Becker's Hospital Review

52 CMO / CARE DELIVERY 5 MUSC Health employees fired for noncompliance with vaccine mandate By Kelly Gooch C harleston-based Medical University of South Carolina Health fired five of its employees for not complying with the health system's COVID-19 vaccine mandate or obtaining an exemption, a spokesperson told Becker's July 12. MUSC Health began mandating COVID-19 vaccination for leaders and new hires on April 15, with April 30 as the compliance deadline. Ninety-seven percent of that group received vaccines, and 3 percent obtained medical or religious exemptions. The mandate was eventually extended to all the health system's employees, about 17,000, with a final deadline of June 30 for com- pliance with either vaccination or exemption. As of June 25, about 2,000 exemptions were obtained, and 24 employees were not compliant or did not have a waiver. As of July 1, five employees were not compliant or did not have a waiver, and they were separated from the organization, said spokesperson Heather Woolwine. MUSC Health is not the only health system where employees have been fired for lack of compliance with a vaccine mandate. At Houston Methodist, 153 employ- ees out of 26,000 either resigned during a two-week suspension period or were terminated June 22 for not complying with the health system's mandate. n Viewpoint: COVID-19 vaccines should be a condition of employment for healthcare personnel By Joshua Schaffzin, MD, PhD, and Erica Shenoy, MD, PhD T he week of July 12 a national coalition of epidemiology, infection prevention, infectious diseases, pharmacy, and legal experts from medical societies repre- senting more than 30,000 healthcare profes- sionals concluded that hospitals, health sys- tems and places where healthcare is delivered should make COVID-19 vaccination a condi- tion of employment, permitting exemptions only for those with medical contraindications and to comply with federal and state laws. e recommendation was reached following an eight-week review of evidence on the safe- ty and effectiveness of the three vaccines au- thorized for use in the U.S. and the applicable employment law. We worked with colleagues to develop the statement, which is being released at a time when the delta variant is now the dominant strain and cases are rising in locations where vaccination rates remain low. Data presented by the Centers for Disease Control and Pre- vention have shown that the vast majority of cases, hospitalizations, and deaths have been in unvaccinated individuals. is statement paves the way for healthcare facil- ities and personnel to communicate clearly that available COVID-19 vaccines are safe and highly effective. A fully vaccinated healthcare workforce reduces the risk of transmission and helps to protect healthcare personnel, their patients, their households and their communities. It supports a healthy work- force and the ability of healthcare facilities to continue to provide care to all patients. Healthcare workers are trusted messengers to their patients, peers, and the public, and the commitment of facilities to vaccine adoption maintains and builds trust in them. e precedent for vaccination as a condition of employment in healthcare is extensive, and research shows substantial improvements in uptake following implementation of condition of employment policies. For example, organi- zations that made flu vaccination a condition of employment saw compliance rates of 94.4 percent compared to 69.6 percent in organiza- tions without a requirement. Earlier this year, the Society for Healthcare Epidemiology of America endorsed influenza immunization as a requirement for those employed or function- ing at a healthcare facility as recommended by the CDC and the Advisory Committee on Im- munization Practices. But a policy of vaccination as a condition of employment involves much more than the nuts and bolts of employee vaccine clinics. Employers implementing such poli- cies need to direct substantial time and re- sources to engage their employees early and oen to develop a fair and ethical process that is in alignment with the facility's mis- sion and culture. An approach based on the principles of diver- sity, equity, and inclusion likely will achieve the goal of broad immunity without generat- ing controversy or resentment. Such an ap- proach may include endorsement by senior leadership, appropriate education to health- care professionals about the vaccines, remov- al of financial and other barriers to access (such as providing paid time off for vaccina- tion and recovery from post-vaccination side effects), and locations and times convenient for healthcare personnel to get vaccinated. If a healthcare institution determines that vac- cination as a condition of employment is not possible, all efforts should be made to increase vaccination rates. If minimal adequate cover- age is not achieved within a reasonable time, the facility should take the next step and im- plement a policy of requiring COVID-19 vac- cination as a condition of employment. e path to controlling the COVID-19 pan- demic includes vaccination of as many peo- ple as possible. Healthcare personnel have been at the forefront of pandemic response, through patient care, research and policy. e publication of this multisociety statement further solidifies the commitment of health- care personnel to end the pandemic. Joshua Schaffzin, MD, PhD, is director, infec- tion control & prevention, Cincinnati Children's and associate professor, University of Cincinnati Department of Pediatrics. Erica Shenoy, MD, PhD, is associate chief, infection control unit, Massachusetts General Hospital in Boston and associate professor, Harvard Medical School in Boston. Both authors served on the writing pan- el that developed the "Multisociety Statement on COVID-19 Vaccination as a Condition of Em- ployment for Healthcare Personnel." n

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