adults will ability to get the vaccine.
Q: It was also found that 13% of Hispanic caregivers, and about 25% of black caregivers don't plan to take a senior under their care to get vaccinated. It also found that nearly half of American family caregivers would either delay or refuse a COVID-19 vaccine, when it was offered to them. What is the cause of some of these decisions? Why is it a concern to their seniors?
A: LatinX and African American caregivers have more complex situations, whether it be for language issues or cultural issues. I think also, you know, whether they're black or LatinX, or just low income, I think there are barriers to getting your loved one vaccinated - things like being able to take time off of work. Some of that is probably due to the fact that they just don't live in a circumstance that allows them to take that time and to get their loved one vaccinated.
I think the general hesitancy, or, I like to think of it more about lack of trust is there because there's a reason that folks are hesitant to take the vaccine. Rather putting it on them, we should put it on us. How do we develop trust to make sure that people understand what is a good thing? What is an important thing versus what might be something that would be harmful? As for the vaccine, it has been tested more than other vaccines have been tested, and on more types of populations. I just think we have not done a really great job of communicating that in a way that matters to the people who really need to engage to get the vaccine.
Q: What further information should people take into consideration about the COVID-19 Vaccines?
A: I wanted to emphasize that the caregivers are the cornerstone to healthy older adults. I think he one message we want to get across is that we need to focus on those caregivers. Being able to take care of themselves and being able to get access to the vaccine and also being able to be motivated to get the vaccine is important. It's really important to ensure that the right folks are getting the messaging out to them and letting them know there is access.
The point about rural communities and access to health resources is absolutely right on when when you have a bunch of folks who have COVID-19 because they've been exposed or they haven't been vaccinated. A rural community hospital is going to be overwhelmed way faster than a large urban hospital. The resources that are available to rural communities really are depending on the fact that more people are going to get vaccinated that more people are going to stay healthy. They are at much higher risk than large urban centers when folks have cases.
I also think trust is a super important aspect of what we're trying to engender here. One of the main reasons we wanted to do the survey was to help people understand that the inequities and the system that has come before us has engendered mistrust. In order to build the trust, we have to listen to people, we have to understand their history - their version of history. We have to have empathy, which means that not only are we listening, but we're caring about what they're saying when we're listening, and that's going to motivate us to actually do something to improve the situation.