AHA Joins Movement to Require Vaccination in Healthcare Facilities

Ken Terry

July 22, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A widespread movement to require all healthcare workers to get vaccinated received a big boost from the American Hospital Association (AHA) this week.

The association, which represents nearly 5000 hospitals, issued a policy statement Wednesday that strongly urges COVID-19 vaccination of all healthcare personnel.

"The AHA also supports hospitals and health systems that adopt mandatory COVID-19 vaccination policies for healthcare personnel, with local factors and circumstances shaping whether and how these policies are implemented," the statement said.

The AHA said it was taking this position because vaccination protects not only health workers, but also the patients they care for from contracting the deadly disease.

Since Houston Methodist Hospital became the nation's first institution to establish a vaccine mandate last winter, dozens of hospitals and health systems have followed suit, including some of the largest US healthcare organizations.

Among the health systems currently requiring vaccination, according to Becker's Hospital Review, are Banner Health, University of Chicago Medicine, Trinity Health, Mass General Brigham, Beth Israel Lahey Health, Hackensack Meridian Health, University of Mississippi Medical Center, Piedmont Healthcare, Virtua Health, Inova Health System, Mercy Health, Yale New Haven Health, Henry Ford Health System, SSM Health, NewYork-Presbyterian, RWJBarnabas Health, and University of Pennsylvania Health System.

In addition, New York City has imposed a vaccine mandate on employees of its public hospitals and clinics, and San Francisco requires personnel in high-risk settings such as skilled nursing facilities, acute care hospitals, homeless shelters, and jails to be vaccinated, according to Becker's.

The facilities that belong to the Connecticut and Maryland hospital associations have agreed to establish vaccination mandates, as well.

There was some initial hesitancy among providers about requiring vaccines that had received only emergency use authorizations from the US Food and Drug Administration (FDA). However, a federal judge in June upheld Houston Methodist's mandate. And in a town hall broadcast on CNN on Wednesday, President Joe Biden predicted that the vaccines will receive full FDA approval by the fall.

Besides the AHA, a number of other healthcare associations have endorsed the concept of vaccine mandates for healthcare workers. These include America's Essential Hospitals, the Association of American Medical Colleges, and a group of seven professional associations.

The latter include the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, the Society for Post-Acute and Long-Term Care Medicine, the Association for Professionals in Infection Control and Epidemiology, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists.

Many Workers Still Unvaccinated

The rapidly growing movement to require vaccinations in healthcare parallels the fast rise of the Delta variant of COVID-19 in the US and abroad. With the daily tally of new cases approaching 40,000 in this country, 1-in-4 American healthcare workers remains unvaccinated, as reported by Medscape Medical News.

The AHA couched its support for vaccine mandates with several caveats. Among other things, the association encouraged hospitals that require vaccination to:

  • Provide exemptions for medical reasons and accommodations consistent with federal Equal Employment Opportunity Commission guidelines.

  • Follow the infection control guidelines of the Centers for Disease Control and Prevention, Occupational Safety and Health Administration requirements, and other federal and state regulations on personal protective equipment and other infection-control practices for unvaccinated staff who receive an exemption or an accommodation.

  • Continue providing education about the efficacy and safety of COVID-19 vaccines to encourage staff to obtain the vaccine voluntarily.

  • Offer scheduling flexibility and/or time off to ensure personnel have time to obtain the vaccine and recover from its possible side effects.

In an interview with Medscape Medical News in April, Houston Methodist CEO Marc Boom, MD, noted that Houston Methodist had been aggressively vaccinating its workers since January, and that it offered them $500 bonuses to get shots by mid-March.

At that point, 84% of the employees had been vaccinated, he said. Nearly all of the system's personnel had gotten shots by the time 178 unvaccinated workers were suspended without pay on June 7.

Asked why this step was necessary, Boom replied, "Our sacred duty and obligation is to care for our patients and to care for them in the safest possible manner. Part of that is to make sure that our team is protected and that we minimize the chance of giving COVID to a patient. It's about patients being at the center of everything we do."

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