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More and more hospitals and major healthcare systems are requiring workers to be vaccinated for Covid-19, citing increased caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities and even in the workforce.

Many hospitals say efforts to vaccinate their staff have stalled, just as the nation’s overall vaccination rates remain stable. below 60 percent, behind many European countries and Canada. Time more than 96 percent of doctors According to the American Medical Association, who say they are fully vaccinated, healthcare workers have proven more resilient, especially in rural areas. thousands of workers died of the virus and countless people fell ill.

Recently a prediction By the end of May, one in four hospital workers had not been vaccinated, and some facilities reported that less than half of their staff had been vaccinated.

Some hospitals, from academic medical centers like NewYork-Presbyterian and Yale New Haven to large chains like Trinity Health, are moving forward with a mission because they realize the only way to stop the virus is to vaccinate as many people as possible. as quickly as possible. Banner Health, a major Arizona-based chain, announced on Tuesday that it will implement a mandate and New York City He said it will require all healthcare workers working in hospitals or clinics in the city to be vaccinated or undergo weekly tests.

Watching the increase in cases has made Trinity Health, a Catholic system with hospitals in 22 states, one of the first large groups to decide earlier this month that it will make vaccinations mandatory. Trinity’s chief clinical officer, Dr. “We are convinced that the vaccine can save lives,” said Daniel Roth. “These are preventable deaths,” he said.

Chad Neilsen, director of infection prevention, said the number of Covid patients treated at UF Health Jacksonville in Florida had risen to levels not seen since January, with only half of healthcare workers vaccinated. The vast majority of the seventy-five employees are unvaccinated and more are awaiting test results. “We’re definitely struggling to find staff right now,” he said.

“It’s like a déjà vu,” said Mr. Neilsen, describing his growing frustration with his colleagues’ refusal to give the injection. “We have reason to believe this could end if people get vaccinated.”

Despite dozens of virtual town halls, question-and-answer sessions, and training videos, many employees remain cautious. “We were still stagnant,” said Mr. Neilsen.

Some employees want more data, while others say the process is too rushed. Many of the same conspiracy theories and misinformation – what vaccines will do woman infertile or contains microchips – Maintain dominance among staff members. “Our healthcare workers are a reflection of the general population,” he said.

Hospital leaders and others said they plan to talk to government officials about the possibility of imposing a mandate in the coming weeks.

Unvaccinated workers also continue to care for even the sickest patients, raising concerns that they will spread the infection, especially since the highly contagious Delta variant accounts for more than 80 percent of cases in the country.

“Nowhere is this more important than in hospitals where medical staff who acted heroically during this pandemic are caring for patients with a wide variety of health conditions under the assumption that the health workers who treat them are not at risk or spreading Covid-19,” he said. The CEO of the American Association of Medical Colleges, which represents teaching hospitals, Dr. David J. Skorton. Declaration made a call to duty last Friday.

On Wednesday, two more groups, American Hospitals Associationjoined the growing clamor for vaccine imperatives. D., CEO of America’s Essential Hospitals, which represents hospitals in underserved communities. “We lost most of our caregivers to Covid-19,” said Bruce Siegel. “The vaccine can reduce our risk of losing more.”

With the official approval of vaccines by the Food and Drug Administration potentially months later, hospitals find themselves at the center of the national debate over making it mandatory. While the vaccines are available under emergency use authorization, supporters argue that there is ample evidence that those available in the United States are both safe and effective.

In states such as Missouri reported sharp increase in casesThere is a newfound urgency. Center St. D., director of infectious diseases at SSM Health, a Catholic hospital system in St. “We felt we couldn’t wait,” Shephali Wulff said. With nearly two-thirds of workers vaccinated, SSM requires everyone to receive their first dose by September 1.

The SSM’s decision was motivated by concerns that Covid infections could increase this fall, when there could also be an increase in other respiratory infections. Dr. “We need a healthy workforce entering flu season,” Wulff said. “We don’t have time to wait for approval”

But some systems are already concerned about staff shortages caused by layoffs during the pandemic, and many employees are leaving due to the stress and burnout of caring for Covid patients. Hospitals are afraid to risk losing more workers if they push the issue.

