More hospitals are requiring workers to be vaccinated against COVID

More and more hospitals and large healthcare systems are requiring their employees to be vaccinated against COVID-19, citing an increase in the number of cases fueled by the delta variant and stubbornly low vaccination rates in their communities and even among their staff.

Many hospitals say their efforts to vaccinate their employees have stalled, in the same way that the country’s overall vaccination rates are stuck below 60%, behind many European countries and Canada. While more than 96% of doctors say they are fully vaccinated, according to the American Medical Association, healthcare workers, especially in rural areas, have been more resilient even though thousands of workers have died from the virus and ‘countless others fell ill.

A recent estimate indicated that one in four hospital workers were unvaccinated as of the end of May, with some facilities reporting that less than half of their employees had been vaccinated.

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Some hospitals, ranging from academic medical centers like NewYork-Presbyterian and Yale New Haven to large chains like Trinity Health, are moving forward with a warrant as they recognize that the only way to stop the virus is to vaccinate so many people. as possible, like As fast as possible. A large Arizona-based chain, Banner Health, on Tuesday announced it would impose a warrant, and New York City said it would require all health workers in city-run hospitals or clinics to be vaccinated or undergo weekly testing.

The increase in cases prompted Trinity Health, a Catholic system with hospitals in 22 states, to become one of the first major groups to decide earlier this month that it will make vaccinations mandatory. “We were convinced that the vaccine can save lives,” said Dr Daniel Roth, clinical director of Trinity. “These are preventable deaths. “

At UF Health Jacksonville, Florida, the number of COVID patients treated has reached levels not seen since January, and only half of its health workers are vaccinated, said Chad Neilsen, director of infection prevention. Seventy-five employees are sick with the virus, the vast majority of whom are not vaccinated, while others are awaiting test results. “We are absolutely struggling to recruit staff at the moment,” he said.

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“It’s like déjà vu,” said Neilsen, who described growing frustration with colleagues refusing to get the pictures. “We have a reason to believe it could be over if people got vaccinated. “

Despite dozens of virtual town halls, question-and-answer sessions and educational videos, many employees are wary. “We have always stagnated,” said Neilsen.

Some employees want more data, while others say the process has been rushed too much. Many of the same conspiracy theories and misinformation – that vaccines will make women infertile or contain microchips – prevail among staff members. “Our healthcare workers are a reflection of the general population,” he said.

Hospital leaders and others plan to meet with state officials in the coming weeks on the possibility of imposing a warrant, he said.

Unvaccinated workers also continue to treat even the sickest patients, raising fears they could spread the infection, especially now that the highly contagious delta variant includes more than 80% of the country’s cases.

“Nowhere is this more important than in hospitals, where healthcare workers – who have been heroic during this pandemic – care for patients with a wide variety of health problems assuming the healthcare professionals who treating them is not at risk of acquiring or transmitting COVID-19, ”said Dr. David Skorton, executive director of the Association of American Medical Colleges, which represents teaching hospitals, in a statement calling for a warrant last Friday.

On Wednesday, two other groups, including the American Hospital Association, joined in the growing clamor for immunization mandates. “We have lost too many of our caregivers to COVID-19,” said Dr. Bruce Siegel, general manager of America’s Essential Hospitals, which represents hospitals in underserved communities. “Vaccination can reduce the risk of losing more. “

With formal approval of vaccines by the Food and Drug Administration potentially months away, hospitals find themselves at the center of the national debate over whether to impose warrants. While the vaccines are offered under emergency use authorization, proponents argue that there is ample evidence that those available in the United States are both safe and effective.

In states like Missouri, which has reported a sharp increase in cases, the urgency has returned. “We felt we couldn’t wait,” said Dr Shephali Wulff, director of infectious diseases for SSM Health, a Catholic hospital system headquartered in St. Louis. SSM, where about two-thirds of employees are now vaccinated, requires everyone to receive their first dose by September 1.

The SSM’s decision was also prompted by fears that COVID infections could increase this fall when there could be an increase in other respiratory infections as well. “We need a healthy workforce for flu season,” Wulff said. “We don’t have time to wait for approval.”

