Hospitals avoid feared staff exodus after COVID vaccine mandate implementation

The February 14th deadline for healthcare workers to receive their first dose of the COVID vaccine does not appear to have significantly worsened the hospital staffing crisis, even in rural hospitals. But the mandate hasn’t necessarily meant that all healthcare workers are now vaccinated, as some hospitals reported approving a flurry of medical and religious exemptions to avoid staff departures. 

The Gist: Just as when states and early-adopter health systems enforced healthcare worker vaccine mandates last year, COVID vaccine uptake jumped just ahead of the federal deadline. 

After months of challenges, we may finally be moving beyond debates over healthcare worker vaccine requirements. And as hospitalizations from the Omicron wave continue to decline, most states and health systems are not planning to implement booster requirements. 

New Jersey requires boosters for healthcare staff

New Jersey requires COVID-19 vaccine for health care workers, ending test  option - 6abc Philadelphia

Workers in New Jersey healthcare facilities and high-risk congregate settings like hospitals and nursing homes will be required to be up to date with their COVID-19 vaccinations, including a booster, Gov. Phil Murphy announced Jan. 19.

Mr. Murphy said there would no longer be an option to opt out of vaccination through testing, except for the purposes of providing an accommodation for people exempt from vaccination.

New Jersey healthcare facilities’ covered workers subject to the CMS vaccination mandate for healthcare settings were already required to ensure covered employees received at least one vaccine by Jan. 27 and completed their primary vaccine series by Feb. 28. Mr. Murphy said the state is now requiring proof that these workers are up to date with their vaccination by Feb. 28, which also includes any booster shots for which they are eligible. Noncompliant workers risk losing their jobs.

Workers at covered healthcare settings not subject to the CMS mandate and covered high-risk congregate settings like prisons and jails have until Feb. 16 to receive their first dose of the primary vaccine series and must submit proof that they are up to date with their vaccination by March 30. Mr. Murphy said workers who become newly eligible for a booster after the two deadlines must submit proof of their booster shot within three weeks of becoming eligible. 

“With the highly transmissible omicron variant spreading across the country and New Jersey, it is essential that we do everything we can to protect our most vulnerable populations,” Mr. Murphy said in a news release. “With immunity waning approximately five months after a primary COVID-19 vaccination, receiving a booster dose is necessary to protect yourself and those around you. It is critically important that we slow the spread throughout our healthcare and congregate settings in order to protect our vulnerable populations and the staff that care for them.”

The rule in New Jersey, which was issued through an executive order, comes after New York and California also announced booster requirements for healthcare staff. 

30% of hospital healthcare workers remained unvaccinated as of September

Dive Brief:

  • Some 30% of U.S. healthcare workers employed at hospitals remained unvaccinated as of Sept. 15, according to an analysis of Centers for Disease Control and Prevention data published Thursday by the Association for Professionals in Infection Control and Epidemiology.
  • The findings include data from 3.3 million healthcare workers at more than 2,000 hospitals, collected between Jan. 20 and Sept. 15.
  • Healthcare personnel working in children’s hospitals had the highest vaccination rates, along with those working in metropolitan counties.

Dive Insight:

The vaccination rate for healthcare workers is roughly in line with that of the general population, though the risk of exposure and transmission can be higher in settings where infected COVID-19 patients are treated, Hannah Reses, CDC epidemiologist and lead author of the analysis, said.

When the shots were initially rolled out, vaccination rates climbed among healthcare workers, rising from 36% to 60% between January and April of 2021, the analysis found. But a major slowdown occurred shortly after.

From April to August, vaccination rates rose just 5%. They then rose 5% again in just one month — from August to September — likely due to the delta variant and more systems implementing their own mandates, the report said.

Researchers also found discrepancies in vaccination rates based on the type of hospitals and their geographic locations.

By September, workers at children’s hospitals had the highest vaccination rates (77%), followed by those at short-term acute care hospitals (70%), long-term care facilities (68.8%), and critical access hospitals (64%).

Among healthcare workers at facilities in metropolitan areas, about 71% were vaccinated by September, compared to 65% of workers at rural facilities.

The findings come as health systems work to comply with new vaccination mandates from the Biden administration.

Healthcare facilities must follow the CMS rule, which stipulates employees must be fully vaccinated by Jan. 4 or risk losing Medicare and Medicaid funding. Unlike the Occupational Safety and Health Administration’s rule that applies to businesses with 100 employees or more but excludes healthcare providers, the CMS rule does not allow for a testing exception.

Both agencies’ rules were met with pushback. The attorneys general of 10 mostly rural states — Missouri, Nebraska, Arkansas, Kansas, Iowa, Wyoming, Alaska, South Dakota, North Dakota and New Hampshire — filed a lawsuit on Oct. 10 against CMS for its rule and said the mandates would exacerbate existing staffing shortages.

“Requiring healthcare workers to get a vaccination or face termination is unconstitutional and unlawful, and could exacerbate healthcare staffing shortages to the point of collapse, especially in Missouri’s rural areas,” the state’s attorney general, Eric Schmitt, said in a statement.

But some regional systems that implemented their own mandates have seen positive results.

After UNC Health and Novant Health in North Carolina required the shots, staff vaccination rates rose to 97% and 99%, respectively, according to a White House report.

