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US hospitals brace as deadlines loom from a vaccine mandate


Medical staff at Western Reserve Hospital in Cuyahoga Falls, Ohio.

By Jesús Jiménez


Health care workers in two dozen states must be fully vaccinated against the coronavirus by March 15 after a Supreme Court decision last week, a ruling that has left some already understaffed hospital systems bracing to possibly lose workers just as the highly contagious omicron variant is inundating them with patients.


The new guidance was issued last Friday by the Centers for Medicare & Medicaid Services after the court upheld President Joe Biden’s vaccine mandate for health care workers. It will affect about 10 million people at about 76,000 health care facilities participating in the Medicaid and Medicare program, including hospitals and long-term care facilities.


Experts say mandates are effective in persuading more people to become vaccinated, which they say is essential to helping prevent the spread of the virus. And Biden has continued to push for more vaccinations and testing, reiterating that schools should remain open and the time for lockdowns was over.


“We’re moving toward a time when COVID-19 won’t disrupt our daily lives,” Biden said at a news conference Wednesday. He called a recent Supreme Court decision to block a vaccination-or-testing mandate for large private employers “a mistake.”


The CDC’s guidance Friday meant that health care workers in 24 states where vaccine mandates were not yet in effect must receive at least one shot of a coronavirus vaccine within 30 days and must be fully vaccinated by March 15, a spokesperson for the Centers for Medicare & Medicaid Services said.


The states affected are Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia and Wyoming. For these states, the federal vaccine requirement had been blocked by a lower court.


The guidance does not yet apply to Texas, where a preliminary injunction still prevents such requirements.


The Supreme Court’s decision does not affect timelines already in place for the other 25 states, Washington, D.C., and U.S. territories, where health care workers must by fully vaccinated by Feb. 28, according to the Centers for Medicare & Medicaid Services.


The requirements come as hospitals across the country are being pushed to their limits by a steep rise in cases and staff shortages. Many health care workers are falling ill with the virus and others who quit under the pressure of the pandemic have not been replaced.


Local and regional hospitals, as well as multistate hospital chains, have wrestled with resistance to vaccination among some nurses and other staff. Many of the larger groups, including the Cleveland Clinic and HCA Healthcare, suspended their own vaccination mandates last month while they awaited the Supreme Court’s decision.


While a study by federal researchers found that 30% of hospital workers were not fully vaccinated as of mid-September, overall immunization rates rose in the following months as mandates took effect.


Some health care systems, such as HCA Healthcare, have acknowledged that the mandate could pose a challenge. HCA Healthcare, which employs about 275,000 workers, said in a statement last week that if workers refused to be vaccinated, that “could compromise our ability to serve our communities and provide care to patients under the Medicare and Medicaid programs.”


A spokesperson for HCA added that more than 90% of its workers were vaccinated or had qualified for an exemption.


Although there are signs that new cases have peaked in some Northeastern states, such as New York, they remain dangerously high across the country. And hospitalizations nationwide have broken records.


Dr. Josh Sharfstein, vice dean of the Johns Hopkins Bloomberg School of Public Health whose work focuses on promoting public health strategies, said the policy could create “potential challenges in the short term” with hospitals that are short staffed.


“It may require some flexibility to get through this period,” he said, “but that doesn’t make the underlying policy less than a good idea.”


Dr. Peter Hotez, a pediatrician and scientist at the Baylor College of Medicine who studies vaccines, said the mandate was the best way to keep medical workers healthy.


“Vaccines represent the most assured way to keep the health care work force, actually in the health care work force,” he wrote in an email.



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