But some systems are already worried about staff shortages caused by departures during the pandemic, with many employees resigning due to the stress and burnout experienced by COVID patient care. Hospitals are reluctant to risk losing more workers if they force the problem.

“They fear it could be a tipping point,” said Ann Marie Pettis, president of the Association of Infection Control and Epidemiology Professionals, one of the professional organizations that urges hospitals to demand the vaccine. .

At Mosaic Life Care, a small hospital group in Missouri, executives are reluctant to adopt a mandate if other hospitals don’t. “We have the potential to lose some caregivers to other systems,” said Joey Austin, spokesperson for Mosaic, which has vaccinated about 62% of its staff.

Many hospitals already require their employees to get their flu shots, a mandate that has been in place for more than a decade. While this has also encountered resistance from employees skeptical about vaccine safety, it is now widely accepted. Individuals can apply for a medical or religious exemption, typically representing a small portion of the workforce, which hospitals say would apply to COVID vaccines as well.

The mandates “set a social norm and say it’s an institutional priority,” said Saad Omer, director of the Yale Institute for Global Health, who stressed that hospitals need to strongly encourage workers to get vaccinated voluntarily to be successful.

Unions like National Nurses United and 1199 SEIU say they want members to be vaccinated but oppose making it a condition of employment. In the first hospital to impose a warrant, Houston Methodist, a group of employees filed a lawsuit to challenge the requirement, but the lawsuit was recently dismissed. About 150 employees eventually resigned or were made redundant for refusing to meet the vaccination deadline out of a total workforce of some 26,000 people.

Hospitals say they are working hard to dispel much of the pervasive misinformation around vaccines, even among doctors and nurses.

“I have to remind them that reputable scientists do not post their findings on YouTube,” Wulff said. In addition to presenting concrete data about the vaccine, she and her colleagues at SSM also share their personal experiences, such as getting the vaccine while trying to get pregnant. “What I find is that people are moved by the stories and the anecdotes,” she said.

“Usually you have to listen a lot and focus on what is driving their fear,” Wulff said.

Some high level systems like Intermountain Healthcare and the Cleveland Clinic are waiting. The clinic, which has a sprawling network of 18 hospitals across the United States, said existing policies, such as masking and close monitoring of infections, protect patients and workers.

“We know that if we make sure these safety precautions are in place, we know we can continue to keep our patients and caregivers safe,” said K. Kelly Hancock, Director of Caregivers at Cleveland Clinic.

About three-quarters of employees are now vaccinated and efforts are continuing “at full speed,” she said.

At Utah-based Intermountain Healthcare, “a good majority” of employees are vaccinated, said Dr. Kristin Dascomb, medical director of infection prevention and control and employee health.

If more safety data is compelling and the FDA approves the vaccines, Intermountain may require vaccination with other hospitals in the state. “We’re starting the conversation now in Utah,” she said.

The lack of full FDA approval has influenced other hospitals as well. Mass General Brigham, who has vaccinated more than 85% of its workforce, said he would adopt the requirement as soon as the vaccines are approved.

Some hospitals argue that a warrant is not necessary. “In my opinion, there is no one right answer,” said Suresh Gunasekaran, general manager of hospitals and clinics at the University of Iowa. About 90% of its workers are now vaccinated, he said, adding that he was confident that virtually everyone would be vaccinated by the end of the year.

The system has “succeeded in eliminating” the reluctance to vaccinate, Gunasekaran said, in part because Iowa participated in clinical trials of the Pfizer-BioNTech vaccine.

Northwell Health, the large New York hospital group, does not require workers to be vaccinated against the flu, but about 90% of its workforce is vaccinated against the flu, said Maxine Carrington, director of human resources at Northwell. It takes an approach similar to COVID.

“We want people to believe,” Carrington said, so they are better able to persuade the community at large to get the vaccine. She described the system as “beating the pavement on education, education, education”. About 76% of its workforce is currently vaccinated against COVID. Northwell will reconsider the idea of ​​a warrant after the FDA approves the vaccines, she said.

Yale New Haven Health now requires employees to get vaccinated, just like other Connecticut hospitals.

“From the start, we made it known that it was not mandatory – yet. We focused on the moment, ”said Dr. Thomas Balcezak, clinical director of Yale.

“Health care must lead,” he said.

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