Among Novant Health’s 35,000 employees, about 375 were suspended for not complying, and about 200 of those suspended employees did end up getting vaccinated so they could return to work, according to the report.

And some major hospital chains across the country are joining suit with the looming deadline, including HCA with its 183 hospitals and more than 275,000 employees.

The chain is requiring employees be fully vaccinated by the CMS deadline on Jan. 4, a spokesperson said in an email statement.

At the same time, this year’s flu season is difficult to predict, though, “the number of influenza virus detection reported by public health labs has increased in recent weeks,” Reses said.

“The CDC is preparing for flu and COVID to circulate along with other respiratory viruses, and so flu vaccination therefore will be really important to reduce the risk of flu and potentially serious complications, particularly in combination with COVID-19 circulating,” Reses said.

Employee badges to identify vaccination status a hit, Wisconsin health system says

Covid-19 vaccine buttons, T-shirts, and merch are selling out fast on Etsy  - Vox

About 8,000 Marshfield (Wis.) Clinic Health System employees have requested black ID badge reels to indicate they are fully vaccinated, the health system told Becker’s Aug. 11.

The nine-hospital health system, which has more than 12,000 employees, started offering the black reels in July. Many Marshfield employees are already required to wear white reels. However, the new black reels are voluntary. Employees who have them may meet in person, but must be masked, if all meeting attendees are vaccinated, the health system said. 

“We all look forward to having the opportunity to interact with co-workers outside of the virtual world,” said health system spokesperson Jeff Starck. “The badge reels are a way for more personal interaction and create a sense of normalcy for many employees during what has been a challenging, mostly virtual work environment. The reaction has been overwhelmingly positive.”

Mr. Starck said that some employees may not have not asked for the new reels because they use clips or other devices to display their name badges. Employees who work off-site and don’t attend in-person meetings may not have requested them since they haven’t needed them, and some employees who are vaccinated simply may not want to identify themselves, he speculated. 

Marshfield Clinic announced Aug. 4 that it would require employees to become fully vaccinated for COVID-19 by Nov. 15.

As of Aug. 11, about 72 percent of employees are vaccinated, although the health system said that number will rise as it receives proof of vaccination from employees who were inoculated outside the health system. 

CommonSpirit Health mandates COVID-19 vaccination for employees in 21 states

About Us | Serving the Common Good | CommonSpirit Health

CommonSpirit Health is requiring full COVID-19 vaccination for its 150,000 employees, the Chicago-based health system said Aug. 12. 

The requirement applies to employees at CommonSpirit’s 140 hospitals and more than 1,000 care sites and facilities in 21 states. It includes physicians, advanced practice providers, volunteers and others caring for patients at health system facilities. 

“As healthcare providers, we have a responsibility to help end this pandemic and protect our patients, our colleagues and those in our communities —  including the most vulnerable among us,” Lloyd H. Dean, CEO of CommonSpirit, said in a news release. “An abundance of evidence shows that the vaccines are safe and highly effective. Throughout the pandemic we have made data-driven decisions that will help us best fulfill our healing mission, and requiring vaccination is critical to maintaining a safe care environment.”

The compliance deadline for the vaccination requirement is Nov. 1, although the implementation date will vary by region in accordance with local and state regulations. Employees who are not in compliance and do not obtain a medical or religious exemption risk losing their jobs.

Vaccination shortfall making it harder to fully staff hospitals

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With vaccine mandates on the rise among healthcare organizations, including many of the health systems we work with, we’ve begun to hear a new argument in favor of getting staff vaccinated—one that weighs against the worry that mandates will drive scarce clinical workers away.

With staffing already stretched, some systems have been concerned that implementing mandates could worsen shortages and force an increase in the use of costly agency labor. But, some executives are now telling us, so could not vaccinating staff. As the highly contagious Delta variant continues to sweep through unvaccinated populations, clinical workers who haven’t gotten their shots are especially susceptible to contracting the virus.

That’s driven a sharp increase in unvaccinated nurses and other workers calling out sick with COVID symptoms, which has made a difficult staffing situation even worse.

Some of the high-profile reports of hospitals running out of beds in the face of the Delta variant are actually driven by running out of staff to keep those beds in use—making it even more critical to ensure that frontline workers are protected against the virus.

As a growing number of hospitals and other care facilities mandate that their workers get vaccinated, we’d hope this unwelcome pressure on an already stretched workforce begins to wane.

Hospitals, health systems mandating vaccines for workers

AHA Calls for Vaccine Mandate in Health Care Facilities

The number of hospitals and health systems requiring COVID-19 vaccination for employees is growing.

Here are the healthcare organizations that have announced mandates:

Sutter Health in Sacramento, Calif., is mandating that its workforce be fully vaccinated against COVID-19 by Sept. 30. The mandate will require employees, volunteers and vendors who enter a Sutter facility or provide patient care off-site to provide documentation of vaccination, unless they have received a medical or religious exemption, the health system said Aug. 4.

Washington Regional Medical System in Fayetteville, Ark., has mandated vaccination for medical staff, as well as its 3,300 employees as of Oct. 1, J. Larry Shackelford, president and CEO, shared with Becker’s Aug. 4. The organization is also requiring prospective new hires to provide proof of having received at least one dose two weeks before beginning work, according to a message sent to staff July 21. Employees may request an exemption based on disability or sincerely held religious belief.

