• Tracking the Impact of COVID Vaccine Mandates in Healthcare

    Healthcare institutions face critical decisions regarding the mandatory vaccination of their employees against COVID-19. In late July, the US Department of Veterans Affairs issued a vaccine mandate for all its frontline health care workers. That same date, nearly 60 medical groups, including the American Medical Association and the American Nurses Association, issued a joint statement urging every health facility to require that workers get vaccinated.

    Some systems are offering healthcare employees a weekly COVID testing option, but it remains to be seen if this alternative will remain following the guidance being formulated by the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS). The CMS rule is expected to require vaccinations for workers in most healthcare facilities that receive Medicare or Medicaid reimbursement, including hospitals, dialysis centers, ambulatory surgical settings, and home health agencies — representing some 17 million healthcare workers. Reuters reports that this “interim final rule” will become effective immediately upon official publication in mid-to-late October.

    When mandates boomerang

    However, the mandates are posing unintended dilemmas for some healthcare system at a time when there was already a pre-pandemic shortage of frontline medical workers, and which has subsequently been exacerbated by nearly two years of frontline workers’ COVID exhaustion. The shortage is now affecting services in some areas — along with mounting concern about its impact on patient safety.

    As reported in USA Today on September 12, Lewis County Hospital in upstate New York plans to suspend infant deliveries as of September 24 citing safety concerns. The decision was made following the resignation of medical staff due to New York state’s vaccine mandate. Earlier this month, AP News reported many hospital systems’ newest dual crises in nurse staffing: burgeoning resignations from cumulative burn-out coupled with the loss of staff nurses to much more lucrative traveling positions.

    Rural peril

    Rural hospitals hold special vulnerability to the mandatory policies. While emphasizing the safety and effectiveness of the vaccines and the imperative for health care workforce providers and staff to be vaccinated Alan Morgan, chief executive officer of the National Rural Health Association, described the specific dilemma the vaccines pose to these more remote healthcare systems.

    “We also know that there are higher rates of hospital workers that are unvaccinated and have no intention of getting vaccinated in the rural context … this is a significant concern,” he told USA Today on September 10.

    “In a large health system or urban provider,” Morgan continued, “you have that workforce ability to adjust. You don’t have that flexibility in a rural context.”

    Country wide by color code

    To follow healthcare systems’ uptake of vaccine mandates, Brown University’s School of Public Health has built a Hospital Vaccine Mandate Tracker map. Updated on a daily basis, the Tracker map depicts hospitals nationwide via color-coded dots. An orange dot represents facilities with a full vaccine mandate in place, orange designates those institutions with a partial mandate, and red means that no mandate has yet been enacted.

    How do your area’s healthcare systems compare?  Check out the “Hospital Vaccine Mandate Tracker” map — updated daily — and learn which have instituted vaccine mandates, to what degree, and on what date at