Throughout the pandemic, hospitals and health systems have implemented COVID-19 vaccination requirements for employees, citing a need to protect patients, workers and the communities they serve. The list continued to grow once CMS announced its vaccination mandate covering healthcare facilities participating in Medicare and Medicaid. Now, health systems continue to update their policies as the virus situation changes and additional vaccines become available.
Take Milwaukee-based Froedtert Health. The health system told some unvaccinated employees they will lose their jobs if they do not receive a new exemption or Novavax's recently authorized COVID-19 vaccine.
The FDA authorized Novavax's vaccine for emergency use in adults in July; that vaccine is protein-based and does not use mRNA technology.
Some employees received exemptions to Froedtert's vaccination policy after indicating that fetal cell lines in mRNA vaccines conflicted with their religious beliefs or medical situation, the Milwaukee Journal Sentinel reported Sept. 8.
Considering the differences in vaccines, the health system has a new policy, first reported by NBC affiliate WTMJ.
A health system statement shared with Becker's reads: "The Novavax vaccination for COVID-19 is now available. This protein-based vaccination option eliminates conflicts for those staff with religious or medical exemptions caused by mRNA-based vaccines and other concerns. Since those staff are now eligible for a vaccination that does not conflict with their religious beliefs or medical situation, their exemption will expire.
"This affects less than 1 percent of our staff. We continue to allow valid medical exemptions and sincerely held religious exemptions for the COVID-19 vaccine. Impacted staff were provided the opportunity to apply for an exemption after learning the previous exemption kept on file was no longer valid."
Bend, Ore.-based St. Charles Health System also recently updated its vaccination policy.
The new policy allows unvaccinated individuals who apply for and receive a medical or religious exception to Oregon's vaccine mandate to work in a St. Charles healthcare setting if they wear an N95 or higher filtering respirator while rendering direct patient care, according to a Sept. 15 news release shared with Becker's. Unvaccinated workers not rendering direct patient care must still wear a medical-grade procedure mask while in a St. Charles healthcare setting unless they are eating in a break room.
"With the use of this type of personal protective equipment, we believe we are taking reasonable steps to ensure unvaccinated providers and staff are protected from contracting and spreading COVID-19 to co-workers, patients and visitors in a manner consistent with state and federal mandates," Joan Ching, DNP, RN, St. Charles' chief nursing executive, said in the release.
St. Charles said revised CDC guidance, the prevalence of COVID-19 in the community, the severity of the current virus strains, availability of personal protective equipment, treatment options and immunity levels in the community all contributed to the policy update.
Another health system, Houston Methodist, is not requiring employees to receive new COVID-19 vaccines targeting omicron subvariants BA.4 and BA.5 — at least for the time being.
The health system, which has about 30,000 employees, notified staff of the decision in an email from Robert Phillips, MD, PhD, executive vice president, chief physician executive and specialty physician group CEO.
"We strongly recommend you get the booster to keep our patients, you and your family even safer from COVID-19," Dr. Phillips wrote in the email, which was shared with Becker's on Sept. 20. "At this time, Houston Methodist will not mandate the new booster. We will continue to follow the scientific data, the level of infections in the community and the availability of vaccines and may mandate the new booster in the future if necessary."
State relaxes rules — but 2 systems do not
While some organizations are updating or may consider updates to their policies, two health systems — Vancouver, Wash.-based PeaceHealth and Oakland, Calif.-based Kaiser Permanente — confirmed to Becker's that they will keep their employee mandates amid changing Washington state rules.
On Sept. 8, Washington Gov. Jay Inslee announced that remaining COVID-19 emergency orders, including the underlying state of emergency, will end by Oct. 31. This means the state's vaccination requirements for healthcare and education workers will end, although employers still have the option of continuing to require them, according to a news release from the governor's office.
Kaiser, which has facilities in Washington state, told Becker's that Kaiser's policy requiring COVID-19 vaccination for all employees and physicians has not changed. The health system initially announced the policy in August 2021.
PeaceHealth told Becker's its vaccine requirement policy "remains in place as the evidence continues to show that vaccines are the best measure to protect people from COVID-19, slow transmission and reduce the likelihood of new variants emerging."
Meanwhile, CMS' federal mandate remains in effect nationwide. The mandate, which the Supreme Court upheld Jan. 13, has been in effect in all states since Feb. 20. It requires healthcare facilities to establish a policy ensuring eligible workers are fully vaccinated, with exemptions allowed based on religious beliefs or recognized medical conditions. As of June 14, nearly 12,000 Medicare and Medicaid certified providers and suppliers had been surveyed for compliance, and 95 percent of them were found to be in substantial compliance with the requirement, CMS said. There are 17 provider types affected by the rule, including hospitals.