Advocate Aurora Health in Downers Grove, Ill., and Milwaukee is requiring its remote and in-person staff, volunteers, and on-site vendors to be fully vaccinated, the health system said in an Aug. 4 news release shared with Becker’s. With limited exemptions for religious or medical reasons, the entire staff must provide proof of full vaccination by Oct. 15.

Nationwide Children’s Hospital in Columbus, Ohio, is requiring all employees, care providers, volunteers and vendors to be fully vaccinated, the hospital told Becker’s Aug. 4. Workers must be fully vaccinated, effective Oct. 1.  

PeaceHealth, a system based in Vancouver, Wash., said Aug. 3 that all caregivers will be required to be vaccinated or submit a qualifying medical exemption. The requirement starts Aug. 31. The health system said those who are unvaccinated must undergo regular COVID-19 testing, as well as additional masking, potential reassignment to non-patient care settings and other safety protocols. 

OhioHealth will require the vaccine for its 35,000 associates, providers and volunteers, the Columbus-based health system said Aug. 3. The requirement applies to employed and independent physicians, those in patient-facing and non-patient-facing roles, students and vendors. The compliance deadline is Dec. 1.

Valley Children’s Healthcare in Madera, Calif. is requiring its staff, physicians, vendors and those conducting business in its facilities to be vaccinated against COVID-19, effective Sept. 21. If an employee is granted a medical or religious exemption, they will have to undergo weekly COVID-19 testing. A large percentage of the hospital’s patient population is too young to receive the vaccine, which increases their vulnerability to contracting the virus, the hospital told Becker’s Aug. 3.

Dartmouth-Hitchcock Health in Lebanon, N.H., announced Aug. 3 that it will require employees to get vaccinated as a condition of employment, effective Sept. 30. The health system said employees must submit documentation that they have been fully vaccinated or obtain an approved medical or religious exemption.

Baptist Health in Louisville, Ky., will require its nearly 23,000 employees to be vaccinated, CEO Gerard Colman said in a statement shared with Becker’s Aug. 3. Mr. Colman said details of the plans are still being shared with employees and the Baptist Health Medical Group.

MultiCare Health System in Tacoma, Wash., is requiring all hospital and clinic employees to get vaccinated against COVID-19 this fall. Details are still being worked out, and more information will be released in the coming weeks, The Spokesman-Review reported Aug. 3.

Rochester (N.Y.) Regional Health, the University of Rochester Medical Center and Monroe Community Hospital in Rochester are mandating employees be vaccinated by Sept. 8 or undergo frequent COVID-19 testing, according to an Aug. 2 news release shared with Becker’s.

Norton Healthcare in Louisville, Ky., will require employees, with allowance for religious and medical exemption, to be fully vaccinated, Russell Cox, president and CEO, said Aug. 2. Employees must receive their first dose by Sept. 15.

Kaiser Permanente, an Oakland, Calif.-based organization with more than 216,000 employees and more than 23,000 Permanente Medical Group physicians, said Aug. 2 that it will make vaccines mandatory for workers. Kaiser’s target date to achieve a fully vaccinated workforce is Sept. 30. Unvaccinated employees and physicians must become fully vaccinated or apply for medical or religious exemption.

Hawaii Pacific Health in Honolulu said it will require employees to be vaccinated, the Honolulu Star-Advertiser reported Aug. 2. The health system’s compliance deadline is Oct. 1. According to the newspaper, employees who obtain medical or religious exemptions must get tested regularly.

Queen’s Health System in Honolulu said it will require employees to be vaccinated, the Honolulu Star-Advertiser reported Aug. 2. The health system’s compliance deadline is Oct. 1. 

Memorial Hermann Health System in Houston announced its mandatory COVID-19 vaccine policy Aug. 2. Uner the policy, managers and above must be compliant by Sept. 11, the health system said. The deadline for all other employees, in addition to the system’s affiliated providers and volunteers, is Oct. 9. Memorial Hermann will provide exemptions for medical or religious reasons. 

Northwell Health in New Hyde Park, N.Y. is mandating vaccines for its employees after vaccine rates stagnated at 77 percent, the health system told Becker’s Aug. 2. Health system employees will have to be fully vaccinated by Aug. 16 or will be required to be tested for COVID-19 on a weekly basis. Unvaccinated employees could also face adverse actions, which could progress to include termination.

All New Jersey hospitals will require their staff to get vaccinated under a new mandate by New Jersey Gov. Phil Murphy. Healthcare staff will have until Sept. 7 to get vaccinated or will have to get a COVID-19 test up to twice a week. However, if vaccination rates don’t increase significantly, the governor will consider requiring vaccinations for healthcare staff as a condition of  employment, he said Aug. 2.

Arkansas Heart Hospital in Little Rock said July 30 its directors, executives, managers, advanced practice nurses, physicians and physician assistants will be required to be fully vaccinated for COVID-19 by Sept. 30. On Aug. 1, new employees will be required to receive their first dose within 30 days of employment.
Phoenix Children’s is mandating vaccines for all staff, effective Oct. 1. The hospital told Becker’s July 30 that most of its staff is already fully vaccinated, but it will support the remaining employees as they work toward getting inoculated.

