An average of 78% of nursing home staff in Hawaii have taken the COVID-19 vaccine, more than double the national rate of 38% in long-term care facilities on the mainland.

More medical workers here are getting immunizations as the pandemic rages across the country, hitting nursing homes particularly hard, according to a new survey by the Healthcare Association of Hawaii, which represents the state’s hospitals and long-term care facilities.

At least three nursing homes reported 100% of their staff chose to be inoculated, while about 90% of workers at 13 other facilities received shots.

Shanthy Tangonan, a certified nursing assistant from Garden Isle Rehabilitation and Healthcare on Kauai, was hesitant to get the vaccine at first but decided she would do it to protect the more than half a dozen residents she takes care of every day.

“I thought that it was my duty to make sure that they’re safe from the virus. As I go out into the community and come back to work I need to make sure that I protect myself, of course,” she said. “After a few days thinking about whether I should get the vaccine or not I was like … ‘I’m going to get it because their safety is definitely my No. 1 concern.’ I can’t take care of them if I’m sick.”

After the second shot, Tangonan developed a fever and felt ill but said it was worth it.

“One day of being sick is definitely worth making sure my residents are healthy and taken care of,” she said. “Almost all the nurses and CNAs got the vaccine and a lot of them said they were sick after the second dose, but everyone’s fine. We’re healthy, happy taking care of our residents and … we never got any cases of the COVID in our facility, so that’s good.”

Hawaii nursing home residents also were more accepting, with a vaccination rate at 90% compared to the national average of 78%. At least half a dozen long-term care facilities immunized all of their residents, the survey showed. Nearly all of the long-term care facilities are participating in the federal pharmacy program, which offers free vaccine clinics through CVS and Walgreens.

“Staff are becoming more comfortable with the concept of vaccinations as they see more of their colleagues being vaccinated with generally minor side effects,” said Hilton Raethel, Healthcare Association of Hawaii president and chief executive officer.

Kalakaua Gardens, a 228-bed senior community in Honolulu, estimates 90% of its staff and 94% of residents will be immunized by next month. It plans to resume tours for seniors interested in moving into the facility.

“We can breathe a sigh of relief and continue to move forward cautiously, while still following guidance on mask wearing and social distancing,” Joel Guron, executive director of Kalakaua Gardens, said in a news release.

Overall, a growing number of Hawaii residents are planning to be vaccinated. A separate Department of Health poll showed 91% of respondents plan to get vaccinated — 55% as soon as their turn comes up and 36% at a later time, indicating a shift in attitudes since mid-December. That’s up from about 50% of residents who indicated they would get the shots, with the other half not planning to or undecided in previous surveys by the Health Department and University of Hawaii taken before the vaccines arrived in the islands.

By contrast, a third of American adults said they “definitely or probably won’t get the COVID-19 vaccine,” according to a survey by the Associated Press-NORC Center for Public Affairs Research.

The vaccine is especially important now as super-­spreading coronavirus variants are rapidly increasing infections across the U.S. Health officials have detected two mutations in Hawaii, one first found in Denmark and another, more contagious strain originally discovered in the United Kingdom.

More transmissible strains mean it might take 80% to 90% of the population to be vaccinated in order to achieve so-called herd immunity, instead of the state’s goal of 60% to 70%, the DOH previously said.

“Getting as many of the staff and residents vaccinated is especially important because of the new COVID variants,” Raethel said. “We all look forward to the day that our long-term care facilities can open up to family and friends of residents who’ve been so patient during this pandemic.”

Wesley Lo, CEO of Ohana Pacific Management Co. and Hale Makua Health Services, said nursing homes have been working diligently to encourage staff to get vaccinated, with education, games, badges of honor and gifts. Those efforts have proved to be fruitful.

“It was a little bit slow in the uptake on the first clinics. It was still early on and there wasn’t enough education going on,” he said. “As we got to the second clinic it certainly improved quite a bit. There was a little bit of community spread going on here, (which) actually sort of had people realize that they need to start getting vaccinated.”

The survey respondents included 41 of 45 centers, or roughly 91% of Hawaii’s licensed nursing facilities, 10 of the 18 assisted-living facilities throughout the islands, and five adult residential care homes.