Hundreds of sought-after nurses are leaving some U.S. hospitals that have established vaccine requirements for all employees, involving some protests and legal opposition. But most workers, especially at large hospital chains, appear to be complying with the policies.
New York hospitals and nursing homes are grappling with the state’s Monday deadline for workers to have received at least one coronavirus vaccine dose, with thousands of workers remaining unvaccinated and at risk of being fired. Several other states and cities have also imposed mandates for health care workers, with deadlines approaching.
All are also facing a looming federal vaccine mandate for hospital and nursing home staff that President Biden ordered, though its exact scope and timing has yet to be announced.
The departures, especially of nurses, have compounded major staffing shortages over the course of the pandemic. The situation has become acutely difficult these past few months, particularly in regions where the Delta variant has overwhelmed hospitals and caused new spikes in Covid cases among nursing home staffs and residents. In one instance, a hospital in upstate New York said it briefly had to stop delivering babies after six of its employees left rather than get vaccinated.
At Novant Health, a large hospital group based in North Carolina, 375 workers were suspended after not meeting the system’s vaccination deadline this month. Another 200 agreed to comply, increasing the vaccination rate to over 99 percent of its more than 35,000 employees, according to Novant.
Yet the loss of some employees “is going to be the cost of doing business in a pandemic,” said Dr. Saad B. Omer, the director of the Yale Institute for Global Health, who has studied vaccine mandates. “I’m not seeing any widespread disruptive effect,” he said.
Dr. David H. Priest, an infectious-disease specialist and senior executive at Novant, said he believed that the hospital would persuade most of its workers by addressing their concerns. The hospital has “been working on this for weeks on end,” he said, by holding webinars and sending emails to help educate employees about the benefits of being immunized.
How the nation’s hospitals are handling the holdouts varies widely, and many facilities are waiting for federal guidelines. Others have set deadlines later this year.
Many hospitals are not establishing sharp cutoffs for when they might eventually fire someone.
UNC Health, another North Carolina group, said that it was confirming the status of about 900 employees. About 70 employees have left as a result of the system’s mandate, and the group has granted about 1,250 exemptions for medical or religious reasons. About 97 percent of its work force have complied. Those who still need to be vaccinated or qualify for an exemption have until Nov. 2, providing what UNC described as “a last chance to remain employed.”
At Trinity Health, one of the first major hospital chains to announce a vaccine mandate, the percentage of its vaccinated staff has increased from 75 percent to 94 percent, said the group, which operates in 22 states.
Understand Vaccine and Mask Mandates in the U.S.
- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations. On Sept. 27, a federal appeals panel reversed a decision that paused a mandate that teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
SSM Health, a Catholic hospital group based in St. Louis, also adopted a mandate but said that few of its workers had left because of its requirement.
Hospitals and nursing homes have raised concerns about their ability to find workers if they impose strict requirements. The situation may be worse in rural areas, where limited numbers of workers are available. But healthy vaccinated workers may also ease staffing shortages.
At Houston Methodist, where 150 employees left from a work force of about 26,000 people, the hospital said that there had been little lasting effect on its ability to hire people. And when Texas was hit with rising numbers of Covid cases over the summer, the hospital found that fewer of its workers were out sick.
“The mandate has not only protected our employees, but kept more of them at work during the pandemic,” a hospital spokeswoman said in an email.
ChristianaCare, a hospital group based in Wilmington, Del., said on Monday that it had fired 150 employees for not complying with its vaccine mandate. But the group emphasized that over the last month it had hired more than 200 employees, many of whom are more comfortable working where they knew their colleagues were vaccinated.