Michigan Medicine in Ann Arbor is mandating its staff be vaccinated against COVID-19, it said July 30. All staff, remote or in-person, must submit proof of vaccination by Aug. 30. Employees who are approved for a religious or medical exemption will be required to complete weekly testing and wear a mask indoors. Ultimately, noncompliant staff will be subject to disciplinary action. As of July 30, 76 percent of hospital employees have reported receiving their COVID-19 vaccines.

Texas Health Resources in Arlington said July 30 that it will require vaccination as a condition of employment. Employees will need to have received either both shots of the Pfizer or Moderna vaccine or one Johnson and Johnson shot, effective Sept. 10. The policy also applies to physicians and advanced practice providers on the medical staffs, students, vendors and contractors.

Conway (Ark.) Regional Health System said July 29 that it will require new hires and leaders, including executive leadership, directors and managers, to get vaccinated. The requirement is effective Aug. 8. Leaders receiving two vaccine doses will be required to receive the second dose by the end of August, the health system said. New hires receiving two vaccine doses will be required to get the second dose within 30 days of employment.   

Millinocket (Maine) Regional Hospital will require employees to receive the Pfizer or Moderna shots when they receive final FDA approval, the Press Herald reported July 29. Staff will be able to request exemptions.

Methodist Health System in Dallas said July 29 that it will require its workforce to be vaccinated by Oct. 1. The health system said once it achieves its workforce vaccination goal, full-time employees will receive a $500 bonus, and part-time employees will receive $250.

Self Regional Healthcare in Greenwood, S.C., is requiring team members to get vaccinated, Fox Carolina reported July 29. The organization said it aims to have unvaccinated employees inoculated by Sept. 30, according to the report.

ChristianaCare said July 29 that it will require employees, medical-dental staff, residents, students, contracted employees, temporary labor, volunteers and vendors to be vaccinated. Caregivers at the Newark, Del.-based health system must receive their first vaccine dose of a two-dose vaccine or their single Johnson & Johnson shot by Sept. 21. 

Children’s Hospital of Philadelphia will require workforce members at any location to get inoculated, the hospital said July 29. A deadline has not been announced.

Mary Washington Healthcare in Fredericksburg, Va., will require its workforce to get vaccinated by Oct. 31, the health system said July 29. The requirement will apply to employees, medical staff and volunteers.

UCHealth, an Aurora, Colo.-based health system with 26,000 employees, said July 28 that it will require employees, providers, volunteers and partners to be vaccinated by Oct. 1. UCHealth’s employees may receive the vaccine of their choice or obtain an exemption for medical or religious reasons. Those who obtain an exemption must wear a mask at all times in UCHealth facilities and be tested weekly, the health system said. 

Pullman (Wash.) Regional Hospital will require employees to be fully vaccinated or complete the exemption process, by Oct. 27, the hospital said July 28. Employees can request a medical exemption, religious belief exemption or personal belief exemption. The personal belief exemption will expire on June 1, 2022, or within two months of full FDA approval of a vaccine. 

Baylor Scott & White Health, a 52-hospital health system based in Dallas, is requiring employees, providers, volunteers, vendors, students and contract staff to receive both doses of the Moderna or Pfizer COVID-19 vaccine, or the single-dose Johnson & Johnson shot, unless granted an exemption, the health system said in a statement shared with Becker’s July 28. The deadline for the requirement is Oct. 1. 

State-run New York hospitals will need patient-facing healthcare workers to get vaccinated by Labor Day, Gov. Andrew Cuomo said July 28. Employees who are not patient-facing and do not get vaccinated will be required to get tested weekly. The requirement will be instated at 10 hospitals and healthcare facilities.

Spectrum Health in Grand Rapids, Mich., said July 28 that it will require the COVID-19 vaccine for team members, medical staff, students, volunteers and contractors. The 14-hospital health system plans to require vaccination within eight weeks of the FDA approving the first vaccine, or sooner depending on pandemic circumstances. Spectrum will consider exemptions.

Ascension, a 149-hospital health system based in St. Louis, will require COVID-19 vaccination for its 160,000 employees. Ascension’s requirement will apply to workers who provide direct patient care, as well as those who work in health system sites of care or remotely, the health system said July 27. This includes workers employed by subsidiaries and partners; physicians and advanced practice providers (employed and independent); and volunteers and vendors entering health system locations. Ascension said employees have until Nov. 12 to complete the vaccine series and meet the vaccination requirement.

Care New England is moving forward with mandatory vaccination for all staff, the Providence, R.I.-based health system said July 27. Vaccination has been required for students, volunteers and new hires since July 1, and the next step is to require managers to begin the vaccination series before Labor Day, said Care New England. 

Baystate Health said July 26 that employed team members, including those working remotely, clinical staff, contractors, volunteers, students, and those conducting business within the Springfield, Mass.-based health system, will be required to be fully vaccinated by Oct. 1. Employees will be able to request an exemption for religious or medical reasons, and pregnant employees may request a deferral.

California healthcare organizations will be required to have all of their employees fully vaccinated or they will be required to get tested weekly, Gov. Gavin Newsom said July 26. Unvaccinated healthcare employees will also be required to wear appropriate personal protective equipment. The policy will take effect Aug. 9 and employees will have until Aug. 23 to fully comply.

Truman Medical Centers/University Health in Kansas City, Mo., said July 26 that vaccination will be a requirement for staff members, according to KMBC. The deadline to be vaccinated is Sept. 20.

