ALBANY — Gov. Andrew M. Cuomo said Tuesday that as many as 30% of employees in nursing homes and hospitals are expected to refuse the COVID-19 vaccine, which he worries could turn some health care workers into "super spreaders" of the virus.

"They are exposed to the people who get the vaccine and if the health care workers get sick, they are then super spreaders," Cuomo said Tuesday. "A 30% refusal, 25% refusal is what we expect to see from the health care community."

Health and government authorities say health care workers share to some extent the general public's reluctance to get the new vaccine. The vaccine has been rushed into use under emergency rules with a shortened period to study side effects and some fear the vaccine could give them the virus — as in some cases with the annual flu vaccine — or have other side effects.

New York City Mayor Bill de Blasio on Tuesday called it "a real issue and we’ve got to look it in the eye … I would place that number over 30%."

Cuomo and de Blasio in separate news conferences on Tuesday said they are confident more health care workers will embrace the vaccine as the track record shows no problems. Meanwhile, the state continues a public education campaign to show the efficacy and safety of the vaccine.

Mitchell Katz, CEO of NYC Health + Hospitals, which runs city hospitals, said the 30% estimate is accurate, and not surprising.

"How many times (has it) turned out that there was some new wrinkle," Katz said at de Blasio’s news conference on Tuesday. "The vast majority of people, once you give them enough time, will agree. And I have no doubt that after millions of people across the country are vaccinated (and) the safety record is shown … people will go and get it … We can allow them the space they deserve for the heroic work they've done."

Bill Hammond, health care analyst for the Empire Center on Public Policy think tank, said health care workers have same concerns as the general public.

"I think people are anxious about having foreign materials injected into their bodies and health care workers are people, too," Hammond said. "I would support the state considering a stronger hand in this area with the coronavirus because it is so infectious … I think it’s a sacrifice you have to make."

Cuomo said Tuesday that he’s not certain he could legally require under his executive orders that health care workers get vaccines to remain on the job. Cuomo has used executive orders to create and amend laws during the COVID-19 state of emergency since April.

"There is a complicated legal question as to whether or not you can mandate a person to take a vaccine that is authorized as an emergency authorization," Cuomo said. "But besides the legal question we haven’t gotten there yet because I don’t know that it is going to be an issue … I don’t believe the refusal rate is going to be that high."

Elizabeth Garvey, Cuomo’s special counsel and senior adviser, said the administration will "continue to look at it and we will continue to monitor."

The amount of reluctance among health care workers surprises some.

"I’m really disappointed to see that number," said Cynthia Leifer, associate professor of immunology at Cornell University. "I’m surprised 30% would say no to this."

Leifer said the refusals also could slow the vaccination process, which the state and the federal Centers for Disease Control and Prevention have prioritized, with health care workers given top priority followed by categories of essential workers, the elderly and the general public.

On Monday, Cuomo and his health commissioner, Dr. Howard Zucker, said about 15% of workers in nursing homes had already refused the vaccine.

Michael Balboni, executive director of the Greater New York Health Care Facilities Association, said he has no hard numbers but has heard anecdotal reports of nursing home staffers refusing to be vaccinated.

"The message to the staff should be, ‘Do this on behalf of the residents you care for, on behalf of your families, and behalf of yourselves,'" Balboni said.

The Pew Research Center said in December that 60% of Americans planned to be vaccinated, up from about half in September, and that more Americans would get the vaccine after watching the experience of others.

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