About half of America’s seniors are fully vaccinated against COVID-19, and close to three-quarters have gotten at least one shot of the Pfizer or Moderna vaccines.

This is good news. Seniors have suffered disproportionately from the coronavirus. They have become gravely ill, passed away, and passed the time over the last year in complete isolation.

When the vaccines first became available, health officials wisely moved older adults to the front of the line. And yet, if we are going to finish the job of vaccinating all of the older members of our community, it’s essential that we place newfound emphasis on a group of people who will likely determine whether the remaining holdouts get their shots: family caregivers.

According to AARP, there are 53 million family caregivers in the United States and 4.5 million in California. AARP estimates the value of their care at almost $60 billion. They shop for food. They make doctors’ appointments. They arrange transportation. They pick up prescriptions and administer medications.

In short, family caregivers play a pivotal role in the health care of America’s seniors. And it is they who will determine when the people under their care get their shots.

Or not.

A new survey of family caregivers shows that their own mistrust of vaccines could explain why close to a quarter of older Americans have not yet received their potentially life-saving vaccine shots.

According to the survey, which polled nearly 2,000 caregivers in the United States, 71% of family caregivers harbor doubts about the safety of COVID-19 vaccines. This doubt appears destined to lead to inaction. Just 63% of caregivers who lack confidence in the vaccines’ safety say they’ll take the senior under their care to get vaccinated.

More troubling still, 77% of African American and 74% of Hispanic caregivers lack confidence that the vaccines are completely safe. Given the disproportionate rate of COVID-19-related deaths among these two groups, respondents’ lack of confidence in the vaccines could translate into a much longer journey to overcome the risk of infection for America’s Black and Hispanic populations.

Additionally, vaccine doubts appear to translate into a hesitancy among caregivers to get themselves vaccinated. Nearly half of family caregivers (47%) say they will either delay or refuse to get vaccinated. The rate jumps to a startling 59% among Black caregivers.

It’s as important for caregivers to get vaccinated as it is for the people under their care. After all, if a caregiver becomes sick with the virus, they won’t be able to care for the person who relies on them—and they could potentially infect their loved one.

These survey results reveal a clear need to take a broader approach to promoting and distributing vaccines. Instead of just focusing on seniors themselves, we should also be focusing on their caregivers. To start, health officials should move family caregivers to the front of the vaccination line. Some states, like Massachusetts and Illinois, have already done this, to some degree. These efforts should be expanded nationally.

Likewise, many caregivers work full-time jobs, and taking time off is often a major impediment to their ability to go to a vaccine site. We should encourage all American employers to offer flexible schedules to family caregivers who either take the person under their care to get vaccinated or get vaccinated themselves.

Also, health care leaders and public officials involved in the vaccination effort should aim to build trust around the vaccines among family caregivers, emphasizing the Black and Hispanic communities.

To accomplish these outreach efforts, physicians will need to play a leading role. Though there is no central database of family caregivers, physicians and their staffs generally know when a patient has a family member caring for them.

As a physician who has worked primarily with older adults, I can say that most of the seniors I’ve encountered who live healthy, independent lives rely on family members for some level of care.

95% of the people who died of COVID-19 in the last year were older than 50. We owe it to those who have passed—and to those we can save—to ensure that we vaccinate all older Americans. And the way to do that is to talk to their caregivers.

Romilla Batra is an internal medicine physician and chief medical officer, SCAN Health Plan. She can be reached on LinkedIn and on Twitter @batrar.

Image credit: Shutterstock.com