I have faced this issue in my own home; my husband and I employ four home health aides around the clock for an ailing family member. By late February, several weeks after private home health aides had become eligible for the vaccine, only one had opted to get vaccinated. In April a second aide decided to get her dose after much cajoling, and a third just agreed to do so this month. One remains unvaccinated. One might reasonably ask, why haven’t we mandated vaccination as a condition of employment? There are a couple of reasons. For one, all the adults in our family have been vaccinated. I have also been confident that our home health aides could be persuaded, with conversations that addressed their concerns and help making their vaccination plans happen... They worry about how well the vaccines will hold up against the variants, and many of them lack confidence in what they view as a profit-obsessed pharmaceutical industry. Distrust of the medical establishment is rooted in structural racism, discrimination and personal experience.