Mayo Clinic in Rochester, Minn., said all health system staff must be fully vaccinated by Sept. 17. Those who do not meet the deadline will be able to keep their jobs. However, they will be required to complete a formal refusal process, which includes watching education modules, wearing face masks and maintaining social distancing while on campus.

The Department of Veterans Affairs is mandating COVID-19 vaccinations for 115,000 of its front-line healthcare workers, the first federal agency to do so. Starting July 28, those workers have eight weeks to get fully vaccinated or face penalties, including possible removal.

Rush University Medical Center in Chicago is requiring its workers, contractors and volunteers to get the shot. They must be fully vaccinated by Oct. 1. 

HonorHealth in Scottsdale, Ariz., said July 23 that it will require vaccination as a condition of employment. Employees must submit proof of vaccination by Nov. 1. 

Sanford Health in Sioux Falls, S.D., said July 22 that all employees across its 46 hospitals and hundreds of other medical facilities will be required to be vaccinated by Nov. 1. More than 90 percent of clinicians and 70 percent of nurses are already vaccinated, the health system said. Those who do not get vaccinated will not be working, but a final decision on a furlough has not been decided.

Duke University Health System, a three-hospital health system based in Durham, N.C., is requiring vaccination for employees. The deadline for employees is Sept. 21, news station ABC11 reported July 22. 

Cone Health in Greensboro, N.C., said July 22 that it will require vaccination for workers, effective July 30. The mandate will apply to employees, medical and dental staff, professional students and volunteers. The deadline for compliance is Oct. 1. 

UNC Health said July 22 that it will require teammates at UNC Medical Center, UNC Rex Healthcare, Chatham Hospital, Johnston Health, UNC Health Southeastern, UNC Rockingham Health Care, UNC Physicians Network Practices and UNC Health Shared Services locations to get vaccinated. The deadline for employees at the Chapel Hill, N.C.-based health system is Sept. 21.

Wake Forest Baptist Health said July 22 that the Winston-Salem, N.C.-based organization is requiring teammates to be fully vaccinated or obtain an approved medical or religious exemption. The mandate applies to remote workers, physicians, medical residents, faculty, fellows, trainees, contractors, students/visiting students, members of the medical staff, temporary workers and volunteer staff.

Novant Health is requiring team members to be fully vaccinated, the Winston-Salem, N.C.-based health system said July 22. Workers must be vaccinated by Sept. 15.   

Atrium Health is making vaccination mandatory for all teammates, the Charlotte, N.C.-based health system said July 22. Teammates, including remote workers, physicians, medical residents, faculty, fellows, trainees, contractors, students/visiting students, members of the medical staff, temporary workers and volunteer staff, must be fully vaccinated or obtain an approved medical or religious exemption by Oct. 31. 

Arkansas Children’s in Little Rock is requiring that its leaders (managers, directors, vice presidents, senior vice presidents and executive vice presidents) receive a first vaccine dose as a condition of employment, according to a message sent July 22 from Marcy Doderer, president and CEO. Leaders must receive their first dose by Aug. 20 and be fully vaccinated by Sept. 30. Beginning Aug. 16, all new Arkansas Children’s new hires will also be required to receive a first shot by their start date and a second one within 30 days of employment, said Ms. Doderer.       

OSF HealthCare, a multistate health system based in Peoria, Ill., said July 21 that it will require all employees to be vaccinated against COVID-19 by the end of September. The requirement does not apply to Michigan Nursing Association bargaining unit members. OSF HealthCare has 150 locations in Michigan and Illinois.

Banner Health will require COVID-19 vaccination as a condition of employment for its roughly 52,000 team members, the Phoenix-based health system said July 20. The deadline for employees to be fully vaccinated is Nov. 1, with limited exceptions. 

Southcoast Health, a three-hospital health system offering services in southeastern Massachusetts and Rhode Island, said vaccines will be mandated for all employees, staff and providers once at least one of the vaccines receives full FDA approval, The Standard-Times reported July 20. Employees will be able to request exemptions if they have documented medical and religious reasons, or if they are pregnant or intend to become pregnant.

Valley Health, a Winchester, Va.-based health system with 6,300 employees and affiliated physicians, said July 19 that it will add COVID-19 vaccination to its list of required vaccinations for all employees, medical staff members and contractors. Health system officials said the standard is effective immediately for new employees, who must provide evidence of vaccination or complete the vaccination series two weeks before beginning work. Employees who are managers or above and medical staff members must provide evidence of prior completion of the vaccination series or receive their first dose by Aug. 16. Remaining staff have until Nov. 1 to either obtain an exemption or be fully vaccinated.

Tidelands Health in Georgetown, S.C., said July 16 that it will mandate vaccination for employees, employed providers, volunteers, learners and contractors. Employees have until Sept. 7 to comply, and the health system is providing an attestation and declination process for those who cannot get vaccinated for medical or religious reasons. Tidelands Health said employees who have previously tested positive for COVID-19 may also choose to decline the shot.

Hackensack Meridian Health, a 17-hospital system based in Edison, N.J., will require its staff to be fully vaccinated against COVID-19, reported July 15. A memo to employees cited by gave Nov. 15 as the deadline for the mandate. Workers, including physicians and nurses, must receive at least one dose of the Pfizer, Moderna or Johnson & Johnson shots by Oct. 1 and a second dose of Pfizer or Moderna by Nov. 15. The deadline to request an exemption is Aug. 16. 

