As the delta variant continues to cause the latest wave of coronavirus, many long-term care providers and advocates are calling for mandatory vaccinations for staff members – a dramatic change in tone from the start of the pandemic.

“I’ve come full circle,” said Michael Wasserman, member of the California Vaccine Advisory Board and former president of the California Association of Long-Term Care Medicine. “It is quite clear that if all nursing home staff were vaccinated, we would have a huge impact on deaths in nursing homes from COVID-19. “

Nursing homes, once deadly epicenters of the coronavirus pandemic, were among the first to be eligible to receive the COVID-19 vaccine due to their vulnerable population of older people, many of whom have underlying illnesses . To date, more than 184,000 residents and nursing home staff in the United States have lost their lives to the virus.

In the months since nursing homes were prioritized for immunization, COVID-19 cases and nursing home deaths have declined significantly. Yet nationwide immunization rates among nursing home staff are far behind.

The American Association of Retired Persons estimates that about 78% of residents in long-term care facilities are fully immunized, while staff immunizations are only 56.7%.

“Some say they think it’s still too early for them to get vaccinated,” Evan Lubline, CEO of Hooverwood Living in Indiana, said of his staff. “So they’re always evaluating and seeing what works for them. They want a choice.”

The Centers of Disease Control has said for some time that when nursing home staff vaccinations lag, epidemics can follow.

In April, the CDC linked a COVID-19 outbreak at a Kentucky nursing home to an unvaccinated health worker at the facility. Authorities have identified a total of 46 cases of COVID-19, resulting in the death of three residents, one of whom had been vaccinated.

“Unvaccinated staff can still cause epidemics,” Wasserman told ABC News. “These epidemics will always kill all unvaccinated residents and also put unvaccinated staff at risk. I find it unacceptable that we do not require vaccines for nursing home staff.”

“We don’t want a repeat of what we’ve been through, for anyone – not for seniors or their caregivers,” Katie Smith Sloan, President and CEO of LeadingAge, an advocacy group for seniors , told ABC News. “If a community is at risk and cases increase, then the elderly and long-term care are at risk. “

A new CDC report released Thursday addressed vaccine reluctance among long-term care staff, although they were prioritized for early vaccination against COVID-19 due to their high-risk roles . The report comes as more than 50 major health organizations demand mandatory vaccines for staff.

Earlier this year, LeadingAge and the American Health Care Association and the National Center for Assisted Living (AHCA / NCAL) – which represent more than 14,000 nursing homes – led a joint national campaign to vaccinate 75% of all nursing home staff by June. 30. However, the campaign did not achieve its goal. As a result, organizations are now calling on all nursing facilities to make staff vaccinations mandatory.

“We can start saving more lives today by ensuring staff are fully immunized,” Sloan said.

But vaccine mandates can go both ways. In some long-term care facilities, vaccine reluctance among staff has been so pronounced that leaders fear that requiring the vaccine will push them out the door.

Kimberly Biegasiewicz, vice president of clinical services at Avante Group, which owns several long-term care facilities in Florida, told ABC News that they do not require staff vaccinations after having conversations with staff. Instead, the group recently launched a ‘vaccination push’ at facilities, with initiatives including offering prizes to facilities with the highest vaccination rates and hosting conferences with health experts. to educate staff.

“We spoke to our staff and they were transparent in saying they wanted to make their own health care decisions,” Biegasiewicz said. “In addition, there is a very real concern that mandatory vaccinations in the framework force these staff out of the profession, and now more than ever we need these hard-working staff to provide quality care to our people. more vulnerable. “

“Staffing issues in long-term care facilities are always a concern,” Lubline said. “We don’t want them to leave.”

As a result, said Lubline, “we’re just trying to educate them. We always give them information about vaccines, but we also tell them that they need to feel comfortable. We don’t want to put too much pressure on them. to make them feel like they have to. “

Likewise, the AHCA recognizes that mandates could hamper staff recruitment efforts and make it more difficult to retain workers. As a result, the organization – while fully supporting mandatory vaccines – encourages nursing care facilities to continue providing education on the efficacy and safety of the coronavirus vaccine, to encourage staff to get vaccinated. voluntarily.

SEIU, the union that represents healthcare workers, including many workers in nursing homes, is also encouraging employers to facilitate the vaccination of staff members.

“[Vaccination] just isn’t happening quickly enough in the face of increasing cases of Delta variants in the United States and around the world, ”SEIU officials said in a statement. “A lack of paid time off for immunization or vaccine side effects, language barriers and access to more reliable messengers from the same culture and community are all factors that make getting the vaccine even better. difficult for workers. At this critical time, more businesses and employers must do their part to remove these barriers. “

Dr Sachin Jain, doctor of internal medicine and CEO of SCAN Health Plan, told ABC News that as a doctor he believes that “it is absolutely essential to vaccinate everyone who comes into contact with the elderly. “.

“We have known for some time that older people are at high risk for serious illness from the coronavirus,” said Dr Jain. “This remains the case. However, we now have effective vaccines that have been shown to reduce the risk of becoming seriously ill.”

Douglas Adkins, the administrator of DaySpring Senior Living, one of the first nursing homes in the country to mandate staff vaccinations in March, told ABC News he is upholding his decision.

“The simple truth is that mandatory vaccination is a win-win solution for everyone,” Adkins said. “Ensuring the safety of residents, staff and our visitors is important to us. “

Terry Fulmer, chairman of the John A. Hartford Foundation, which works to improve care for the elderly, said it was time for nursing homes to get tough.

“Previously we were in an education and awareness phase,” said Fulmer. “But now we have a set of individuals who are unlikely to change their minds, and mandatory vaccines are the only way to protect the elderly.”