In North Carolina and Ohio, most nursing-home employees are declining the Covid-19 vaccine. A Florida physician and a New York City paramedic are saying no. The federal government, which left the states to sort out immunizations, is suggesting pizza parties and raffle prizes as incentives for medical staffs to roll up their sleeves.

Reluctance to get the shot that could end the pandemic goes well beyond anti-vax activists who spout unproven theories on social media. Nurses and firefighters are among those questioning its safety after approval in record time.

“We hear, ‘Why do I have to be first in line to take it?’ We hear terms like ‘guinea pigs,”’ said Neil Pruitt Jr., chief executive officer of Georgia-based PruittHealth Inc., among the biggest private nursing-home operators in the U.S. “You’re among the first people to be able to get the vaccine. When you have a gift like that, you have more of a responsibility to accept that gift.”

More than two-thirds of Americans say they intend to be vaccinated against a virus that has killed 365,000 coast to coast. The manufacturers, Pfizer Inc. with BioNTech, and Moderna Inc., say their products are safe, and they’ve made unprecedented disclosure of research, protocols and production plans.

But in a Kaiser Family Foundation poll, 27% -- most notably Republicans, Black people and rural residents -- say they want nothing to do with it.

Some medical workers opposed to the Covid-19 vaccine cite documented short-term side effects, or unknown long-term hazards. Others say they’re in less peril than infectious-disease experts suggest, or they’ve built immunity or have confidence in readily available treatments. Disinformation and conspiratorial suspicions also have found purchase, even among those who put science to work every day.

David W. Moskowitz, 69, a physician with an internal medicine and nephrology practice in Leesburg, Florida, said he distrusts the new-to-the-market messenger RNA technology. He has treated more than 100 Covid-19 patients, he said, with “25-cents-a-pill,” over-the-counter Coricidin to fight cytokine storms, which are extreme immune responses.

“I find the vaccine extremely irresponsible from a public-health point of view, except quite lucrative from a business point of view,” Moskowitz said in an interview. “It can turn out to be one of the greatest business scams of all time: billions, if not trillions, of dollars changing hands from taxpayers to a few companies.”

There is no sign of widespread harm from Covid-19 inoculations. More than 43,000 people participated in the Pfizer trials and 30,000 in Moderna’s, and the formulas’ effectiveness is about 95%. The U.S. Centers for Disease Control and Prevention puts the chance of a severe reaction at 0.001%.

The CDC recommended that states make the nation’s 16.8 million health-care workers among the first recipients. To date, more than 8 million doses have been administered in the U.S. to medical professionals, nursing-home residents, the elderly and others.

Jonathan Damato, a 41-year-old paramedic on Staten Island’s south shore, was eligible Dec. 23. Though he got an annual flu shot, he said no to this immunization, citing incorrect information as one of his reasons.

“The developers skipped trials in mice -- there’s a reason why they test vaccines on mice,” Damato said in an interview. “There’s never been a vaccine developed and approved this quick.”

In fact, the vaccines were tested on mice and monkeys, in addition to more than 73,000 humans. But “limited data are currently available” for shots to pregnant women, according to CDC guidance, and many nurses have cited such concerns in passing up their turn. Safety information also isn’t available for people with HIV, weak immunity or inflammatory bowel diseases.

While vaccines can take a decade or more to come to market, the Covid-19 formulas took less than a year, with stages of development and testing running concurrently.

“There was a decision at the beginning that this was the priority,” said Philip Dormitzer, Pfizer’s vice president and chief scientific officer of viral vaccines.

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