Beacon Health System in South Bend, Ind., said July 15 that it will require employees and others who work regularly at a Beacon facility to be fully vaccinated by Oct. 1. Employees may request an exemption.

Vanderbilt University Medical Center in Nashville, Tenn., will require its entire staff to get the vaccine, according to an employee newsletter distributed July 15. All hospital leaders must get the first dose or achieve a medical exemption by Aug. 15 They must fully be vaccinated by Sept. 15. The deadline for all employees is under consideration.

The University of Mississippi Medical Center in Jackson said July 15 that it will implement a new vaccination policy requiring those who work or learn in a medical center-controlled space to be fully vaccinated against COVID-19, with limited exceptions, or wear an N95 mask while at any medical center facility. Medical center officials said those who are fully vaccinated will only be required to wear a mask of their choosing or as determined according to the clinical situation in patient care areas. The policy will be phased in over three months, with all who work in a medical center-controlled space required to be fully vaccinated or wearing an N95 mask at all times on or by Nov. 1.

Hartford (Conn.) HealthCare said July 14 that it will require COVID-19 vaccination for its employees. Health system officials said employees may apply for an exemption, but those without an approved exemption must show proof of vaccination by the end of September.

St. Jude Children’s Research Hospital said July 14 that the Memphis, Tenn.-based hospital and its foundation partner, ALSAC, are requiring that St. Jude and Memphis-area ALSAC employees be vaccinated against COVID-19 by Sept. 9. In a memo, St. Jude President and CEO James Downing, MD, told employees they must have their final dose scheduled and administered by the deadline, or, if vaccinated outside of St. Jude, have the documentation to the hospital by the deadline date.

University of Chicago Medicine will require its workers to be vaccinated against COVID-19, according to a July 13 memo to students, faculty and staff. The mandate will apply to employees of University of Chicago Medical Center and to medical center volunteers and contractors at both the Hyde Park campus and other medical center sites, health system leaders wrote. They added that the mandate may be subject to discussion with unions representing workers.

Piedmont Healthcare in Atlanta said June 12 it is requiring leaders, physicians, providers and new employees to be fully vaccinated against COVID-19, with plans to eventually extend the mandate to all its more than 23,000 workers. As of Sept. 1, the mandate will apply to that initial group and to the rest of Piedmont’s employees in “the near future,” following Sept. 1.

Virtua Health in Marlton, N.J., will require its more than 14,000 workforce members to be fully vaccinated against COVID-19. Virtua employees must be fully vaccinated by Sept. 15. Virtua said July 12 that all employees, regardless of vaccination status, will continue to maintain COVID-19 safety protocols per CDC guidelines, and it will consider employee requests for exemptions based on religious beliefs or disability/medical condition. 

Inova Health System in Falls Church, Va. informed its 18,000 employees that they will have to be vaccinated by Sept. 1.

Trinity Health in Livonia, Mich., will require its 117,000 employees across 22 states to get the COVID-19 vaccine after the number of employees who received at least one shot stagnated at 75 percent.

St. Luke’s Health System in Boise, Idaho, will require its employees to be vaccinated against COVID-19, according to a memo sent to employees July 8 from Chris Roth, president and CEO of the health system. St. Luke’s will require all employees, providers, volunteers and contractors to receive their first vaccine dose by Sept. 1. 

Mercy in St. Louis will require its 40,000 employees across 44 hospitals and healthcare facilities to receive the COVID-19 vaccine, health system officials said on July 7. All employees will be required to be vaccinated by Sept. 30.

University Hospital in Newark, N.J. will require all of its employees to be vaccinated, according to a June 30 report.

Yale New Haven (Conn.) Health officials said in a June 30 press conference that all health system employees will be mandated to get the vaccine, however, the deadline is still being determined.

Connecticut Children’s Medical Center in Hartford will require all employees to be fully vaccinated against COVID-19. The hospitals’ CEO and president, Jim Shmerling, PhD, said hospital employees will have until Sept. 30 to get vaccinated, according to a June 29 letter to employees.

Henry Ford Health System in Detroit, which employs more than 33,000 people, said June 29 it will require its workforce to be vaccinated, effective Sept. 10. The requirement applies to team members, students, volunteers and contractors. 

SSM Health in St. Louis said June 28 it will require its nearly 40,000 employees, providers and volunteers to be fully vaccinated by late September. Team members can request a medical or religious exemption.

Medical University of South Carolina Health employees were provided a final deadline of June 30 to be vaccinated, or to obtain a medical or religious exemption, as part of the Charleston-based health system’s mandate. The health system fired five out of about 17,000 employees for noncompliance.

Mass General Brigham will require employees to be vaccinated, the Boston-based health system said June 24. The requirement will apply to Mass General Brigham’s 80,000 employees once one of the three vaccines being distributed in the U.S. is fully approved by the FDA. The health system said employees will be able to request exemption if they are pregnant or intend to become pregnant. Employees may also request an exemption for medical and religious reasons. A deadline for the mandate will be determined after FDA approval. 

