More Hospitals Are Now Mandating COVID-19 Vaccines for Healthcare Workers

As the highly transmissible Delta variant spreads throughout the country, a growing number of hospitals and health systems are now requiring their employees to get vaccinated against COVID-19.

More than 65 healthcare institutions have already established vaccine mandates for employees, including notable names like the Mayo Clinic Health System and Duke University Health System.

A survey from the Kaiser Family Foundation in April found that about 48% of frontline healthcare workers were still not vaccinated against COVID-19, even though they are among the first groups of people to be offered the vaccine back in December. This is in stark contrast to the 96% vaccination rate among practicing physicians, as reported by the American Medical Association (AMA).

Last month, a U.S. district judge upheld the Houston Methodist Hospital's vaccine requirement—the first federal court decision on vaccine mandates by an employer. Despite this ruling, the legality of mandates continues to be debated because the COVID-19 vaccines are operating with an Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA), rather than full approval.

Unvaccinated Health Workers Are a Risk

The American Hospital Association (AHA) encourages hospitals and health systems to adopt vaccine mandates to protect patients, personnel, and communities from getting COVID-19.

“Patients are a vulnerable population and should not be subjected to increased risk from the very people that they are looking to for care and safety,” Howard P. Forman, MD, MBA, professor of radiology and biomedical imaging at the Yale School of Medicine and professor of public health, management, and economics at Yale University, tells Verywell.

In March 2021, an outbreak in a skilled nursing facility was traced back to an unvaccinated healthcare worker, demonstrating how unvaccinated individuals can spread the virus to vulnerable populations. However, they do not only endanger their patients but also themselves.

“In general, healthcare personnel is both at much higher risk of getting respiratory diseases because they share air with a large number of sick people, and of spreading them to the most vulnerable because they come into contact with many people who may have weakened immune systems,” David Dowdy, MD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, tells Verywell. “This is why we routinely have healthcare workers get vaccinated against influenza, for example. With COVID-19—which has the potential to be much more severe than the flu—this is even more important.”

The goal of vaccine mandates is to protect both patients and employees, but not all health institutions can easily establish it. Still, the healthcare space has a history of mandating vaccines among its staff.

“Mandating vaccines in healthcare environments is longstanding practice with very well established precedent,” Iahn Gonsenhauser, MD, MBA, chief quality and patient safety officer at The Ohio State University Wexner Medical Center, tells Verywell. “At this point, it’s very difficult to say what additional strategies could succeed. It seems as though most options have been exercised, from reward to consequence, and still this very large gap remains across the country.”

What’s Keeping Some Places From Mandating the Vaccine?

Although a growing number of hospitals are requiring their employees to get vaccinated, other health institutions face a number of barriers that hinder them from following suit.

“It's challenging to impose COVID-19 vaccine mandates simply because a substantial fraction of the population has concerns about these vaccines,” Dowdy says. “Some of these concerns may be reasonable—for example, historical mistreatment by the medical community—whereas others are less so [like the] belief that the side effects of the vaccine are worse, on average, than the disease itself.”

A survey shows that unvaccinated healthcare workers are concerned about the potential side effects of the vaccine, and don't trust the government to ensure that they are safe and effective.

“I think it's important to understand the reasons for not getting vaccinated, on an individual basis,” Dowdy says. “By meeting individual employees where they are, helping them to understand the importance of getting vaccinated—if not for themselves, for their patients—making sure to listen and take their employees' concerns seriously. We may not be able to get 100% of healthcare workers vaccinated, but I think we can do better than where we are right now.”

Many healthcare institutions are also reluctant to require COVID-19 vaccination because none of the available vaccines have full approval from the FDA, which may cause backlash from employees.

How to Ensure the Safety of Employees and Patients

Although COVID-19 vaccine uptake is higher among healthcare workers than the general public, it's still inadequate to prevent the spread of the virus in hospitals and other care settings.

“Every unvaccinated individual increases the risk to everyone around them,” Gonsenhauser says. “In a healthcare setting, particularly a high acuity one, the potential to infect patients and the limited resource of clinicians and support personnel puts already sick patients at great risk and everyone who may need healthcare services at risk as well.”

To protect both patients and employees, experts recommend that health institutions employ several strategies for the staff who decide not to get vaccinated, including:

• Providing leave or time off to get the vaccine and recovery from its side effects
• Assigning responsibilities that do not involve direct contact with patients
• Requiring frequent testing
• Establishing additional precautions that might not be required of vaccinated employees

With COVID-19 cases on the rise again and a number of hospitals reaching full capacity, it is crucial to take all the necessary measures to minimize transmission as much as possible.

“Most employers have wanted to give individuals sufficient time to become comfortable with the safety data on all of our vaccines,” Forman says. “Now that 163 million Americans have been fully vaccinated, it is harder to deny the voluminous evidence of safety and efficacy.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.