Hospitals coast to coast are demanding their employees get vaccinated against covid as the highly contagious delta variant tears through populations with low vaccination rates.
Nearly 1,500 hospitals 鈥 roughly a quarter of all hospitals in the U.S. 鈥攏ow require staffers to get a covid vaccine, said Colin Milligan, a spokesperson for the American Hospital Association. More follow suit every day as hospital leaders aim to head off staff shortages like those experienced last year and to keep employees from becoming vectors of the disease.
But that鈥檚 not an option in Montana, where passed this year amid a pandemic backlash prohibits employers, including most health care facilities, from mandating any vaccine for their staffs. Nor is it in Oregon, where a 32-year-old law similarly bans vaccine mandates for health workers.
At least seven states have enacted laws to prevent covid vaccine mandates or so-called vaccine passports that would provide proof of vaccination, . Most restrict only state and local governments or specifically exempt health care facilities, but Montana鈥檚 law goes further. It prohibits employers 鈥 including hospitals 鈥 from discriminating against a worker based on vaccination status. Employers can鈥檛 require vaccinations and workers don鈥檛 have to tell their bosses whether they鈥檙e vaccinated.
That worries hospital leaders as covid hospitalizations hit not seen nationally since February. In Montana, at the beginning of August compared with two weeks before, and about 90% of covid patients hospitalized at the end of July hadn鈥檛 been vaccinated, according to the .
鈥淚 cannot imagine passing any worse law than that,鈥 said John Goodnow, CEO of Benefis Health in Great Falls. 鈥淚magine if that would have been passed back when we were fighting polio, or smallpox before that.鈥
Benefis for its 3,400 staffers back in April, before state lawmakers passed the bill preventing the hospital from doing so.
Those who back the law said it鈥檚 an issue of personal rights.
鈥淵our health care decisions are private, they鈥檙e protected by the constitution of the state of Montana,鈥 Rep. Jennifer Carlson, a Republican, as she introduced the bill. 鈥淎nd your religious rights are protected.鈥
Health care professionals are more likely to be against covid than the general population. Nonetheless, there remain nurses, doctors and other hospital employees who work directly with patients who are hesitant or resistant to inoculation, especially in rural regions.
Dr. Greg Tierney, chief medical officer of Benefis, said he鈥檚 concerned about potential rancor between vaccinated and unvaccinated staff members as their workload rises with the caseload.
鈥淵ou have the people who have been vaccinated looking at the person next to him who’s choosing not to,鈥 Tierney said. 鈥淲hereas, they were literally brethren in arms.鈥
In northwestern Montana, a region with a 34% vaccination rate to date and the epicenter of the state鈥檚 latest surge, Logan Health officials said existing staffing shortages are worsening as health care workers become infected or must quarantine. Chief medical officer Dr. Doug Nelson said the shots have been proven safe and effective, and Logan would likely consider a staff vaccine mandate if state law allowed it.
鈥淲earing a mask whenever you’re in our facilities, that helps, but being able to vaccinate everyone would help more,鈥 Nelson said.
In Billings, Montana’s most populated city, the Billings Clinic鈥檚 intensive care unit reached capacity the first week of August and officials started shifting patients to overflow beds. At that time, roughly 60% of the system鈥檚 employees reported being vaccinated.
Hospital leaders are hosting weekly town halls to answer clinic workers鈥 vaccine questions or try to dispel myths in between caring for a growing number of covid patients.
鈥淜nowing there are solutions out there that can help prevent this from happening, like simple vaccination, makes you frustrated,鈥 said Dr. Fernando Caceres, an intensivist in Billings Clinic鈥檚 ICU.
In July, nearly 60 major U.S. medical organizations called for get vaccinated in a joint statement that included the American Medical Association and the American Nurses Association. The Department of Veterans Affairs gave health care personnel eight weeks to get the shot.
In August, California became the first state to workers in health care settings to be fully vaccinated and for visitors in health settings to show proof of vaccination or a negative covid test. And in Massachusetts, Republican Gov. Charlie Baker ordered most nursing home workers to get the jab by October 10, a massive increase in cases among staffers and residents.
Some hospitals have had to enforce their mandates. In Texas in June, Houston Methodist of more than 150 health care workers who didn鈥檛 get the jab.
Trinity Health 鈥 a Catholic health system with 117,000 workers across 22 states 鈥 employees without a shot or exemption would be fired.
鈥淭rinity Health has counted our own colleagues and patients in the too-high coronavirus death toll,鈥 Mike Slubowski, the organization鈥檚 president and CEO, said in the announcement. 鈥淣ow that we have a proven way to prevent covid-19 deaths, we are not hesitating to do our part.”
How Trinity鈥檚 policy will work in Oregon, where the three-decade-old law prevents vaccine requirements, is unclear
Attempts to change the law won鈥檛 happen before next year鈥檚 legislative session, Democratic Gov. Kate Brown said. In the meantime, she last week to pressure health care workers to get vaccinated, saying they will face weekly covid tests if they don鈥檛 鈥 and their employers will foot the bill.
鈥淭his new safety measure is necessary to stop delta from causing severe illness among our first line of defense: our doctors, nurses, medical students and frontline health care workers,鈥 Brown said in the statement. Before Brown鈥檚 announcement, Kaiser Permanente, a national health system based in California, had said all of its employees must be vaccinated against covid 鈥 even those in Oregon. (KHN, which produces California Healthline, is not affiliated with Kaiser Permanente.)
After Brown鈥檚 announcement, KP spokesperson Michael Foley said those who don鈥檛 get the vaccine in Oregon will undergo weekly testing; employees in other states, however, will have to apply for medical or religious exemptions or find a new job if they refuse to be vaccinated.
