Only 52% of staff at Pennsylvania’s nursing homes opted to get vaccinated against the coronavirus, according to a long-awaited survey released Thursday by the state Department of Health, despite how hard-hit the facilities were by the pandemic.

In every Pennsylvania county, the rate of vaccine decline among nursing home employees was much higher than among residents. Among the five Philadelphia-area counties, the percentage of workers declining the vaccine ranged between 32% in Chester County and 42% in Philadelphia and Delaware Counties.

“Anecdotally, what we heard is there were a number of staff who didn’t want to be the first to get vaccinated,” Department of Health Executive Deputy Secretary Keara Klinepeter said. “They wanted to see their colleagues, their families get vaccinated, and then they were willing to get vaccinated.”

Klinepeter noted that while the staff vaccination rate appears low, it is higher than the national average in these facilities. About half of nursing home staff nationwide had been vaccinated as of last month, according to Centers for Disease Control and Prevention data provided to the Center for Public Integrity, and in some states such as Arkansas and South Dakota that number was closer to 10%.

The nursing home industry is working to reach a goal of getting 75% of long-term care staff in the United States vaccinated by June 30 — underscoring the importance of inoculating workers who can bring the virus into facilities — and there are indications that hesitancy among staff has decreased since the start of the rollout.

Vaccine hesitancy among nursing home staff remains a concern nationwide as they look to expand visitation and resume social activities for residents, many of whom endured months of isolation when the pandemic struck and were among the first groups eligible to be vaccinated.

In Pennsylvania, about 80% of nursing home residents have been vaccinated, many through a federal pharmacy partnership that brought vaccination teams into the facilities. The state did not release information on the rates of vaccination among residents and staff of assisted-living facilities, which are regulated by a different department.

The publicly available nursing home data — which reporters and senior advocates had been requesting for months — is based on mandated self-reports from the facilities, Klinepeter said, and it will be next updated at the end of June.

“We absolutely hope that that data is higher at [that] time and that we’re seeing an increased number of staff and residents be vaccinated,” she said, noting officials will continue to address questions and concerns.

That may be difficult to do, however, if the state does not get detailed data about why people are declining shots, said Diane Menio, executive director of the Philadelphia-based Center for Advocacy for the Rights & Interests of the Elderly (CARIE).

“When you understand why people are refusing or not getting it, that’s how you target your education,” Menio said. Hesitancy is not the only barrier: Night-shift workers may be unable to attend clinics held during the day, she said, or employees who recently got the virus may still be recovering.

Menio said she also had hoped the state would implement a more regular, public vaccination reporting requirement for facilities as opposed to a quarterly survey. She’s unsure, she said, how point-in-time survey results will help Pennsylvanians looking to move themselves or a loved one into a nursing home, given how often staff and resident turnover occurs.

“You want to know what you’re walking into” before deciding on a home, she said. “We’re getting some raw numbers, but that’s just about it.”

Some residents and staff are still awaiting vaccines, either because they changed their mind about wanting the shots or recently arrived at the facilities, said a spokesperson for the Pennsylvania Healthcare Association. While the federal pharmacy partnership has ended, vaccines remain available for nursing homes.

Nationally, staff willingness to get the vaccine has increased significantly, a survey by OnShift showed, with 62% of respondents saying they were willing to get the vaccine in March compared with 32% in December. Many employees who planned to decline the vaccine said it was because it was “too new” or they were concerned about potential side effects, according to the survey.

The benefits of vaccinating this vulnerable community have already been made evident: Inoculation efforts, which began in late December, have brought a sharp decline in nursing home cases and deaths, according to the American Health Care Association.

Between December and March, the number of active cases among Pennsylvania nursing home residents dropped 97%, according to federal data from the National Healthcare Safety Network, while staff cases dropped nearly 94%.

» READ MORE: Nursing home group cites evidence COVID-19 vaccine is already working for their residents

As a result, most long-term care facilities are allowing family visitation, according to the Pennsylvania Health Care Association. However, outbreaks are still occurring, according to a PHCA survey, and stricter rules remain in place at homes where many residents are turning down shots.

In the five-county region, Philadelphia had the highest percentage of residents declining, at just under 17%, while Chester County had the lowest at 6%. In a few counties outside the area, those numbers were between 20% and 50%, according to the data.

In Fulton County, in the south-central part of the state, half of residents said no to the vaccine, as did 88% of staff, the highest rate of decline of any county in both categories.

Statewide, more than 14,500 employees of long-term care facilities have contracted COVID-19 since the pandemic began, according to state numbers, along with 70,000 residents. And 13,000 Pennsylvanians in long-term care facilities have died of the virus to date.

Staff writer Stacey Burling contributed to this article.