POST 163. May 23, 2021. CORONAVIRUS. RWJBarnabas Health in New Jersey announced a mandate…saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.

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“More hospitals and health systems nationwide are requiring their health care workforce to get the COVID-19 vaccine.

Driving the news: RWJBarnabas Health in New Jersey announced a mandate on Thursday, saying supervisors and those of higher rank must get the vaccine by June 30. They will eventually require the system’s 35,000 employees to do the same.

Philadelphia’s six-hospital University of Pennsylvania Health System also extended requirements Thursday to its 44,000 employees and clinical staff.

In April, Houston Methodist, was one of the first hospital systems to announce a mandate, said it would require its 26,000 employees to receive a COVID-19 vaccine by June 7, MedPage reports…

The state of play: Even in health care settings, vaccine mandates raise questions of ethics and workers’ rights. Health care facilities have long required workers to get other vaccines, including flu shots.

In December, the Equal Employment Opportunity Commission said mandating coronavirus vaccines would not violate federal disability law or civil rights statutes on discrimination as long as there are options to apply for a religious or medical exemption.

Still, other health systems have decided not to mandate the vaccine until a shot is approved by the FDA.

“What we’re hearing from many hospitals is that they will likely make determination of requirement of the COVID-19 vaccine for their own employees at the time the vaccines receive full approval from the FDA, which has not happened yet, but will likely happen soon,” Nancy Foster, the American Hospital Association’s vice president of quality and patient safety policy, tells Axios.

What to watch: Those who do require shots risk having to dismiss those who won’t comply when health care staffing for many systems is tight.”  (A)

“One of New Jersey’s largest private employers, the RWJBarnabas Health system, will require supervisors and higher-level staff to be vaccinated for COVID-19 by the end of June — a decision it said Thursday will eventually be extended to all 35,000 members of its staff.

The 11-hospital system is “committed to providing a culture of safety,” said Barry Ostrowsky, its president and CEO. “We have an obligation to do all we can to protect our patients and the communities we serve.”

About 500 members of the supervisory staff are unvaccinated, an RWJBarnabas spokeswoman said. The policy for those who do not comply “is being finalized over the next several days,” she said.

The health system appears to be the first major employer in New Jersey to require at least some of its staff to be vaccinated. No other major New Jersey company has made such a requirement, said Tom Bracken, CEO of the New Jersey Chamber of Commerce.

“Our position is if employers want to do it, they can do it,” he said. “We’re very much in favor of getting the workforce vaccinated. It creates a safer work environment. It helps open the economy up and gets us back to where we want to be.” ..

A majority of the RWJBarnabas Health staff already are fully vaccinated, and vaccinations will be available throughout the system to any who need them, the company said…

Other health systems said they weren’t planning to mandate staff vaccines at this time.

Hackensack Meridian Health, with three teaching hospitals and nine community hospitals, said through a spokesman that its vaccine rate “is approaching 70% and is 89% for our leaders.

“We continue to carefully evaluate our options,” said Benjamin Goldstein, director of public relations.

Bergen New Bridge Medical Center, the county-owned  facility in Paramus, said that a mandate wasn’t necessary, because 82% of its staff has been vaccinated. It does, however, require all new employees, volunteers, students and interns to get the shots.

St. Joseph’s Health, with hospitals in Paterson and Wayne, is not considering a mandate at this time, said Pam Garretson, a spokeswoman. Currently, 72% of its staff are vaccinated. Holy Name Medical Center in Teaneck is not mandating COVID vaccines because they are still administered under “emergency use authorization” from the FDA rather than full approval, a spokeswoman said.

Virtua Health, with hospitals in Camden, Mount Holly, Marlton, Voorhees and Wiilingboro, does not mandate the vaccines, but is “strongly encouraging and promoting the vaccine among our workforce,” said a spokesman. Slightly fewer than 70% of its staff are vaccinated.

And Atlantic Health System, which includes Morristown Medical Center, Chilton Medical Center in Pompton Plains, Overlook Medical Center in Summit, Newton Medical Center and Hackettstown Medical Center, does not mandate vaccines. About 70% of its employees are vaccinated, said Luke Margolis, a spokesman.” (B) 

“So far, 83% of “supervisory and above level staff” have been vaccinated, (RWJ) spokeswoman Carrie Cristello told NJ Advance Media.

