Healthcare Hygiene magazine October 2021 October 2021 | Page 34

employee did not provide the necessary documentation and still refused to get vaccinated , so the hospital terminated the employee , treating the termination as a voluntary separation so as not to bar the employee from reapplying for another position at the hospital in the future . In deciding the summary judgment in favor of the employer , the court discussed that the hospital had gone above and beyond to try to accommodate the employee but given that the employee was in a patient-facing role , it would be considered an undue hardship on the employer to accommodate the employee ’ s request to not receive the flu vaccine .
Not all requests for COVID-19 vaccine exemptions are being honored , with skepticism abounding , even as earnest individuals with genuine causes for exemption are being judged harshly and perhaps unfairly , as workarounds to vaccination , healthcare workers say .
Ever since the early 2000s , when the first influenza vaccination mandates began to emerge , medical and religious exemptions have been studied . For example , Boone , et al . ( 2020 ) analyzed all personal and religious exemption requests at Vanderbilt University Medical Center ( VUMC ) for three consecutive influenza seasons 2015 to 2018 , categorizing these requests by one of 12 standardized employee categories and one of 18 unique reasons for vaccine exemption . During this time , 1.1 percent to 2.1 percent of all VUMC employees requested religious or personal exemption from vaccination . The frequency of religious and personal exemption approval increased annually from 296 of 452 ( 65.5 percent ) to 196 of 248 ( 80.2 percent ) to 283 of 323 ( 87.6 percent ) over the three seasons . Of the five most common reasons against vaccination , four were explicitly religious in nature . Non-clinical staff submitted the most religious and personal exemption requests of any job category , submitting approximately one-third of all requests every year .
The multi-society consensus statement ( 2021 ) specifies exemption for those with medical contraindications and other circumstances in compliance with federal and state laws : “ Accommodations may include providing an alternative form of the vaccine , requiring an exempted employee to wear a face masks , or requiring an exempted employee to follow physical distancing measures ( including reassignment away from vulnerable patient populations , curtailing job duties to lessen or eliminate direct patient contact , or allowing the employee to work remotely if feasible ). The law requires that accommodations be tailored to the individual employee and their job duties ; for that reason , employers should try to avoid making blanket statements about what they will or will not do if an employee qualifies as exempt from a vaccination requirement .”
Mandating vaccination as the ultimate weapon in the arsenal against SARS-CoV-2 is not without its potential infringements upon civil liberties , as there are considerable ethical , legal , and practical considerations relating to imposing vaccination as a unilateral mandate . What healthcare-based proponents of mandatory vaccination point to consistently is what they see as the precedent established through influenza vaccination as well as immunization against other occupational health-related threats such as hepatitis B virus . And in the public sector , mandate proponents insist on raising the historical mandates related to polio and smallpox eradication efforts . Mandatory inoculations can be viewed as morally reasonable but also tread upon individual rights and freedoms of choice . Mandate supporters in both the
• Resistance to vaccination likely cuts across different healthcare occupations making it difficult for hospitals , nursing homes , and other healthcare organizations to properly plan and adapt .
public and healthcare sectors insist that federal- , state- and / or industry-mandated vaccination without any exceptions or exemptions is sanctioned action in the public interest . What must be remembered is that any compulsory vaccination policy without considering all the science , and not just what fits a particular political narrative , is problematic , in that it creates significant downstream consequences .
Is Mandatory Vaccination Fueling the Healthcare Workforce Shortage ?
One of the hardest-hit areas in the country , New York , is bracing for impact . According to the Associated Press , “ Gov . Kathy Hochul is prepared to call in medically trained National Guard members , retirees and workers outside New York to address potential staffing shortages created by an approaching vaccine mandate for healthcare workers . If necessary , Hochul said , she will declare a state of emergency through an executive order designed to address staffing shortages in hospitals and nursing homes once the mandate takes effect [ Sept . 28 ). Many healthcare workers have still not received a required first shot of the COVID-19 vaccine days before the deadline , leaving the prospect of potentially thousands of health care workers being forced off the job . The order would allow healthcare professionals who are licensed in other states or countries , are recent graduates or are formerly practicing healthcare professionals to practice in New York , Hochul said , noting she is exploring ways to expedite visa requests for medical professionals . The governor said she also has the option of deploying National Guard members and partnering with the federal government to deploy Disaster Medical Assistance Teams .”
In late September , a federal judge in Utica , N . Y . issued an order that will temporarily restrain employers from enforcing a state vaccine mandate on healthcare workers who have sought a religious exemption from receiving the shots . According to Lyons ( 2021 ), the ruling by U . S . District Judge David N . Hurd was handed down in a case filed against Gov . Kathy Hochul , health Commissioner Howard Zucker and state Attorney General Letitia James on behalf of 17 medical professionals . The plaintiffs are mostly physicians and nurses “ who allege that their sincere religious beliefs compel them to refuse the COVID-19 vaccines that are currently available ,” Hurd ’ s ruling states . Lyons ( 2021 ) reports that “ Hurd ’ s order was issued after the head of the state Health Facilities Association urged the health department to pause its vaccine mandates for healthcare workers because nursing homes and other assisted-living facilities — and also hospitals — are facing critical staffing shortages that are expected to worsen when potentially thousands of employees will face termination next month if they are not vaccinated .” Lyons ( 2021 ) quotes
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