More and more hospitals and major health systems are requiring staff to receive the COVID-19 vaccine, fueled by the delta variant’s growing caseload and low vaccination rates in their communities and even within their work force. referring to.
Many hospitals say their efforts to vaccinate their staff have stalled, just as the country’s overall vaccination rate lags behind many European countries and Canada at less than 60 percent. while more than 96 percent doctors Say they have been fully vaccinated, health care workers, especially in rural areas, have proved more resistant, according to the American Medical Association, even though thousands of workers have died from the virus and countless more have become ill. .
a recent assessment indicated that one in four hospital workers had not been vaccinated by the end of May, with some facilities reporting that less than half of their staff had received shots.
Some hospitals, from academic medical centers like New York-Presbyterian and Yale New Haven to large chains like Trinity Health, are moving forward with a mandate because they believe the only way to stop the virus is to vaccinate as many people as possible. , as quickly as possible. Banner Health, a large Arizona-based chain, announced Tuesday that it would implement a mandate, and New York City said it would require all health care workers in city hospitals or clinics to undergo vaccinations or weekly tests.
Seeing the surge in cases, Trinity Health, a Catholic system with hospitals in 22 states, became one of the first major groups to decide earlier this month that it would make vaccinations mandatory. “We believed the vaccine could save lives,” said Dr. Daniel Roth, Trinity’s chief clinical officer. “These are preventable deaths.”
Chad Nielsen, director of infection prevention, said that at UF Health Jacksonville in Florida, the number of COVID patients being treated has risen to levels seen since January, and only half of its health care workers have been vaccinated. has gone. Seventy-five workers are sick with the virus, most of whom have not been vaccinated, while more await test results. “We’re just struggling to fully staff,” he said.
“It’s like déj vu,” said Mr Nielsen, who described the growing frustration with coworkers refusing to take shots. “We have a reason to believe that this could be over if people vaccinated.”
Despite dozens of virtual town halls, question-and-answer sessions and educational videos, many employees are wary. “We are still stable,” said Mr Nielsen.
Some employees want more data, while others say the process has been hurried. Many of the same conspiracy theories and misinformation – that vaccines will make women infertile or have microchips – sway among staff members. “Our health care workers are a reflection of the general population,” he said.
He said hospital leaders and others plan to hold meetings with state officials in the coming weeks.
Uninfected workers also continue to care for the sickest patients, raising concerns that they will spread the infection, especially now that the highly contagious delta variant comprises more than 80 percent of the country’s cases.
“Nowhere is this more important than in hospitals, where health care workers – who have been heroic during this pandemic – are caring for patients with a variety of health challenges under the assumption that the health care professionals treating them There is no risk of getting it. Or transmitting Covid-19,” said Dr David J. Skorton, chief executive officer of the Association of American Medical Colleges, which represents teaching hospitals, said Statement Demanded the mandate last Friday.
With formal approval of vaccines by the Food and Drug Administration potentially months away, hospitals find themselves at the center of a national debate over whether to enforce the mandate. While the vaccines are being offered under emergency use authorization, proponents argue that there is ample evidence that the vaccines available in the United States are both safe and effective.
In states like Missouri, which has reported a sharp increase in cases, there is a renewed urgency. “We figured we couldn’t wait,” said Dr. Shefali Wolf, director of infectious diseases for SSM Health, the 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 motivated by concerns that while other respiratory infections may also increase, COVID infections may exacerbate this decline. “We need a healthy work force going into flu season,” Dr. Wolf said. “We don’t have time to wait for approval.”
But some systems are already concerned about staff shortages caused by departures during the pandemic, with many employees leaving due to the stress and irritation experienced by caring for COVID patients. Hospitals are hesitant to risk losing more workers if they force the issue.
July 21, 2021 at 1:55 pm ET
“They fear it may be a moot point,” said Ann Marie Pettis, president of the Association for Professionals in Infection Control and Epidemiology, one of the professional associations. requests to hospitals for the need for a vaccine.
