An advisory panel of experts for the Centers for Disease Control and Prevention on Tuesday recommended that healthcare workers should be first-in-line to receive a coronavirus vaccine.
In a 13-1 vote, the Advisory Committee on Immunization Practices said vaccine allocation should prioritize the country's 21 million frontline healthcare workers and 3 million residents in long-term care facilities, it is unclear whether hospitals will require their workers to inoculate once it becomes available.
Rush University Medical Center in Chicago has no plans to make a coronavirus vaccine mandatory for staff in the next year, according to Dr. John Segreti, a hospital epidemiologist and medical director of infection control and prevention at Rush. He said the provider's decision stems from supply and delivery uncertainties, as well as questions about potential adverse reactions from the vaccines.
"I think the healthcare industry will strongly encourage their (healthcare personnel) to get vaccinated — I doubt many will mandate it this year," he said.
Like other employers, hospitals have the right to mandate vaccinations as a condition of employment. Employees can opt to exempt themselves from such requirements for medical reasons or religious beliefs, which would then require employers to provide them with "reasonable", alternative work accommodations.
The number of providers who have flu vaccination requirements has steadily increased in recent years in an effort to reduce rates of infections and illnesses acquired within healthcare settings. A 2018 JAMA Network Open study that surveyed more than 500 hospitals on their policies regarding mandatory influenza vaccination requirements found that the share of providers who require staff to get a flu shot had increased from 44% in 2013 to nearly 70% in 2017.
Experts say mandatory vaccination policies have been a major factor in driving up flu vaccination coverage among healthcare staff. Flu vaccination coverage among healthcare personnel was more than 80% during the 2019-2020 flu season, according to the CDC, compared to 64% during the 2010-2011 season. Personnel who were required to get a flu shot had a rate of 94%, while employees who were not required to a get a shot had a coverage rate of 70%.
Segreti said Rush requires its employees, volunteers and students to receive the flu vaccine each year. But he said say they are taking a wait-and-see approach with coronavirus vaccines.
"If the vaccine proves safe and effective, we may mandate it in the future," Segreti said.
UNC Health in Chapel Hill, North Carolina is taking a similar approach to Rush,saying it plans to recommend all its employees get vaccinated if the remaining trials are positive. But the health system doesn't plan to make vaccinations mandatory.
"While we do not yet have answers to many key questions surrounding a potential vaccine and its rollout plan or timeline, we are grateful to have a team of regional and national experts to review vaccine data and to guide our decisions and planning efforts," according to UNC Health's statement. "Our goal is to then provide as much data and information as possible to both our co-workers, patients and the community related to the vaccine."
But Dr. Steven Corwin, CEO of New York-Presbyterian Hospital, said in a recent interview with Modern Healthcare that the organization was inclined to mandate staff get vaccinated but stressed the decision would come down to how much supply is available versus the demand to get vaccinated.
"I would be inclined to mandate it because we don't want our healthcare workers to get sick, and we don't want our healthcare workers to infect each other, which can happen, or infect patients, which can happen," Corwin said. "I think that's critically important to do."
Federal officials have estimated the most promising coronavirus vaccine candidates — one from Pfizer and BioNTech and another developed by Moderna — could gain emergency use authorization by the U.S. Food and Drug Administration and start to be distributed in a few weeks.
Yet the speed at which the vaccines were developed is playing a part in the public's mixed view over its safety and efficacy.
A recent Gallup Panel survey conducted between Oct. 19 and Nov. 1 found 58% of Americans reported they were willing to get vaccinated against the coronavirus, an increase from 50% who said they were willing back in September. Among those who said they would not get vaccinated, 37% reported the development timeline of the vaccine was their top reason for concern, while 26% said they wanted to wait to confirm the vaccine was safe.
Corwin acknowledged there remained concerns over the safety of a new coronavirus vaccine in certain populations, such as among pregnant women. He said any vaccination mandate the health system instituted would exclude those individuals, along with others with qualified exemptions.
"But short of that, I think it would be unfair to the public to (not have the workforce get vaccinated) to be honest with you," Corwin said.
