Can Facilities Require Staff to Get the COVID-19 Vaccine?

Can Facilities Require Staff to Get the COVID-19 Vaccine?

The COVID-19 has had a heavy impact on the health care system. As a health care facility, you’ve had your experiences with staff and patient exposures, quarantines, and lockdowns. You know firsthand how it has put a great deal of stress on your staffing, morale, and patient and employee health.

With the recent approvals of the new COVID-19 vaccines, it feels like we’re finally a step closer to the end of the pandemic, but only if as many people as possible become immune to the coronavirus long enough for herd immunity to do its job. 

That immunity is especially important for health care facility staff, who are at high risk of getting and spreading the coronavirus. As vaccines begin to trickle through supply chains, many facilities might be asking, can you require your staff to get the COVID-19 vaccine?

The short answer to this question is yes. Your facility can require your staff to get the COVID-19 vaccine with a few exceptions. Many health care facilities like hospitals require staff to get certain vaccines as a condition of employment or hiring.

But with the pandemic and vaccine situation constantly changing, there’s a lot for you to consider as you begin to put together potential vaccine requirements. As you finalize your COVID-19 vaccine plans and policies for your facilities, here’s what to keep in mind.

Refer to Flu Shot Requirements and Laws

It’s still unknown how long immunity will last after getting vaccinated for COVID-19, but many researchers and health care officials are preparing for the instance that we’ll need to get the COVID-19 vaccine every year. 

That will make the vaccine very similar to the flu shot. If you already have flu shot requirements in place, then you can likely consider adapting them to include COVID-19 or using them as a basis for the new requirements.

Take into account state laws regarding flu vaccines, too. Several states have flu vaccination laws that either requires certain health care workers to get the annual flu shot or facilities to document every worker’s vaccination status. 

Although it’s difficult to say if or when states might make the same laws regarding the COVID-19 vaccine, the current laws will give you an idea of what such laws might look like, so you potentially won’t have to reassess your policies later.

That Includes Exemption Policies

Just like with the flu shot or any other vaccine, your health care staff can decline to get the vaccine based on medical or religious exemptions.

In pre-pandemic times when it was just the seasonal flu that we mostly worried about, employees declining a vaccine due to legally covered exemptions would need reasonable accommodation to continue to do work without the vaccine. Normally, that means they’re required to take extra precautions, like wearing a mask when at work for the entire flu season.

But COVID-19 is different. Once someone is vaccinated, the Centers for Disease Control and Prevention (CDC) still recommends that they continue to follow infection prevention precautions, like quarantining when exposed, wearing a mask, and social distancing, the same precautions that someone who doesn’t get the vaccine is expected to take.

As you look at a potential vaccine mandate for your facility, keep in mind that some flu shot policies might not carry over simply to COVID-19 policies.

It May Become Required for Medicare or Medicaid Funding

If you’re a facility that regularly receives funding from Medicare or Medicaid, you’ll need to plan for the highly likely event that the Centers for Medicare & Medicaid Services (CMS) will incorporate the COVID-19 vaccine into its regulatory requirements. 

Late in August 2020, CMS made routine staff COVID-19 testing one of its requirements for facilities that received its funding. There were also fines, some as high as $8,000, for facilities in noncompliance with the requirement.

Of course, it’s difficult to say when or if CMS will make mandatory COVID-19 vaccines for staff a requirement for participation in its programs. But it’s better to be prepared for whatever they might decide.

Doses Will Stay Limited for Several Months

As you craft your COVID-19 vaccine policies for employees, remember that even with more than one vaccine authorized for use, doses will be limited for several months as manufacturing and distribution catches up to demand.

You’ll also need to pay attention to your state’s vaccination allocation plans. Nearly all states aim to have all health care workers vaccinated against COVID-19 as part of Phase I of their plans, but the order in which workers get the vaccine first depends on their risk of exposure or severe illness. 

For example, in some plans, frontline workers in critical care and emergency departments will be the first in line to be fully vaccinated, and then inpatient care workers, and then outpatient care workers. Long-term care workers and residents are also expected to be included in the first few waves of vaccine deliveries.

However, even for those critical populations, there aren’t yet enough doses to cover the required two-dose course for everyone who’s eligible. That situation will likely continue for weeks to months.

What this means is that any facility policy requiring staff to get the vaccine will need to plan for not getting enough doses to cover all of your high-risk staff or patients at the same time. 

Many Staff May Be Hesitant

As you begin to define your vaccine policy for these new vaccines, understand that there are many concerns that might prevent your staff from complying with a vaccine requirement.

It’s no secret that the COVID-19 vaccines are the fastest vaccines ever developed and authorized for public use. That combined with a noticeable distrust of the political climate and issues like racial biases against minority populations in health care has made it so many health care professionals are wary of getting the vaccine too soon.

Part of your vaccine policy needs to be addressing staff concerns compassionately and from a place of understanding. Listening and educating your staff the right way will increase compliance and help them in turn learn how to talk to patients about getting the COVID-19 vaccine. 

If your facility is a long-term care facility, then staff compliance is especially vital. The CDC’s surveys to determine health care professional flu vaccination rates during the 2018-2019 flu season found that long-term care staff reported only 67.9% of staff had gotten the flu vaccine.

That’s the lowest of the clinical settings surveyed. Hospitals were at 95.2%, and ambulatory care was at 79.8%.

As you discuss potential COVID-19 vaccine mandates for your facility, make sure to include discussions on how to positively encourage and reassure your staff about your decision to make the vaccine a requirement. 

Taking these extra steps in preparing your faculty for the arrival of the COVID-19 vaccine will not only potentially save you time later down the road if similar laws or mandates are put into place, but it’ll better protect your patients and staff. 

Michelle Paul

Michelle Paul is an RN Content Specialist at Clipboard Health. She has worked with a variety of patient demographics, ranging from young adults in foreign countries, to elderly residents in skilled nursing facilities, to healthy blood donors in her community. Her experience in content creation gives her a unique perspective on communication within the healthcare field.