At Mosaic Life Care, a small Missouri hospital group, officials are reluctant to adopt a mandate if other hospitals do not. “We have the potential to lose some caregivers to other systems,” said Joy Austin, a spokesperson for Mosaic, which has vaccinated 62 percent of its workforce.
Many hospitals already require their employees to get the flu shot, a practice that has been in place for more than a decade. While this was also met with resistance from staff doubting the safety of vaccines, it is now largely accepted. Individuals can seek medical or religious exemptions, usually representing a small segment of the workforce, which hospitals say will also apply to COVID vaccines.
Saad B. Omar, director of the Yale Institute for Global Health, said the mandate “establishes a social norm and says it is an institutional priority.”
Unions such as National Nurses United and 1199 SEIU say they want members to be vaccinated, but oppose making it a condition of employment. At the first hospital to implement a mandate, Houston Methodist, a group of employees sued to challenge the requirement but the lawsuit was recently dismissed. About 150 workers out of a total workforce of about 26,000 people eventually resigned or were fired for refusing to meet vaccination deadlines.
Hospitals say they are working hard to clear up misinformation about vaccines, even among doctors and nurses.
“Let me remind them that eminent scientists do not publish their findings on YouTube,” Dr. Wolf said. In addition to presenting hard data about vaccines, she and her colleagues at SSM are also sharing their personal experiences, such as getting vaccinated while trying to get pregnant. “What I’m finding is that people are infatuated with stories and anecdotes,” she said.
“Usually it’s what’s driving their fear, there’s a lot of listening and making a home on it,” Dr. Wolf said.
Some high-profile systems like Intermountain Healthcare and Cleveland Clinic are waiting. The clinic, which has a vast network of 18 hospitals in the United States, said existing policies, such as masking and closely tracking infections, protect patients and workers.
“We know that if we take these safety precautions we know we can continue to keep our patients and caregivers safe,” said Kelly Hancock, Cleveland Clinic’s chief care officer.
About three-quarters of employees have now been vaccinated, and “full force” efforts are underway, she said.
At Intermountain Healthcare, based in Utah, “a good majority” of employees are vaccinated, said Dr. Kristin Dascombe, medical director for infection prevention and control and employee health.
If more safety data is compelling and the FDA approves vaccines, Intermountain may require vaccinations as well as other hospitals in the state. “We are starting talks in Utah now,” she said.
The lack of full FDA approval has affected other hospitals as well. Mass General Brigham, which has vaccinated more than 85 percent of its workforce, said it would adopt the requirement as soon as vaccines are approved.
Some hospitals argue that the mandate is not necessary. “In my opinion, there isn’t a single right answer,” said Suresh Gunasekaran, chief executive officer of the University of Iowa Hospitals and Clinics. About 90 percent of its employees are now vaccinated, he said, adding that he is confident that almost everyone will be vaccinated by the end of the year.
Mr. Gunasekaran said the system has been “successful to give up” on vaccine hesitation, as Iowa Pfizer-BioNtech was involved in clinical trials of the vaccine.
At Northwell Health, New York’s large hospital group, workers are not required to be vaccinated against the flu, but about 90 percent of its workforce is vaccinated against it, said Maxine Carrington, Northwell’s chief human resources officer. It is adopting a similar approach to Covid.
“We want people to be believers,” Ms Carrington said, so they are able to persuade the community at large to get vaccinated. He described the system as “education, education, sharpening the pavement on education”. About 76 percent of its workforce is currently vaccinated against COVID. He said Northwell will revisit the idea of a mandate once the vaccines are approved by the FDA.
Yale New Haven Health now requires employees to get vaccinated, as at other hospitals in Connecticut.
“From the beginning, we sent the message that it’s not mandatory — yet. We insisted so far,” said Dr. Thomas Balczek, Yale’s chief clinical officer.
“Health care has to lead,” he said.