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Loida Berena, a PSW at Heritage Nursing Home, in Toronto's East end on Feb. 4, 2021.Kate Dockeray/The Globe and Mail

When Toronto personal support worker Loida Berena was first offered a chance to receive Pfizer’s COVID-19 vaccine last December, she said no. Her boss, surprised, reminded her she was leader of the union local representing 200 health care workers at the long-term care home: What if her refusal deterred others?

Though almost all residents at The Heritage Nursing Home were on board to be vaccinated, hesitancy among staff proved to be widespread. Doctors from the nearby hospital where the vaccine was administered came to explain the science behind the vaccine, to reassure them it was safe. Still, only 15 of Ms. Berena’s colleagues signed up to get their first dose just before Christmas. Ms. Berena, a Filipina immigrant, peppered them with questions about side effects and their responses reassured her. In the new year, she received her first dose.

“When the doctors were explaining it to us, I had no proof,” she said. “Now that I see my co-workers got it, it’s influencing, right?”

In December, elation about the vaccine’s approval was soon tempered by polls conducted by unions and workplace safety associations that suggested nearly half of long-term care staff in Canada were unsure if they’d get the vaccine or were flat-out opposed to it – results that caught long-term care management and provincial governments flat-footed.

But in the span of a few weeks, even in the midst of vaccine shortages, uptake of the vaccine among this population has grown significantly.

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The B.C. government announced Friday that 89 per cent of long-term care staff have received their first dose of the vaccine. In Ontario, about 70 per cent have. The picture of vaccine uptake among long-term care staff in some provinces is unclear. Saskatchewan and Manitoba have not released a breakdown by occupation at all; in Alberta, about 25,000 staff in long-term care and supported living have received at least one dose, but the province would not say what per cent of the overall staff population that represents.

The turnaround offers insight into the complicated world long-term care staff have had to navigate throughout the pandemic – where more than anyone or anything else, they’ve turned to each other for guidance.

Samir Sinha, a geriatrician at Sinai Health Systems in Toronto, wasn’t surprised in the same way others were when he saw initial low rates of uptake among long-term care staff.

“They feel like they’re being treated as guinea pigs. And they’re being encouraged to get the vaccine by the same government that promised them an iron ring of protection, and really left them for dead,” Dr. Sinha said. Since last April, 11 staff have died and more than 6,400 have been sickened in Ontario.

Internal polling from the Ontario Personal Support Workers Association in mid-January showed that 79 per cent of personal support workers did not think vaccines should be mandated and 49 per cent said they were unsure about or against receiving it voluntarily.

Ms. Berena’s chief concern was whether side effects from the vaccine would get in the way of her performing her job. One of her colleagues suffered fever, body pain, headache and other adverse reactions from her first dose – but, reassuringly, recovered within 24 hours. While Ms. Berena, who has worked 16 years at the same home, has 14 sick days to draw from annually, part-time colleagues only have three and were worried about having to use them after receiving the vaccine.

Another obstacle staff across the country had to navigate was logistics. While some homes, such as Ms. Berena’s, allowed staff to get their vaccines during paid hours and provided safe transportation, others left staff – many working extended shifts – on their own to figure out how to get to and from a vaccine clinic.

In B.C., there were initially only two sites where workers could get vaccinated, which required long bus commutes for some. That proved to be a major barrier, said Jennifer Lyle, the chief executive of SafeCare BC, the workplace safety association for long-term care homes.

Bringing the vaccine into the care homes has made a marked difference in staff vaccination rates, she said – especially when public health offers multiple opportunities for staff.

An early December poll by her organization found 57 per cent were willing to get vaccinated. But as of Friday, 89 per cent of long-term care staff in the province have received their first dose, according to B.C.’s Ministry of Health.

Ms. Lyle credits much of that turnaround to health care workers speaking with each other about the vaccine.

“Having those conversations in the staff room is actually where we’ve seen a really significant positive impact,” she said. “It’s a discussion among peers, so it doesn’t feel like there’s a hierarchy involved.”

But that camaraderie can be a double-edged sword. Miranda Ferrier, CEO of the Ontario Personal Support Worker Association, says she’s had to reject articles being posted on the association’s Facebook group, which has almost 12,000 members, that spread misinformation – including the incorrect suggestion that the vaccine has caused deaths.

Attitudes quickly shifted, Ms. Ferrier said, when Toronto-area workers began sharing pictures of themselves getting vaccinated.

Pam Hayer, a 47-year-old PSW at Tall Pines long-term care home in Brampton, Ont., gave permission for Peel Region – the regional government that oversees Brampton – to publish her vaccine photos to encourage others to do the same.

Ms. Hayer, who came to Canada from India in 1998, was initially reluctant to get vaccinated. “I was like, ‘Should I take it or not? I don’t know what the long-term effects are going to be.’ It was not easy.”

Two weeks later, she came around, determined to protect herself and frail and vulnerable residents.

In the photo of her first dose, a needle is stuck in her arm and Ms. Hayer wears a concerned expression. After her second dose, Ms. Hayer raises her arm triumphantly for the camera. Though she wears a blue mask, her eyes betray a relaxed, confident smile.

Now, the conversation around vaccines is changing, said Michael Hurley, regional vice-president of Canadian Union of Public Employees Ontario, which represents 30,000 long-term care workers.

“I think there has been a shift from anxiety over the vaccine – like was it rushed through trials, was it safe – to hey, when’s it coming?” he said. “The concern now is, I think, about the delay in the arrival.”

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