Florence Agcaoili, a registered nurse, had spent the pandemic taking care of some of Hawaii’s most vulnerable residents, seniors recovering from strokes, surgeries and falls and other health conditions that required rehabilitation, when news broke late last year that a vaccine was ready to be deployed to combat the coronavirus.

She says she was both excited and scared. The vaccine signaled the potential end to a pandemic that by the end of December had infected more than 19 million Americans and killed more than 330,000. But Agcaoili, who was among the first to be eligible for the vaccine, says she was nervous that the vaccine, which was developed in record time, would have side effects.

Still, she got vaccinated in January and has felt a sense of relief ever since.

“An ounce of prevention is a pound of cure,” she said.

Agcaoili is among a large majority of staff at Hawaii’s nursing homes who are now vaccinated. A new statewide survey conducted by the Healthcare Association of Hawaii found an average of 84% of staff at skilled-nursing facilities and other long-term care providers had received the COVID-19 vaccine. That rate is up 6 percentage points from the health care trade group’s last survey in February.

The results include surveys from 29 of the state’s 45 nursing facilities. The surveys were conducted April 7-15 after a federal pharmacy partnership program offering on-site vaccinations at nursing homes concluded.

The survey included all employees of the facilities, such as nurses, administrators, food service employees and custodians.

At The Villas, where Agcaoili has worked for five years, the rate is even higher with 97% of employees vaccinated.

Hawaii’s success at vaccinating staff at nursing homes has consistently surpassed national averages.

In early February the national vaccination rate among employees at long-term care facilities stood at just 38% despite the federal vaccination campaign. By then the rate in Hawaii was already 78%.

By mid-March the federal program had managed to inoculate only about half of long-term care workers nationwide. In some states the rates of vaccinated workers were much lower.

Patrick Harrison, senior director for post-acute care at the Healthcare Association of Hawaii, said it wasn’t clear exactly what was driving Hawaii’s high vaccination rates, but it could have to do with the closeness of the community.

“Just with the way our community engages with each other and having a very collaborative and close-knit community here in Hawaii amongst our facilities and families and culture, that suggests it has something to do with it,” he said.

While nursing homes have been hit hard during the pandemic, federal efforts to protect staff, as well as the vulnerable residents they care for, have run up against surprising resistance.

Harrison said that locally, staff who have been resistant to getting the vaccine have often expressed concerns about potential unknown side effects. He said other obstacles include misinformation on social media and concerns about the vaccine being developed so quickly.

“Many are also taking a wait-and-see approach, wanting to see full FDA approval before they take the vaccine,” Harrison said.

The U.S. Food and Drug Administration has granted emergency use authorization for the vaccines but has not yet granted full approval, though that could come as early as this summer.

With full approval, employers could become increasingly eager to mandate the vaccine, particularly in settings where there are high-risk populations and easy transmission.

Nationally, more than 130,000 nursing home residents and 1,913 staff have died during the pandemic, according to data compiled by the Centers for Medicare and Medicaid Services. Nursing home deaths accounted for about one-third of all deaths during much of the pandemic prior to the vaccine rollout, which prioritized nursing homes.

Hawaii hasn’t suffered the major outbreaks that other states have, but its nursing facilities weren’t completely spared. At the Yukio Okutsu State Veterans Home in Hilo, for instance, 26 residents died last year after the majority of residents at the 95-bed facility and dozens of staff contracted COVID-19. The outbreak prompted government hospital administrators to take over operating the veterans care home.

Harrison said that helping facilitate vaccination appointments, having one-on-one conversations with staff about the vaccine and making sure vaccination safety information is translated into different languages also can help drive up vaccination rates.

The latest survey provides a good indicator overall of how Hawaii’s nursing homes are doing with vaccinations, but the public soon will have detailed information on vaccination rates at individual nursing homes. Under new CMS rules that take effect June 14, long-term care facilities will be required to report weekly data on COVID-19 vaccination rates for both residents and staff to federal agencies.

State Department of Health officials Friday reported two new coronavirus-related deaths and 61 new confirmed and probable coronavirus infections statewide, bringing the state’s total since the start of the pandemic to 35,726 cases.

The latest deaths were an Oahu man in his 70s and an Oahu woman in her 70s. Both had been hospitalized with underlying health conditions, state health officials said in an email.

By island, Oahu had 39 new cases, Hawaii island and Kauai each had three, Maui and Molokai each had one and Lanai had none, and there were 14 Hawaii residents diagnosed outside the state.