When asked what happens if an employee refuses to be vaccinated or cites a medical reason why they can’t be vaccinated, Cristello said the company’s policy will be finalized over the next several days.” (C)

“The University of Pennsylvania Health System, the largest private employer in Philadelphia, on Wednesday announced that all employees and clinic staff will be required to be vaccinated against COVID-19 by Sept. 1…

Penn Health officials decided the only issue that really matters is protecting people.

“We recognize that not everyone will agree with this decision,” said a Wednesday memo to UPHS employees. “As an industry grounded in the science and art of healthcare, we believe it is imperative for the UPHS to take the lead in requiring vaccinations to protect our patients and to set an example for those who remain hesitant both within our institution and in the broader community. The safety of our patients and staff are our highest priorities. The threat of further harm and the possibility of more dangerous viral mutants emerging before we reach herd immunity compels us to take this step.”…

New UPHS hires will have to provide proof of vaccination, or be fully immunized two weeks before starting work. Religious or medical exemptions may be granted, just as with the seasonal flu shot policy in place for more than a decade. But non-exempted workers who remain unvaccinated will be subject to disciplinary actions, including firing, the memo said.

In a statement, UPHS said all employees and clinicians have been offered the vaccine, and more than 33,000 — nearly 70% of the 47,000-member workforce — are now fully immunized.

“Ultimately, people do have a choice,” Patrick J. Brennan, chief medical officer and senior vice president of UPHS, said in an interview. “But there is evidence that unvaccinated workers are still getting sick and spreading it in nursing homes and other health-care settings. And staff members are getting sick and dying. So it’s a double-edged sword. No one is forced to be vaccinated, but it is a choice that affects employment” at UPHS.

Ezekiel J. Emanuel, a Penn professor of medical ethics and health policy, echoed that sentiment in a recent pro-mandate opinion piece in the New York Times: “Health care workers are professionals whose primary obligation is to their patients’ health and well-being.”” (D)

“There are also legal considerations.

The FDA has approved vaccines manufactured by Pfizer-BioNTech, Moderna and Johnson & Johnson for emergency use. However, the federal government has not given the vaccines full approval.

The FDA’s emergency use authorizations specify that people must give consent to being vaccinated, Lawrence Gostin, a professor at Georgetown University Law Center in Washington, D.C., with expertise in health law, told The Washington Post in an April 5 article. Therefore, he told the newspaper, mandating a vaccine only authorized for emergency use could raise legal questions. 

The CDC has said the decision by employers about mandates is a matter of state or other applicable law, and if employers require proof from workers that they have been vaccinated, the employer can’t require the employee to provide medical information as part of the proof. The CDC said employers may implement religious and medical exemptions.

And the Equal Employment Opportunity Commission has released guidance on the issue. The commission told Becker’s April 22 that for employers requiring vaccination be obtained in the community as an employment condition, the Americans with Disabilities Act may require reasonable accommodation [unless there is significant difficulty or expense for the employer] for those who cannot be vaccinated because of disability. Similarly, according to the commission, Title VII of the Civil Rights Act of 1964 may require reasonable accommodation of employees’ religious beliefs or practices related to vaccines, unless the accommodation constitutes undue hardship on the employer’s operations under the law.

“Whether there are feasible accommodations that do not pose an undue hardship will depend on many facts specific to each workplace and the duties of the individual,” a commission spokesperson said… “ (E)

• A.More hospitals require health care workers to get COVID vaccine, by Marisa Fernandez, https://www.axios.com/health-care-workers-required-get-covid-vaccine-1ef73f68-9a9d-4707-977c-13c11348fded.html
• B.RWJBarnabas Health, one of NJ’s largest employers, mandates COVID vaccine for staff, by Lindy Washburn, https://www.northjersey.com/story/news/health/2021/05/20/rwjbh-covid-vaccine-required-staff/5182578001/
• C.Major N.J. hospital system to require COVID vaccines for employees, By Karin Price Mueller, https://www.nj.com/coronavirus/2021/05/major-nj-hospital-system-to-require-covid-vaccines-for-employees.html
• D.Penn Health System takes the lead in requiring employees to be vaccinated against COVID-19, by Marie McCullough, https://www.inquirer.com/health/coronavirus/penn-health-covid-vaccine-requirement-20210519.html
• E.How health systems are deciding whether to mandate COVID-19 vaccinations, Kelly Gooch, https://www.beckershospitalreview.com/hospital-management-administration/how-health-systems-are-deciding-whether-to-mandate-covid-19-vaccinations.html
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