More and more hospitals and major health systems are requiring workers to receive the Covid-19 vaccine, citing the increasing caseload fueled by the Delta variant and persistently low vaccination coverage in their communities and even within their workforce.
Many hospitals say their efforts to immunize their employees have stalled, just as the country’s overall vaccination rate remains below 60 percent, behind many European countries and Canada. While more than 96 percent of doctors say they are fully vaccinated, health professionals, particularly in rural areas, have proven to be more resistant, according to the American Medical Association, even though thousands of workers have died from the virus and countless more have fallen ill.
A recent estimate indicated that one in four hospital workers had not been vaccinated by the end of May, and some facilities reported that fewer than half of their employees had received the injections.
Some hospitals, ranging from academic medical centers like NewYork-Presbyterian and Yale New Haven to big chains like Trinity Health, are going ahead with a mandate because they recognize that the only way to stop the virus is to vaccinate as many people as possible, like so. fast as possible. A major Arizona-based chain, Banner Health, announced Tuesday it would impose a mandate, and New York City said it would require all health workers in city hospitals or clinics to be vaccinated or tested weekly.
Seeing rising cases, Trinity Health, a Catholic system with hospitals in 22 states, became one of the first major groups to make vaccinations mandatory earlier this month. “We were convinced that the vaccine could save lives,” said Dr. Daniel Roth, Trinity’s Chief Clinical Officer. “These are preventable deaths.”
At UF Health Jacksonville, Florida, the number of Covid patients being treated has risen to levels not seen since January, and only half of health professionals have been vaccinated, said Chad Neilsen, the director of infection prevention. Seventy-five workers are sick with the virus, the vast majority of whom have not been vaccinated, while more are awaiting test results. “We are definitely having a hard time with staff right now,” he says.
“It’s like déjà vu,” said Mr. Neilsen, who described growing frustration with colleagues refusing to take the injections. “We have reason to believe this could be over once people get vaccinated.”
Despite dozens of virtual town halls, question-and-answer sessions and educational videos, many employees are wary. “We were still stagnant,” said Mr Neilsen.
Some employees want more data, while others feel the process was too rushed. Many of the same conspiracy theories and misinformation — that the vaccines make women infertile or contain microchips — are prevalent among the employees. “Our health professionals are a reflection of the general population,” he said.
Hospital leaders and others plan to meet with state officials in the coming weeks about the possibility of imposing a mandate, he said.
Unvaccinated workers continue to care for even the sickest patients, raising concerns that they will spread the infection, especially with the highly contagious Delta strain accounting for more than 80 percent of cases in the country.
“Nowhere is this more important than in hospitals, where healthcare workers – who have been heroic during this pandemic – care for patients with a wide range of health problems under the assumption that the healthcare workers who treat them are not at risk of becoming infected. or transmitting Covid-19,” said Dr. David J. Skorton, the chief executive of the Association of American Medical Colleges, which represents teaching hospitals, said in a statement last Friday calling for a mandate.
With the Food and Drug Administration’s formal approval of the vaccines potentially months away, hospitals are at the center of the national debate over whether to impose mandates. While the vaccines are being offered with permission for emergency use, supporters argue that there is ample evidence that the vaccines available in the United States are both safe and effective.
In states like Missouri, which have reported a sharp increase in the number of cases, there is a renewed urgency. “We felt we couldn’t wait,” says Dr. Shephali Wulff, director of infectious diseases at SSM Health, a Catholic hospital system headquartered in St. Louis. SodM, where about two-thirds of the employees have now been vaccinated, demands that everyone receive their first dose before September 1.
SodM’s decision was also prompted by concerns that Covid infections could peak this fall when there could also be an increase in other respiratory infections. “We need a healthy workforce going into flu season,” said Dr. wulff. “We don’t have time to wait for approval.”
But some systems are already concerned about staff shortages due to departures during the pandemic, with many employees quitting due to the stress and burnout associated with caring for Covid patients. Hospitals are hesitant to risk losing more workers if they force the issue.
