Institutions should start developing vaccination policies early , beginning with robust educational campaigns to promote voluntary vaccination , while realizing that expecting
HCP ’ s unquestioning acceptance and trust in COVID-19 vaccines may currently be unrealistic .”
In their paper , Gur-Arie and her colleagues acknowledge the “ tension between wanting to prepare HCP for a potential COVID-19 vaccine mandate while respecting HCP ’ s skepticism given their lived experiences on the frontlines of this pandemic .” As she says , “ Engaging with HCPs takes time , a resource that neither healthcare institutions nor HCPs have a lot of . This challenge is exacerbated during the pandemic . Everyone , institutions , and HCPs , are just trying to keep their head above water . I personally do not think that this excuses institutions from not engaging with HCPs , however practically , this may be the reason . Engaging with HCPs requires long-term investment and commitment to developing sustainable infrastructure for doing so .”
The potential workforce shortage that mandates will exacerbate isn ’ t lost on Gur-Arie , who says , “ Any qualified HCP who can work but leaves the profession is a loss for healthcare systems and society as a whole – particularly given the HCP workforce shortage globally . However , should institutions decide to implement a vaccine mandate , they should expect HCPs to quit . Practically all research I have read on vaccine mandate implementation among HCPs results in HCPs quitting . Therefore , in my opinion , it is an institution ’ s responsibility to anticipate and prepare for any consequences of a vaccine mandate , including the potential for some HCPs to quit , usually a small minority , but obviously this number varies .”
What has not helped matters is the politicization of the vaccine mandate , and as Gur-Arie says , “ Science policy , including vaccine policy , has always been political – COVID-19 has just made this challenge more obvious and mainstream .”
Advocating dialogue between both sides , Gur- Arie and her colleagues acknowledge that “ ethical arguments for or against COVID-19 vaccine mandates should be sensitive to the policy level at which they are being implemented .” Even though these words were written and published well before the current mandate , Gur-Arie notes , “ We stand by this claim even today .”
As we have seen , Gur-Arie , et al . ( 2021 ) acknowledge healthcare workers ’ heroic efforts during the pandemic and state that “ HCP have overwhelmingly displayed their commitment to their duty of care in recent months . However , HCP ’ s duty to care is not infinite — its limits are revealing themselves as the pandemic progresses .”
Healthcare professionals , better than anyone , understand the risks from COVID-19 , and should be allowed to continue to exercise prudence , especially pertaining to their own health- and wellbeing-related needs , which may or may not include vaccination with still largely unknown vaccines .
“ It is always hard for me to see healthcare personnel be villainized for their personal beliefs and choices ,” Gur-Arie says . “ People tend to forget that healthcare workers are people first . Their white coats , vast knowledge , and social authority help us forget . Just like there are plenty of vaccine hesitant and refusing members of the public , there are plenty of vaccine hesitant and refusing HCPs . I think that the early heroization of HCPs early in the pandemic was obviously incredibly well-earned . However , when heroes show humanly qualities ( such as , being vaccine hesitant ), the public easily is able to villainize them . Villainizing practically never helps anything . This approach , in my opinion , is very unfortunate .”
Gur-Arie , et al . ( 2021 ) advise healthcare institutions to focus on gaining the trust of healthcare personnel and strengthening safety protections to prevent what could be a strong resistance by workers in certain settings : “ Institutions should start developing vaccination policies early , beginning with robust educational campaigns to promote voluntary vaccination , while realizing that expecting HCP ’ s unquestioning acceptance and trust in COVID-19 vaccines may currently be unrealistic . Policymakers should navigate how to make the best decision for HCP and patients alike from appropriate social , cultural and political perspectives . They should also consider how to respond to potential negative impacts on individual HCP and wider public perceptions resulting from a mandatory policy . Herein lies the tension between wanting to prepare HCP for a potential COVID-19 vaccine mandate to avoid backlash , while respecting HCP ’ s understandable skepticism given their lived experiences on the frontlines of this pandemic . Reconciling this tension requires a willingness to both engage with HCP ’ s lived experiences and take their ethical concerns seriously .”
Vaccination Coverage Reporting
Some members of the healthcare epidemiology sector are pushing for mandatory reporting of healthcare vaccination coverage among healthcare personnel , pointing to recently proposed changes to the Hospital Inpatient Quality-Reporting Program by the Centers for Medicare & Medicaid Services ( CMS ) that will include this new measure . If the proposed rule is enacted , hospitals and long-term care facilities will be required to report healthcare worker HCP vaccination rates to CMS beginning this month .
Among the proponents are Yang , et al . ( 2021 ), who explain that “ The precedent for this type of rule is mandatory reporting of influenza vaccination coverage among select categories of HCP . However , healthcare facilities should not wait until October to begin reporting COVID-19 vaccination rates for HCP . Rather , public reporting should begin as soon as possible . During this crucial period of transition to the next phase of the pandemic , public reporting can encourage health systems to improve vaccination uptake and can empower patients to seek care in settings that are less likely to place them at risk .
Yang , et al . ( 2021 ) observe , “ Public reporting can be a potent motivator to improve performance on quality measures . We anticipate that most health systems are actively working to vaccinate as many of their employees as possible , and mandatory
www . healthcarehygienemagazine . com • october 2021
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