Vaccine Mandates Cause for Concern

Jennifer Bridges, RN, a former medical-surgical nurse at Houston Methodist, was let go last June after refusing to get vaccinated. “I was told I didn’t care about my patients because of that decision — but I worked with so many COVID patients last year and loved helping them,” says Ms. Bridges.

Vaccine mandates have created a national divide. About 57% of Americans have been fully vaccinated, according to the most recent CDC data. While a recent study from Northeastern University says only 27% of healthcare workers remain unvaccinated, it shows 15% of the group is firmly opposed to doing so. The sagas of Ms. Yarber and Ms. Bridges are harbingers of what could play out across the country as health systems await clarity on the details of federal vaccine mandates. Healthcare workers who don’t want to get the shots might have to decide between getting vaccinated and remaining employed. 

In September, CMS proposed a rule that would require the vaccination of all staff within Medicare- and Medicaid-certified hospitals and ASCs. At the time of press, CMS had yet to issue its final rule and questions remained about what it would entail. Will it include a twice-weekly COVID-19 testing alternative for healthcare professionals who refuse to get vaccinated? Will it mirror requirements for healthcare workers who don’t get annual influenza shots and must wear masks during flu season?

Cherokee Gonzalez, director of three Florida Medical Clinic ASCs in the greater Tampa area, says waiting for the specific requirements is difficult. “The truth is no one knows how facilities will respond,” says Ms. Gonzalez. “There’s no doubt pushback will occur if vaccines are mandated. There will be workers who will refuse to get their shots, so that’s something we’ll be forced to manage.”

Healthcare systems across the country are preparing to operate with a federal vaccine mandate in place, and facility leaders say clinical operations will be impacted when deadlines to get vaccinated are established. Employees who don’t want to get the shots might leave their jobs or get fired, and terminations could make existing personnel shortages even worse.

Some scenes are already playing out. Houston Methodist terminated about 150 of its 25,000 employees. Kaiser-Permanente suspended 2,200 of its employees across the country, about 2% of the workforce, on Oct. 1 and the workers have until Dec. 1 to get vaccinated or stand to lose their jobs. Northwell Health, New York State’s largest healthcare provider and private employer, terminated 1,400 employees, less than 2% of its total workforce, in October.

While Northwell said the terminations were regrettable, the health system also said it is proud that the moves kept its staff 100% vaccinated. The “rapid and aggressive” strategy was necessary to maintain patient safety, the health system said in a statement.

“Northwell believes that having a fully vaccinated workforce is an important measure in our duty to protect the health and safety of our staff, our patients and the communities we serve,” says the statement. “Northwell regrets losing any employee under such circumstances, but… we understand our unique responsibility to protect the health of our patients and each other. We owe it to our staff, our patients and the communities we serve to be 100% vaccinated against COVID-19.”

Ms. Yarber exhausted some of her savings while out of work for two months after leaving Houston Methodist. She got a job at another hospital, which instituted a vaccine mandate of its own shortly after she was hired, so she worked there for only two weeks. Since August, Ms. Yarber has worked as a telehealth nurse for an insurance company. She says getting fired from Houston Methodist was stressful and costly, but she’s at peace with her decision to remain unvaccinated.

“I wasn’t going straight to another job, so my future was up in the air,” says Ms. Yarber. “It was clear to me that the development of the vaccine was rushed and with no long-term studies to support it, there’s no science to trust that tells me the benefits outweigh the risks.”

She’s also genuinely confused about people’s stance on the issue, saying, “When the pandemic hit, you needed us to take care of you and your family members, and you didn’t question our ability to do so. However, now that there’s a vaccine in place, you question whether we’re safe enough to take care of you. We were safe enough last year. What’s changed?”

Ms. Bridges, meanwhile, was contacted by a private nursing company that is supportive of her position on vaccines and offered her a job. Her first day there was the day she was officially terminated from Houston Methodist. She travels across Texas to oppose vaccine mandates, has been interviewed by media outlets worldwide about her firing and hopes her activism is an extension of her nursing. “I love helping patients, and I know hundreds of healthcare workers got vaccinated against their wishes in order to keep their jobs,” says Ms. Bridges. “I don’t want anyone else to be terrified and full of anxiety about taking a shot they don’t want because they can’t afford to be fired.”

Ms. Gonzalez understands if her employees who have preexisting medical conditions or who’ve had COVID-19 and are naturally immunized don’t want to get vaccinated. She feels everyone else should get the shots. “It’s not just about protecting patients,” she says. “Most surgery centers are small. We share close spaces, from break rooms to the ORs. To me, it’s about protecting each other.” OSM