Administrators at hospitals around the nation are issuing mandates for COVID-19 vaccines to their entire workforce in light of spiking cases primarily due to the Delta variant and vaccine hesitancy among their staff. Many facilities also cite that enforcing vaccination across their facilities helps protect their staff, who’ve borne the brunt of the pandemic, and their patients and facility visitors. While these healthcare facilities have always encouraged their staff members to get vaccinated, some going so far as offering incentives to do so, many now feel they must require the shots as a condition of employment to ensure facility-wide compliance and protection against the virus. The number of facilities requiring vaccinations is rapidly growing and those who are hesitant to draw the hardline won’t have a choice when the federal government steps in.

According to estimates from the American Hospital Association, about 2,150 hospitals, or a little less than 60% of hospitals, had issued staff vaccination policies, as of August 18, 2021. This number was up from zero less than five months ago, but it still leaves numerous health systems that have chosen not to mandate vaccines. President Joe Biden unveiled new vaccine mandates on September 9 that force hospitals that haven’t already issued their own mandates to require COVID-19 vaccinations among its employees to combat the pandemic and the more contagious Delta variant.

• The Path Out of the Pandemic COVID-19 Action Plan mandates vaccination for more than 17 million workers in healthcare settings that receive Medicare or Medicaid reimbursements, with limited medical and religious exemptions. The Centers for Medicare & Medicaid Services is developing an Interim Final Rule with Comment Period to be issued in October and encourages facilities nationwide to make efforts now to get its staff vaccinated to ensure they’re in compliance and meet new federal requirements when the rule takes effect. Although hospital participation in Medicare and Medicaid is voluntary, they account for over 60% of all care provided by hospitals so very few can afford to not participate in these programs.
• To further reduce the number of unvaccinated Americans, another part of this plan is a rule being developed by the Department of Labor’s Occupational Safety and Health Administration. OSHA’s rule will require any employers with 100 or more employees to either require workers to be fully vaccinated or submit a negative test result at least once a week before coming to work.

States Banning Vaccination Mandates

Governors in some states don’t agree with vaccination mandates and have taken steps to ban them. The National Academy for State Health Policy listed 23 states that have issued statewide COVID-19 vaccine mandates for healthcare workers, as of September 2021, but some allow workers to opt-out and undergo weekly testing instead. Alternately, 10 states banned vaccine mandates through legislation signed by their governors. While many of these bans on vaccination mandates impact healthcare workers, four states exempt health organizations. The states with bans include:

• Arizona: Vaccination ban signed by the governor on April 19, but healthcare institutions are exempt from the ban and can require employees to be vaccinated.
• Arkansas: State enacted a bill that bans vaccination mandates on April 28.
• Georgia: Governor banned vaccination mandates on May 25.
• Indiana: Governor signed a law prohibiting the requirement to show proof of vaccination on April 29.
• Montana: Governor signed a bill prohibiting discrimination based on vaccination status on May 7, which included prohibiting employers from refusing employment based on vaccination status or possession of an immunity passport.
• North Dakota: Governor signed a bill on May 7 that banned requiring private businesses to verify vaccination status through documentation. Healthcare organizations are exempt from this ban.
• Oklahoma: Governor issued an order on May 28 prohibiting the requirement that people show proof of vaccination to enter public buildings. However, all existing laws and orders exempt healthcare institutions.
• Tennessee: Governor signed a bill on May 25 prohibiting vaccination mandates.
• Texas: Governor issued an executive order on August 25 blocking government vaccine mandates regardless of approval status. There are limited exceptions to this ban for those employed by nursing homes, assisted living facilities, state-supported living centers, and acute care facilities. The order doesn’t ban private businesses from issuing mandates, but it did ban public and private entities that receive public funds from requiring vaccination proof.
• Utah: Governor signed a bill on March 16 prohibiting state agencies from requiring vaccination as a condition of employment. This ban doesn’t apply to those working in a medical setting.

Mandates Causing Further Staffing Shortages

Many hospitals already feeling the strain of staffing shortages due to the toll the pandemic has taken on its healthcare workers may see this strain further increased by COVID-19 vaccine mandates. Several facilities across the nation have already experienced protests, staff resignations, and lawsuits. Healthcare facilities often rely on travel nurses to help fill vacant positions at least temporarily, but some traveling nurses are declining jobs in facilities or states mandating vaccines because they don't want to get inoculated, further exacerbating staffing shortages.

Still, other healthcare facilities have held to their mandates and terminated employees who refused vaccination. While some facilities have only terminated a handful of their employees for noncompliance, others have fired more than 100 staff members. Losing employees due to the hardline presented by vaccine mandates is a concern for some hospitals because of ongoing staffing shortages. However, many facilities felt the risk of having unvaccinated staff who could infect patients and other staff members outweighed their staffing worries.

What hospitals are mandating COVID vaccines?

The list of hospitals and health systems mandating COVID-19 vaccinations among its staff continues to grow nearly daily. As of October 18th, 2021, the following healthcare facilities had implemented vaccination mandates, but healthcare workers can expect the list to continue growing as the new CMS rules loom.

List of hospitals requiring COVID vaccine for staff >

Know of a hospital/system that we've missed? Leave your comment below.