“They fear this could be a tipping point,” said Ann Marie Pettis, president of the Association of Infection Control and Epidemiologists, one of the professional organizations. push the hospitals want the vaccine.

At Mosaic Life Care, a small Missouri hospital group, administrators are reluctant to accept a job if other hospitals don’t. “We have the potential to lose some caregivers to other systems,” said Joey Austin, spokesperson for Mosaic, which has vaccinated about 62 percent of its staff.

Many hospitals already require their employees to get the flu shot, a mandate that has been in place for more than a decade. While this has been met with resistance from employees who are skeptical of the safety of vaccines, it is now widely accepted. Individuals can request a medical or religious exemption, which typically represents a small fraction of the workforce, which hospitals say will also apply to Covid vaccines.

“Establish a social norm and say it is a corporate priority,” said Saad B. Omer, director of the Yale Institute for Global Health, emphasizing that hospitals must voluntarily encourage workers for vaccines to be successful.

Unions like National Nurses United and 1199 SEIU say they want their members to be vaccinated, but are opposed to making it a condition of employment. At the first hospital to implement a mandate, Houston Methodist, a group of employees sued to challenge the requirement, but the lawsuit was recently filed. from work. Out of a total workforce of approximately 26,000 people, about 150 employees eventually resigned or were laid off for refusing to meet the vaccine deadline.

He says hospitals are working hard to dispel much of the common misconception about vaccines, even among doctors and nurses.

Dr. “I need to remind them that respected scientists don’t post their findings on YouTube,” Wulff said. In addition to presenting concrete data on vaccination, she and her colleagues at SSM also share personal experiences, such as getting vaccinated while trying to get pregnant. “What I have found is that people are influenced by stories and anecdotes,” he said.

Dr. “Usually this means listening to what triggers their fears and focusing on them,” Wulff said.

Some high-profile systems such as Intermountain Healthcare and Cleveland Clinic are waiting. The clinic, which has an extensive network of 18 hospitals in the United States, said current policies such as masking and closely monitoring infections protect patients and staff.

“We know that if we make sure these safety measures are in place, we can continue to keep our patients and caregivers safe,” said K. Kelly Hancock, chief caregiver at the Cleveland Clinic.

About three-quarters of workers have been vaccinated, he said, and efforts are continuing “at full strength”.

At Intermountain Healthcare, headquartered in Utah, “a good majority” of employees are vaccinated, says Dr. Kristin Dascomb.

If more safety data is compelling and the FDA approves the vaccines, Intermountain may require immunizations with other hospitals in the state. “We’re starting the conversation now in Utah,” he said.

The lack of full FDA approval has affected other hospitals as well. General Brigham, who has vaccinated more than 85 percent of his workforce, said he would enforce that requirement as soon as vaccines are approved.

Some hospitals argue that an authorization is not necessary. “I don’t think there is one right answer,” said Suresh Gunasekaran, President of Hospitals and Clinics at the University of Iowa. He said about 90 percent of his employees are now vaccinated, adding that he is confident nearly everyone will be vaccinated by the end of the year.

Mr Gunasekaran said the system has been “successful” in eliminating vaccine hesitancy, in part because Iowa is involved in clinical trials for its Pfizer-BioNTech vaccine.

Maxine Carrington, Northwell’s chief of human resources, said the large hospital group Northwell Health in New York doesn’t require its workers to get a flu shot, but about 90 percent of its workforce does. It’s taking a similar approach to Covid.

“We want people to be believers,” said Ms. Carrington, so they can better persuade the public to get vaccinated. He described the system as “hitting the pavement in education, education, education.” About 76 percent of the workforce is currently vaccinated against Covid. Northwell said he would reconsider the idea of ​​authorization once the FDA approves the vaccines.

Yale New Haven Health, like other Connecticut hospitals, now requires its employees to be vaccinated.

“We have informed from the very beginning that this is not mandatory – yet. We’ve just highlighted it,” said Dr. Thomas Balcezak, Yale’s clinical chief.

“Healthcare should take the lead,” he said.