FARGO — A campaign to promote vaccination in North Dakota will include doctors as trusted sources of information to try to overcome reluctance to getting vaccinated against COVID-19.

It turns out, however, that some doctors and nurses are themselves reluctant to get the jab.

The North Dakota Medical Association estimates that 90% of physicians have been vaccinated, based on the rates from large health systems and other databases, said Dr. Joshua Ranum, vice president of the physician’s group and an internal medicine doctor at West River Health Services in Hettinger.

A survey a few months ago by the North Dakota Nurses Association found that 60% were planning to get vaccinated, but 40% were hesitant.

At Sanford Health in Fargo, 90% of physicians and 78% of all workers have been immunized.

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Essentia Health doesn’t have a breakdown, but estimates that 75% to 80% of its employees have been vaccinated.

Ranum said physicians "have been the most ready to accept vaccination.” Surveys have shown that physicians are the most willing among health care professionals to be vaccinated, followed by advanced practitioners, such as physician assistants and nurse practitioners, then nurses, he said.

“That seems to be the pattern,” noting that hesitancy seems to increase the further removed workers are from clinical practice, Ranum said.

Among his fellow doctors, Ranum has spoken to a couple who have expressed reluctance to get vaccinated.

Their attitude was, “I'm young and I'm in decent health,” he said, recalling conversations. “I want to give it a bit of time to make sure it’s well tolerated and effective.”

It’s possible since then that they’ve been persuaded by multiple studies showing that the vaccines authorized for use are safe and effective. Ranum and all of his fellow physicians at West River Health Services in Hettinger have been vaccinated, he said.

Only a tiny percentage of those who have gotten the vaccine have had adverse reactions. The pause in administering the Johnson & Johnson vaccine, which was investigated to determine whether six of 6.8 million people vaccinated developed blood clots.

Federal officials have determined that the benefits of the vaccine outweigh the risks. The risk of getting a blood clot from COVID-19 is far greater than the risk of getting it from the vaccine, Ranum said.

“The disease has very real risk,” he said, adding that adverse health effects are inevitable in such a large group and usually will have nothing to do with the vaccine. “I wonder how many of those 6.8 million got hit by a car subsequently.”

Tessa Johnson, a registered nurse in Dickinson and president of the North Dakota Nurses Association, said her group tries to educate its members on the safety and effectiveness of the vaccines, which have ample evidence behind them at this point.

“I’m surprised and shocked at the hesitancy yet,” she said. “The hesitancy I see with younger females still scared of fertility problems,” she said, adding that there is no evidence to support such worries. “People are still hesitant because of that.”

A lot of myths and misinformation circulating on social media are fueling much of the hesitancy, Johnson said. Overcoming that is difficult. “That’s what scares me,” she said.

Those in the health professions should be willing to be vaccinated to protect their patients and the community against infectious diseases, Johnson said.

“It’s our duty to keep people safe,” she said. “When you sign up to work in long-term care, you’re signing up to protect people.”

Members of the public also should consider the protective effect of getting vaccinated, which means the person can’t get infected and therefore can’t spread the virus, Johnson said. “It’s not just about you,” she said.

A national poll in early March found that 52% of frontline health care workers reported receiving at least one dose of COVID-19 vaccine. The poll, by the Kaiser Family Foundation and Washington Post, found higher rates in hospital and clinic settings: 66% of frontline hospital workers and 64% in clinics said they had been vaccinated, while 50% in nursing homes and assisted care facilities reported they had been vaccinated.

The chief reason for hesitancy, cited by 82%, was concerns about potential side effects. The newness of the vaccines was a reason given by 81% of frontline health care workers who haven't been vaccinated, the Kaiser survey found.

Both Essentia and Sanford require their employees to be vaccinated against influenza. Because the COVID-19 vaccines so far are authorized for emergency use, neither health system is mandating the vaccines, but both are strongly encouraging their employees to get vaccinated.

Both health systems are targeting employee groups with low vaccination rates, both trying to answer their questions and make getting vaccinated more convenient.

“We’re kind of creating SWAT teams to go into these areas to help them understand the benefits of the vaccine,” said Melodi Krank, a registered nurse at Sanford who coordinates its vaccination efforts. “We’ve also done town halls,” with physicians, including an infectious disease specialist, presenting information and fielding questions to try to overcome reluctance.

Similarly, Essentia has done webinars for certain departments where vaccination rates have lagged, using education to try to overcome resistance. “We are doing some targeted efforts within our facility,” said Dr. Richard Vetter, chief medical officer at Essentia Health in Fargo.

Essentia has considered offering incentives to encourage reluctant employees to get vaccinated, but rejected the idea for a health system. “We thought about it but are not implementing it,” Vetter said.

The idea might be better suited for those outside health care, he said. Sanford also has decided not to offer incentives for employees to get vaccinated.

Both Sanford and Essentia could require employees to get vaccinated against COVID-19, as they do for influenza, once the vaccines are approved for routine use.

“We haven’t really ruled that in or out for the future,” Vetter said. “For now we’re not requiring it. We’ve left the door open.”