TABLE 2.

Examples of suggested responses to concerns raised by skilled nursing facility healthcare workers and staff during 26 town hall meetings

Concerns	Example responses
The vaccine was developed too quickly	I thought so too at first, but the technology was made possible by decades of work. Enormous resources devoted to the vaccine and collaboration between the drug companies and government allowed quick development. All of the normal safety measures were undertaken, but studies and production overlapped.
Short term side effects	Provide stories of persons with allergies who were vaccinated/plan to be vaccinated. Anaphylactic reactions have been rare (1/100,000), and many people had history of anaphylaxis with other vaccines. Provide stories of other facilities that demonstrate that staff have rarely needed to call out due to side effects.
Long‐term side effects	Vaccines rarely have side effects beyond 60 days. The studies waited until most people were 60 days from the second dose to look at safety data. The vaccine is degraded quickly in your body and does not alter your DNA.
Infertility and safety in pregnancy	The vaccine never touches your DNA and does not alter your DNA. The vaccine causes your body to make the same antibodies that you would make if you had COVID‐19. Millions of women worldwide have contracted COVID‐19 and there is no evidence it affects fertility. Pregnant women were not included in the studies, but medical experts believe that it is safe in pregnancy. Lactating women are encouraged to get vaccinated.
Wait and see how others react to the vaccine	Remind staff that getting vaccinated helps all of us get back to normalcy. This approach could be risky given the rise in COVID‐19 in the community and new viral strains.
Belief that it causes COVID‐19	Explain in lay language how the vaccine works (e.g., it is a blueprint that tells your body to make a protein that is found on the outside of the COVID‐19 virus). Tell stories staff and patients who tested positive following vaccination to illustrate that a positive test came from exposure before or immediately after vaccination.
Bell's palsy	Explain Bell's palsy is rare (2/10,000) and may occur in persons with COVID‐19. Tell stories of persons with a history of Bell's palsy who were vaccinated.
Requirement for a booster shot	Remind staff that booster shots are typical for other vaccines (e.g., measles)
Ineffective in new COVID‐19 variants	The spike protein on the UK variant is similar, and medical experts are optimistic the vaccine will be effective against this strain. The vaccines are so effective against COVID‐19 (95%) that even if the efficacy is less with the variant strains, the vaccines will likely protect most people.
Previously tested positive for COVID‐19	Tell stories of staff's experience with getting the vaccine and stories of staff who were ill with COVID‐19.
Uncertainty as to whether getting vaccinated will change precautions	In the short term getting vaccinated will not change precautions because we do not yet know that the vaccine limits asymptomatic spread. Medical experts are optimistic that it will reduce asymptomatic spread and expect that we will start to see lifting of precautions when enough people have been vaccinated.
Microchip	That would be scary if it were true. The vaccine does not contain a microchip. This technology does not exist. If the drug companies included anything in the vaccine that was not on the label, they would be sued.
Safety in persons with chronic disease	The vaccine was tested in all sorts of people with different co‐morbidities including autoimmune disease and cancer. People with comorbidities and immunocompromised persons are at the highest risk of getting severely ill with COVID‐19 and so vaccination is recommended. The vaccine may be less effective (but not less safe) in people who are severely immunocompromised.
Mortality associated with vaccine	• In the large safety studies, there was no difference in mortality among people who received the vaccine or placebo.
Historical abuse of Blacks	Due to systemic racism including alarming cases of medical racism, many Black, indigenous, and people of color (BIPOC) are concerned about the safety of the vaccine. However, the COVID‐19 virus is disproportionately affecting and killing BIPOC, and so BIPOC should strongly consider getting vaccinated.
Related to influenza pandemic of 1918	This is a different virus. Similar to 1918, it spread quickly because no one had immunity. If enough people get vaccinated, the virus will have nowhere to go and will die off.
Guillain‐Barre syndrome	No cases of Guillain‐Barre were reported in the vaccine studies.
Trust that God will protect	God has given us the technology to create the vaccine. Pope Francis and other religious leaders have strongly encouraged vaccination.
Vaccine contains fetal cells	The vaccine does not contain fetal cells, but fetal cells (stem cells) were used in its development.
Mark of the Beast	That would be scary if it were true. The vaccine does not contain any mark or tracer.