Beth Israel Lahey Healthin Cambridge, Mass., said June 24 it plans to require all physicians and staff to be vaccinated against COVID-19 and the flu as a condition of employment. Flu vaccination will be required later this year, and COVID-19 vaccination for employees will be required after one of the vaccines is fully approved by the FDA.

Wellforce in Burlington, Mass., which includes Boston-based Tufts Medical Center, will require vaccination for employees, the system said June 24. The requirement takes effect after full FDA approval of one of the vaccines, which is expected later this year.

Dana-Farber Cancer Institute in Boston said it will require employees to be vaccinated, The Boston Globe reported June 24. Dana-Farber will wait until after the FDA fully approves a vaccine.

The Connecticut Hospital Association said June 24 it has adopted a consensus, statewide policy reflecting a commitment by the state’s hospitals and health systems to implement mandatory vaccination for employees and clinical staff. The association will develop best practices for implementation.

Meritus Health in Hagerstown, Md., said June 16 it will require vaccination for employees. The requirement applies to employees, medical staff members, volunteers, contractors and partners. As of Aug. 1, new employees must be vaccinated before starting work, the health system said. And as of Sept. 1, all employees, medical staff, volunteers, contractors and partners must be vaccinated or will need to be tested every 14 days. Meritus Health is providing medical and religious exemptions. 

BJC HealthCare in St. Louis will require employees to be fully vaccinated beginning in the fall, according to a June 15 statement from the health system. Employees and those who work in BJC facilities must comply with the mandate by Sept. 15 or receive a medical or religious exception.

San Francisco will require personnel in high-risk settings such as skilled nursing facilities, acute care hospitals, homeless shelters and jails to be vaccinated, the city said June 14. The requirement takes effect once one of the vaccines being distributed in the U.S. receives full FDA approval. 

University of California Health will require COVID-19 vaccines for faculty, staff, academic appointees and students accessing University of California campuses this fall, the system said June 14.

NewYork-Presbyterian in New York City said all employees, physicians, students, clinical rotators, volunteers and vendors must have received their first dose no later than Sept. 1. For two-dose vaccines, workers must complete the vaccination process on the prescribed timeline. Newly hired employees also must follow a vaccination or exemption process. 

Community Health Network in Indianapolis is requiring employees to be fully vaccinated by Sept. 15 unless they receive exemptions for religious or medical reasons, according to a June 10 news release. The requirement applies to vendors, contractors and volunteers who work at Community’s hospitals and care sites.

The District of Columbia Hospital Association, said June 9 that hospitals in Washington, D.C., signed a consensus statement to mandate vaccination for their workers. Each of the 14 hospitals will set their own vaccination deadline.   

University of Maryland Medical System in Baltimore announced June 9 that it will require vaccination for current and new employees. The 13-hospital health system said teammembers and partners who remain unvaccinated will be required to get tested weekly, and health system leaders at the manager level and above will have until Aug. 1 to be vaccinated or comply with weekly testing. Beginning Sept. 1, all teammembers will be required to get inoculated or participate in weekly testing.

The Maryland Hospital Association said June 7 that hospitals and health systems in the state signed a consensus statement to mandate vaccination for their workers. Each organization will set their own vaccination deadline.

Indiana University Healthin Indianapolis is requiring employees to be fully vaccinated, The Indianapolis Star reported June 1.  Employees must be vaccinated by Sept. 1 or obtain an exemption.

University of Louisville (Ky.) Health is requiring team members and providers, including residents, fellows and rotating students, to be fully vaccinated by Sept. 1, according to a May 26 news release.

RWJBarnabas Health in West Orange, N.J., is requiring supervisors and employees ranked above them to be vaccinated no later than June 30 and said May 20 that it plans to extend the mandate to all employees.

University of Pennsylvania Health System in Philadelphia said May 19 that it is making the vaccine mandatory for all employees and clinical staff by no later than Sept. 1. New hires must provide proof of at least one dose two weeks before beginning work.  

Benefis Health System in Great Falls, Mont., said May 19 it made the vaccine mandatory for about 250 employees working in senior services. Employees who are not exempt are required to get their second doses by July 1.

Houston Methodist rolled out its mandatory vaccination policy March 31, with April 15 as the deadline for managers to receive at least one dose or get an exemption. All employees had a deadline of midnight June 7 to get the COVID-19 vaccine as part of the health system’s mandate. The count as of June 8: Nearly 100 percent compliance with 24,947 workers being fully vaccinated. 

A tidal wave of vaccine mandates

EP14: What Motivates You? The Carrot or the Stick? | Live and Lead for  Impact Podcast with Kirsten E Ross

State governments, private businesses and even part of the federal government are suddenly embracing mandatory coronavirus vaccinations for their employees.

Why it matters: Vaccine mandates have been relatively uncommon in the U.S. But with vaccination rates stagnating and the Delta variant driving yet another wave of cases, there’s been a new groundswell of support for such requirements.

Driving the news: Monday was a turning point.

  • The VA became the first federal agency to require its employees to be vaccinated.
  • More than 50 medical groups called for mandatory vaccinations of all health care workers, WaPo first reported.
  • California announced that state employees and health care workers must show proof of vaccination or get tested regularly.
  • New York City brought all municipal workers — including teachers and police officers — under a vaccine requirement that had previously only applied to health workers.
  • Even the SF Bar Owner Alliance hopped onboard, announcing that the 500 San Francisco bars it represents will require indoor customers to show proof of vaccination or a negative test.

