VA requires vaccines for its health workers
The Department of Veterans Affairs makes COVID-19 vaccines mandatory for most healthcare workers, making it first federal agency to do so. Nearly 60 medical as well as California and New York City also call for health workers to be vaccinated.
The Department of Veterans Affairs, which runs one of the nation’s largest health systems, announced Monday it would mandate coronavirus vaccines for its front-line workers, becoming the first federal agency to do so and signaling what some experts said could be a national pivot to such requirements.
Faced with the explosive growth of a new virus variant, the state of California and the city of New York gave workers a
choice: Get vaccinated or face weekly testing. And an array of hospitals from coast to coast, including the prestigious Mayo Clinic, declared they would require staff to get vaccinated, following a joint plea from the nation’s major medical groups.
Healthcare leaders say the moves represent an escalation of the nation’s fight against the coronavirus — the first concerted effort to mandate that tens of millions of Americans get vaccinated, more than seven months after regulators authorized the shots and as new cases rip through the nation. VA’s mandate applies to more than 100,000 front-line workers, New York City’s applies to about 45,000 city employees and contractors, and California’s applies to more than 2.2 million state employees and health workers.
“You can call it a tipping point,” said Mark Ghaly, California’s health secretary, noting that millions of people have declined the shots despite public health experts’ appeals and a range of incentives. “For so many Californians and Americans, this might be the time to get vaccinated.”
Ghaly noted that in California, about 900 coronavirus cases in mid-June were severe enough to require hospitalization versus nearly 3,000 now, driven by the hyper-transmissible delta variant. “As we stare down schools opening up in just a matter of a couple of weeks, as we look at the projections with delta, we felt now is the right time,” he said.
Confirmed coronavirus infections nationwide have quadrupled in July, from about 13,000 cases per day at the start of the month to more than 54,000 now, according to Washington Post tracking. Hospital leaders in states such as Florida as well as Alabama and Missouri have implored holdouts to get vaccinated, citing data that the shots prevent the most severe forms of the disease that lead to hospitalization and even death.
“We have reached a confluence where healthcare workers want vaccine mandates, and government is responding,” said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who organized the joint statement from nearly 60 medical groups, including the American Medical Association and the American Nurses Association, urging every health facility to require workers to get vaccinated.
“I fully expect more healthcare employers — health systems, long-term care companies, pharmacies and others — will mandate their employees get vaccinated,” Emanuel added. “The nation will be better off for it.”
About 60 percent of all U.S. adults are fully vaccinated, with the rate of new immunizations slowing since mid-April, according to The Post’s tracking. The White House has said it will not impose national mandates but supports private employers that create new requirements for their workers.
Many healthcare workers also remain unvaccinated, despite having priority access to coronavirus vaccines, which first became available in December. More than 38 percent of nursing home staff were not fully vaccinated as of July
11, despite caring for patients at elevated risk of the coronavirus, according to data collected by the Centers for Medicare and Medicaid Services and analyzed by LeadingAge, which represents nonprofit nursing homes and other providers of elder care.
An analysis by WebMD and Medscape Medical News estimated that 25 percent of hospital workers who had contact with patients had not been vaccinated by the end of May.
VACCINE RATES ‘LOW’ AT JACKSON
The percentage of healthcare workers vaccinated at Jackson Health System, Miami-Dade County’s public hospital, was “low,’’ Jackson Health CEO Carlos Migoya said in an interview with the Herald last week. Among Jackson Health’s nearly 13,000 employees, only about 58 percent have been vaccinated, Migoya said.
He attributed the low vaccine rate to rumors and misinformation about the vaccine.
At the Miami VA Medical Center, public affairs officers with the center did not respond to a request for comment Monday on the federal agency’s new mandate.
But a federal database maintained by the Department of Veterans Affairs reports that at least two people who worked at the Miami VA have died of COVID-19 during the pandemic.
A total of 2,188 Miami VA employees were fully vaccinated as of Monday, according to the database, which did not provide the number of people who work at the medical center.
In addition, the Miami VA has vaccinated more than 26,000 military veterans. The medical center has seen 2,506 COVID-19 cases during the pandemic, including 73 cases that were active as of Monday.
Among those patients were 63 veterans, five employees and one veteran-employee. Four of the patients were categorized as “other.”
Nationally, a total of 146 VA employees have died of COVID-19 as of July 23, including two at the medical center in Gainesville and one each at facilities in Tampa and West Palm Beach.
Health leaders across the country said the slowedpace of vaccinations, coupled with the threat of the delta variant, compelled them to act.
“We feel that it’s important to sign our name onto this,” said Rachel Villanueva, an OB/GYN and the president of the National Medical Association, which represents more than 50,000 Black physicians and is calling for a vaccination mandate for the first time.
Villanueva added that new coronavirus cases could disproportionately affect front-line workers — many of whom are African American — and communities of color that continue to lag behind Whites on vaccination rates. “We want to continue to dispel myths, educate, increase confidence and increase vaccination rates in our communities,” she said.
Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who organized Monday’s statement, said he thinks that requiring vaccinations could boost uptake of the shots, beginning with health workers.
“Despite everything — cajoling, making access readily available at any pharmacy, making it free, having the president plead — all of this hasn’t really moved the needle very much in the nation,” said Emanuel, who spent two weeks organizing the joint statement and praised the buy-in from so many groups.
“One of the things that resonated with people is, ‘Look, we’re the medical community. This is a health problem. We need to lead — and we need to have the courage of our convictions.’”
HESITATION IN MANDATING VACCINES
Healthcare facilities generally have hesitated to mandate coronavirus vaccines for employees, noting that the vaccines have not yet received full approval from the Food and Drug Administration and citing the threat of lawsuits. Fewer than 9 percent of hospitals have required their workers to get vaccinated, according to tracking by the American Hospital Association, whichannounced separately last week that it supported suchmandates.
Emanuel cited the example of Houston Methodist, which has said it was the nation’s first health system to impose a coronavirus vaccination mandate. Some staff members opposed the rule — including more than 150 who refused to get vaccinated and left the organization. But 97 percent of Houston Methodist workers complied, with about 2 percent obtaining exemptions or deferrals. A federal judge also dismissed a lawsuit filed by former staff members who refused to get vaccinated, ruling that Houston Methodist was “trying to do their business of saving lives without giving [patients] the COVID-19 virus.”
Emanuel said that the University of Pennsylvania Health System, which imposed its own coronavirus vaccination mandate two months ago, also has seen a similar uptake in shots.
“The sky didn’t fall,” Emanuel said. “When we do it, and we have a good justification, people respond.”
Healthcare leaders frame vaccinations in their industry as a shared responsibility. Ernest Grant, president of the American Nurses Association (ANA), said his members are reeling from the prospect of another surge of coronavirus cases.
“I get phone calls and emails and conversations on a daily basis from nurses across the country that are saying, ‘I just reached my limit, I’m exhausted,’ ” Grant said. “It is very frustrating when you know there are vaccines out there that are effective and can drive down the spread.”
About 83 percent of nurses were vaccinated as of early May, according to an ANA survey — a figure Grant said was heartening, citing data that about twothirds of nurses in March 2020 said they had no immediate desire to get vaccinated or else were opposed.
“Nurses are people, too,” he said, conceding that some were still questioning the vaccines’ effectiveness.