Required COVID vaccines put Michigan hospital worker hesitancy to the test
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The clock is ticking for Sharon Petty to decide whether she’ll submit to a COVID-19 vaccination or lose her job as a phlebotomist at Beaumont Hospital in Dearborn, but she said her mind is already made up.
If her request for a religious exemption isn’t approved, Petty said, she’ll walk off the job she has held for nearly seven years. And she said she knows others who feel similarly.
“There are several who have already left,” Petty said Friday. “There’s a ton that are scrambling for some type of exemption.”
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A day after President Joe Biden announced vaccine requirements that would cover virtually all Michigan healthcare workers, the state’s largest hospitals lauded the news as a win for patient safety, while workers’ unions warned the regulations could force an exodus from a sector already struggling to find nurses and other personnel.
Early data from Michigan health systems that have already required vaccines, meanwhile, offers reason to believe most workers will get the jab.
Biden on Thursday announced a new plan to combat the pandemic that will require all employees at hospitals or medical operations that receive medicare or medicaid funding to get inoculated against COVID-19.
Beyond healthcare, Biden’s plan will mandate vaccinations or weekly virus tests for workers employed by companies with 100 or more people, including more than 2 million in Michigan, as well as vaccines for federal employees and contractors.
The Biden plan sets up a showdown with healthcare workers who have yet to get vaccinated — particularly nurses and other non-physician staff who are both in short supply and disproportionately hesitant to get one of three approved COVID-19 vaccines.
Now, they’ll face a choice: Get the jab, or find another job.
“I think there will be at least some proportion of these folks that will refuse,” said Craig Donahue, vice president and chief operating officer at the Michigan Health Council, exacerbating an industry-wide worker shortage that has caused staffing crises at hospitals across the country.
Nurses, home care workers particularly hesitant
Mirroring the broader population, COVID vaccination rates among healthcare workers vary along political, geographic, professional and other lines.
Rural and conservative healthcare workers are less likely to be vaccinated than their urban and liberal counterparts, according to one survey. Black and Hispanic workers are less likely than their white counterparts. Those with higher levels of education are more likely to be vaccinated. And studies have revealed higher rates of vaccine hesitancy among nurses and “allied medical professionals” such as phlebotomists and anesthesiologists’ assistants, while doctors have taken the vaccine at near-unanimous rates.
A survey in Israel, for example, showed that while 78 percent of physicians planned to get vaccinated, only 61 percent of nurses did.
In the U.S, a recent American Medical Association study found that some 96 percent of physicians are now vaccinated. Rates are significantly lower for nurses, although estimates of hesitancy vary from study to study.
Across the spectrum of healthcare workers, a recent study found the vaccination rate to be 73 percent.
Most of the state’s largest healthcare systems had already mandated vaccines for their staff, starting with Henry Ford Health System in June. But others had not, worried that such mandates would further drive away staff, said Brian Peters, CEO of the Michigan Health & Hospital Association.
For Petty, the Beaumont phlebotomist, the decision to leave rather than get vaccinated comes down to worker choice. The U.S. vaccine rollout was rushed, she believed, and she wants more proof that it’s safe and effective before getting a shot. The timeline for Petty and colleagues to make a jab-or-job decision is more urgent than for many hospital workers — Beaumont instituted a staff vaccine order earlier this summer, months before the Biden plan was announced.
The idea of leaving a job she loves “makes my stomach churn,” she said. Instead of mandating vaccines, she said, hospital systems could do a better job of adhering to hospital safety protocol to prevent COVID from spreading among patients.
“We are already dangerously understaffed, and now you're going to mandate a vaccine where people are going to walk,” she said. “You're not going to be able to run this hospital at capacity.”
Will wary workers stay or leave?
With vaccines no longer just an option, “there will be a significant number of people who will walk away,” said Jeff Morawski, a long-time nurse and president of the OPEIU Local 40, which represents nurses and other medical staff at McLaren Macomb Hospital in Mount Clemens as well as the Ascension Providence Rochester Hospital.
Lansing-based Sparrow Health System was among those that had yet to enact a worker vaccine mandate before Biden’s announcement, though chief medical and quality officer Dr. Karen Kent said the hospital system was working on one.
Getting staff buy-in is difficult, she said, and “when somebody else is willing to step up and provide the stick, frankly, it's helpful.”
Kent said she believes those who have so far opted out of vaccinations will choose to get immunized rather than lose their jobs.
The previous piecemeal approach to vaccinations, with policies varying from hospital to hospital, she said, made it risky for already short-staffed hospitals to impose mandates because they risked losing vaccine-hesitant workers to competing health systems that didn’t require vaccination.
“This levels the playing field,” she said.
As for those workers who’ve threatened to quit jobs if mandates come down? The experience at Henry Ford Health System, Michigan’s first to require vaccines, indicates those willing to risk their employment to avoid vaccination are few in number.
More than 95 percent of Henry Ford workers had received a shot as of Friday, according to a release from the health system. Meanwhile, a group of workers who had sued the system over its mandate dropped their complaint following the White House announcement, signaling another win for vaccine mandates.
Henry Ford workers who haven’t received a shot or an approved exemption by midnight on Friday will be suspended and given until Oct. 1 to get their first dose. If they don’t, they’ll lose their job.
A spokesperson for Henry Ford Health offered a written statement lauding Biden’s order.
"We have long known that vaccination is the best way to protect people against COVID-19 and we are supportive of science driven measures to increase the vaccination rate and address this public health crisis,” the statement read.
At Beaumont Health, about two-thirds of workers have so far been vaccinated, said Dr. Nick Gilpin, the hospital system’s director of infection prevention and epidemiology.
Gilpin said in an email that the hospital system is processing requests for medical and religious exemptions, but did not provide information about how many workers have requested them.
A spokesperson for the Detroit Medical Center, which had not mandated vaccines before Biden’s announcement, declined to comment on Biden’s policy.
But for hospitals with higher percentages of vaccine hesitant staff, the policy may be double-edged, according to the Michigan Health & Hospital Association, an industry group.
Just this week, MHA, hospital leaders and doctors pleaded with unvaccinated residents to get their shots as more patients are hospitalized. While COVID hospitalization levels are nowhere yet near what they were in earlier waves, facilities are strained due to fewer staffers to care for them; a trend attributed to the stress of the ongoing pandemic, which prompted some to retire early, transfer to other providers or work for temporary services where they’re paid more, or leave health care altogether.
On Friday, MHA leaders said they were awaiting details on the Biden plan from the federal Occupational Safety and Health Administration and the Centers for Medicare and Medicaid Services, even as they worried about the impact of a federal mandate on the health care workforce, said spokesperson John Krasinski.
“While this may create a clear national standard for healthcare facilities, it may also further exacerbate the severe workforce shortage problems that currently exist,” he told Bridge Michigan in an email.
But in the end, argued Kent of Sparrow, the new policy is a win for patients: They don’t have to worry about getting admitted for a broken arm, only to catch COVID from their caregivers.
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