The big picture: Vaccine requirements are also gaining steam internationally.

  • France has required health workers to get vaccinated. Members of the public must also have a vaccine or a negative test to enter most indoor venues.
  • Although the measure has sparked protests, it’s also encouraged millions of people to get vaccinated, per the NYT.

Yes, but: Many Republican-led states have preemptively prohibited vaccine requirements, at least in some settings.

The bottom line: Vaccine mandates have been unpopular in part because they’ll inevitably create a backlash.

  • But the vaccination effort seems to have run out of carrots to incentivize more people to get a shot, and with rates remaining as low as they are in light of a worsening domestic situation, resorting to sticks has clearly become a more attractive option.

Encouraging hospitals to implement vaccine mandates

Bills to Block Mandatory Worker Vaccines Falter in the States | The Pew  Charitable Trusts

With the Delta variant now accounting for more than 83 percent of all new COVID cases in the US, daily new case counts more than quadrupling across the month of July, and hospitalizations—particularly in states with low vaccination rates—beginning to climb significantly, we appear to have entered a new and uncertain phase of the pandemic, now being dubbed a “pandemic of the unvaccinated”.

Welcome news, then, that this week the American Hospital Association (AHA) publicly encouraged its members to put in place vaccine mandates for their employees. While several large health systems have taken the lead in implementing vaccine mandates, including Trinity Health, the Livonia, MI-based Catholic system that operates hospitals across 22 states, Phoenix, AZ-based Banner Health, Houston Methodist in Texas, and the academic giant NewYork-Presbyterian, others have been more reticent to compel employees to get vaccinated, citing concerns over employee privacy and the potential for workforce backlash.

The New York Times reports that a quarter of all hospital employees remain unvaccinated nationwide, with many facilities reporting that more than half of their healthcare workers have not gotten the COVID vaccine. In our discussions with health system executives, one consideration frequently cited is the desire for full Food and Drug Administration (FDA) approval of the new vaccines before mandates are put in place.

In a CNN town hall meeting this week, President Biden suggested that approval could come as soon as the end of August, although other reports point to likely approval much later, potentially not until January of next year. Facing a new variant of the virus that is much more transmissible and possibly more virulent than earlier strains, hospitals—and their patients—can’t afford to wait that long. 

For safety’s sake, hospitals should quickly put in place vaccine mandates, with appropriate exceptions.

More hospitals poised to require COVID-19 vaccines

It’s “a trickle that will become a torrent,” Ashish Jha, dean at Brown University’s School of Public Health, tweeted.

More hospitals are likely to require employees receive a COVID-19 vaccine, experts said, to further protect the sick and vulnerable patients who rely on them for care.

A Houston-area hospital captured headlines after taking a firm stance on requiring vaccines that prevent severe illness of the coronavirus, which has killed more than 600,000 in the U.S. and ravaged the economy.

Houston Methodist employees who refused the vaccine were either terminated or resigned. A judge earlier this month sided with the hospital and tossed out an employee lawsuit that was seeking to block the mandated inoculation. The ruling may give other hospitals the green light to require the jab, and as more facilities put a similar policy in place, others are likely to follow, experts said.

It’s “a trickle that will become a torrent,” Ashish Jha, professor and dean at Brown University’s School of Public Health, posted Thursday on Twitter.

3 large health systems in Massachusetts to require all workers to be vaccinated.

Given the critical need to protect vulnerable patients, its critical all hospitals do this.

Leading systems will do it soon.

Laggards will get there eventually.

Joining the growing tide of vaccine mandates are a variety of systems and hospitals, including Mass General Brigham in Boston, BJC Healthcare in St. Louis and Inova Health System in Virginia.

Some of the nation’s largest health systems have yet to mandate the shot, including Kaiser Permanente and CommonSpirit Health.

“Vaccination will only be required for Kaiser Permanente employees if a state or county where we operate mandates the vaccine for health care workers,” the company said in an email.

The American Hospital Association continues to hear that a growing number of its members are requiring the vaccine, with some exemptions. However, many member hospitals are waiting until the FDA grants full approval, a time when more safety and efficacy data will be made available.

“Getting vaccinated is especially critical for health care professionals because they work with patients with underlying health conditions whose immune systems may be compromised,” AHA, which has not taken on stance on the requirement, said in a statement.

The mandates raise ethical questions, some say, pointing to the profession’s promise to “do no harm.”

Arthur Caplan, head of medical ethics at New York University School of Medicine, said the codes of ethics that doctors and nurses says to put patients first, do no harm and protect the vulnerable.

“Of course they should be vaccinated,” he said. “If they don’t want to get vaccinated, I think they’re in the wrong profession.”

The Equal Employment Opportunity Commission said employment law does not prohibit employers from requiring the jab, essentially giving the green light to employers to put incentives and requirements in place for their workers. The EEOC is the federal agency tasked with ensuring that workplaces do not discriminate.

Some states are going against the tide and signing legislation that bars vaccine mandates, including Florida. The city of San Francisco will require hospital employees and workers in high-risk settings to get the vaccine. San Francisco, like other employers and universities, will require all city workers get inoculated.

The differing policy stances across the country creates additional hurdles for corporations with a large footprint.