“They’re worried it could be a tipping point,” said Ann Marie Pettis, the president of the Association for Professionals in Infection Control and Epidemiology, one of the professional organizations urging hospitals to demand the vaccine.
At Mosaic Life Care, a small hospital group in Missouri, executives are reluctant to take on a mandate when other hospitals don’t. “We have the potential to lose some health care providers to other systems,” said Joey Austin, a spokeswoman for Mosaic, which has vaccinated about 62 percent of its staff.
Many hospitals are already requiring their employees to get a flu shot, a mandate that has been in effect for more than a decade. While that also met resistance from workers who were skeptical about the safety of the vaccines, it is now largely accepted. Individuals can apply for a medical or religious waiver, usually a small portion of the workforce, which hospitals say also applies to the Covid vaccines.
Mandates “set a social norm and say it’s an institutional priority,” said Saad B. Omer, the director of the Yale Institute for Global Health, who emphasized that hospitals must strongly encourage employees to voluntarily get the vaccines to be successful. to be.
Unions such as the National Nurses United and 1199 SEIU say they want members vaccinated, but are against making this a working condition. At the first hospital to mandate, Houston Methodist, a group of employees filed a lawsuit to challenge the claim, but the lawsuit was recently dismissed. About 150 workers eventually resigned or were fired for refusing to meet the vaccination deadline out of a total workforce of about 26,000 people.
Hospitals say they are working hard to dispel much of the ubiquitous misinformation surrounding vaccines, even among doctors and nurses.
“I have to remind them that renowned scientists do not publish their findings on YouTube,” said Dr. Wulf. In addition to presenting hard data on the vaccine, she and her colleagues at SodM also share their personal experiences, such as getting vaccinated while trying to conceive. “What I notice is that people are moved by stories and anecdotes,” she said.
“Generally speaking, it’s a lot of listening and focusing on what drives their anxiety,” said Dr. wulff.
Some high-profile systems like Intermountain Healthcare and the Cleveland Clinic are waiting. The clinic, which has an expansive network of 18 hospitals in the United States, said existing policies, such as masking and monitoring infections, protect patients and employees.
“We know that if we make sure these safety measures are in place, we know we can continue to keep our patients and caregivers safe,” said K. Kelly Hancock, chief healthcare provider at the Cleveland Clinic.
About three-quarters of workers are now vaccinated and efforts are continuing “at full throttle,” she said.
At Intermountain Healthcare, based in Utah, “a good majority” of workers are vaccinated, said Dr. Kristin Dascomb, medical director for infection prevention and control and workers’ health.
If more safety data is imperative and the FDA approves the vaccines, Intermountain, along with other hospitals in the state, may require immunization. “We’re starting the conversation in Utah now,” she said.
The lack of full FDA approval has affected other hospitals as well. Mass General Brigham, who has vaccinated more than 85 percent of its staff, said it would adopt the requirement once the vaccines are approved.
Some hospitals state that a mandate is not necessary. “In my opinion, there is no one right answer,” said Suresh Gunasekaran, the director of the University of Iowa Hospitals & Clinics. About 90 percent of workers are now vaccinated, he said, adding that he was confident virtually everyone would have been vaccinated by the end of the year.
The system has been “successful” in the vaccine hesitation, Mr. Gunasekaran said, in part because Iowa was involved in the clinical trials for the Pfizer-BioNTech vaccine.
Northwell Health, the major hospital group in New York, doesn’t require employees to be vaccinated against the flu, but about 90 percent of staff are vaccinated against it, said Maxine Carrington, Northwell’s chief of human resources. It takes a similar approach to Covid.
“We want people to be believers,” said Ms Carrington, so they can better convince the community at large to get vaccinated. She described the system as “pounding the curb on education, education, education.” About 76 percent of the workforce is currently vaccinated against Covid. Northwell will reconsider the idea of a mandate after the FDA approves the vaccines, she said.
Yale New Haven Health is now requiring employees to be vaccinated, just like other hospitals in Connecticut.
“From the beginning, we have sent a message that it is not yet mandatory. We emphasized it further,” said Dr. Thomas Balcezak, Yale’s Chief Clinical Officer.
“Healthcare must be leading,” he said.