ST. PAUL -- Among staff working at long-term care homes, a significant percentage remains hesitant to get a COVID-19 vaccine.

According to the Minnesota Department of Health, 57% of staff in skilled nursing homes statewide have their shots, and a somewhat smaller percentage — 48% — of workers in assisted living facilities are vaccinated. A much higher proportion of long-term care residents, 80 to 90%, have their vaccines.

That lower staff vaccination rate worries many in the industry, especially since the pandemic was disproportionately deadly to residents of long-term care.

At Episcopal Homes in St. Paul, staff members walk by a video playing on a loop. On the video, leaders at the nonprofit say they got their vaccinations in an effort to convince employees to do the same.

Inez Kalle, director of nursing at Episcopal Homes, said they’ve repeatedly polled staff on whether they planned to get vaccinated. They zeroed in on the “maybes.”

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“Those were staff members that we could easily convert. So we worked on those even more,” Kalle said.

Kalle said the hesitancy derived from different factors ranging from religion, to mistrust of health systems based on experience, to questions about the vaccine’s development.

When staff saw colleagues and leaders from similar backgrounds get their shots, attitudes toward COVID-19 vaccines changed. Episcopal Homes also held one-on-one and group question-and-answer sessions. The efforts appear to have resulted in three-quarters of the staff opting for shots.

But she said four staff members who refused contracted COVID-19 in recent months, which has slowed down visitation and the openness of the facility.

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“It takes a lot of effort to make them see the reality, so to speak. So yeah, we're still fighting,” Kalle said. “Because whether we like to acknowledge the fact or not, the vaccine will take us through this pandemic.”

Recent COVID-19 outbreaks among staffers have shut down visitation and activities at several homes across the state.

Patti Cullen, president and CEO of Care Providers of Minnesota, said the one-on-one approach seems to be the most effective industrywide, with some homes seeing staff vaccinations as high as 90%, but others far less.

While employer incentives may help improve vaccination rates, Cullen said she doesn’t expect vaccination status will determine whether people hold onto their jobs.

“It's not going to work to mandate it in our settings, we have too many vacant positions,” Cullen said, fearing that employees will just walk away.

At this point, all long-term care facilities have had multiple large-scale vaccine clinics on site, but the Minnesota Health Department will help in other ways. Kris Ehresmann, the department’s infectious disease director, said employees hold calls with facilities across the state on how to get more staff vaccinated.

“If you have a population that, as you said, is working with very high risk and vulnerable individuals, it is concerning when they are not, you know, as fully vaccinated as they could be,” Ehresmann said.

At Episcopal Homes, Bode Osaro, a certified nursing assistant, was skeptical of a vaccine developed so quickly.

Conversations with other staffers, including Kalle, and the realization that he could hurt those he was caring for, helped change his mind and to try to convince others to do the same.

“It's not about me, you know, the people I take care of, they could get infected through me,” Osaro said.

“We have to take it because we are in the front line. And people trust us with their lives.”