Healthcare Associations Call for Vaccination Mandates, As DVA Imposes Mandate

July 27, 2021
A group of 58 national healthcare associations called for the implementation of vaccine mandates for all healthcare workers, on the same day that the Department of Veterans Affairs imposed the first federal mandate

Ezekiel J. Emanuel, M.D., a prominent healthcare policy leader who helped to shape the Affordable Care Act (ACA) under President Barack Obama, has organized the issuance of a joint statement on the part of 58 prominent national healthcare associations that is calling for vaccine mandates for all U.S. healthcare workers, on the same day that the Department of Veterans Affairs announced that it was imposing the first federal employee mandate so far, for 115,000 of its staff members.

The entirety of the statement was posted on Dr. Emanuel’s page, and shared on many association websites and across the mainstream media from there.

Altogether, 58 organizations participated as signatories (see the full list below), including the American Medical Association, American Nurses Association, American College of Surgeons, and Association of American Medical Colleges. Absent from the list was the American Hospital Association. Emanuel served as Special Advisor for Health Policy to Peter Orszag, the former Director of the Office of Management and Budget in the Obama administration.

Here is the full text of the statement:

“Joint Statement in Support of COVID-19 Vaccine Mandates for All Workers in Health and Long-Term Care

Due to the recent COVID-19 surge and the availability of safe and effective vaccines, our health care organizations and societies advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine. This is the logical fulfillment of the ethical commitment of all health care workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being.

Because of highly contagious variants, including the Delta variant, and significant numbers of unvaccinated people, COVID-19 cases, hospitalizations and deaths are once again rising throughout the United States.1 Vaccination is the primary way to put the pandemic behind us and avoid the return of stringent public health measures.

Unfortunately, many health care and long-term care personnel remain unvaccinated. As we move towards full FDA approval of the currently available vaccines, all health care workers should get vaccinated for their own health, and to protect their colleagues, families, residents of long-term care facilities and patients. This is especially necessary to protect those who are vulnerable, including unvaccinated children and the immunocompromised.  Indeed, this is why many health care and long-term care organizations already require vaccinations for influenza, hepatitis B, and pertussis.

We call for all health care and long-term care employers to require their employees to be vaccinated against COVID-19.

We stand with the growing number of experts and institutions that support the requirement for universal vaccination of health workers.2,3 While we recognize some workers cannot be vaccinated because of identified medical reasons and should be exempted from a mandate, they constitute a small minority of all workers. Employers should consider any applicable state laws on a case-by-case basis.

Existing COVID-19 vaccine mandates have proven effective.4,5 Simultaneously, we recognize the historical mistrust of health care institutions, including among many in our own health care workforce. We must continue to address workers’ concerns, engage with marginalized populations, and work with trusted messengers to improve vaccine acceptance.

As the health care community leads the way in requiring vaccines for our employees, we hope all other employers across the country will follow our lead and implement effective policies to encourage vaccination.  The health and safety of U.S. workers, families, communities, and the nation depends on it.”

The signatory associations are as follows:

Academy of Managed Care Pharmacy (AMCP)
American Academy of Ambulatory Care Nursing (AAACN)
American Academy of Child and Adolescent Psychiatry (AACAP)
American Academy of Family Physicians (AAFP)
American Academy of Nursing (AAN)
American Academy of Ophthalmology (AAO)
American Academy of PAs (AAPA)
American Academy of Pediatrics (AAP)
American Academy of Allergy, Asthma & Immunology (AAAAI)
American Association of Clinical Endocrinology (AACE)
American Association of Colleges of Pharmacy (AACP)
American Association of Neuroscience Nurses (AANN)
American College of Clinical Pharmacy (ACCP)
American College of Physicians (ACP)
American College of Preventive Medicine (ACPM)
American College of Surgeons (ACS)
American Epilepsy Society (AES)
American Medical Association (AMA)
American Nurses Association (ANA)
American Pharmacists Association (APhA)
American Psychiatric Association (APA)
American Public Health Association (APHA)
American Society for Clinical Pathology (ASCP)
American Society for Radiation Oncology (ASTRO)
American Society of Health-System Pharmacists (ASHP)
American Society of Hematology (ASH)
American Society of Nephrology (ASN)
American Thoracic Society (ATS)
Association for Clinical Oncology (ASCO)
Association for Professionals in Infection Control and Epidemiology (APIC)
Association of Academic Health Centers (AAHC)
Association of American Medical Colleges (AAMC)
Association of Rehabilitation Nurses (ARN)
Council of Medical Specialty Societies (CMSS)
HIV Medicine Association Infectious Diseases Society of America (IDSA)
LeadingAge
National Association of Indian Nurses of America (NAINA)
National Association of Pediatric Nurse Practitioners (NAPNAP)
National Council of State Boards of Nursing (NCSBN)
National Hispanic Medical Association (NHMA)
National League for Nursing (NLN)
National Medical Association (NMA)
National Pharmaceutical Association (NPhA)
Nurses Who Vaccinate (NWV)
Organization for Associate Degree Nursing (OADN)
Pediatric Infectious Diseases Society (PIDS)
Philippine Nurses Association of America, Inc (PNAA)
Society of Gynecologic Oncology (SGO)
Society for Healthcare Epidemiology of America (SHEA)
Society of Hospital Medicine (SHM)
Society of Infectious Diseases Pharmacists (SIDP)
Society of Interventional Radiology (SIR)
Texas Nurses Association (TNA)
The John A. Hartford Foundation Transcultural Nursing Society (TCNS)
Virgin Islands State Nurses Association (VISNA)
Wound, Ostomy, and Continence Nurses Society (WOCN)

Not all healthcare-related national associations signed. As the Washington Post’s Dan Diamond wrote on Monday evening, “Some health-care union officials who had raised previous concerns about vaccination mandates remained largely silent after the wave of announcements Monday. Representatives for National Nurses United and the SEIU [Service Employees International Union] did not return requests for comment. But other labor organizers spoke out against the push.”

“In order for everyone to feel safe and welcome in their workplaces, vaccinations must be negotiated between employers and workers, not coerced,” Randi Weingarten, the president of the American Federation of Teachers, said in a statement.

Department of Veterans Affairs imposes vaccination mandate

The publication of the statement came on the same day that the Department of Veterans Affairs (DVA) announced that it will require 115,000 of its frontline healthcare workers to be vaccinated in the next two months, making it the first federal agency to mandate vaccination for employees.

Here is the full statement, which was posted to the DVA’s website in a press release on Monday:

“Department of Veterans Affairs Secretary Denis McDonough announced he will make COVID-19 vaccines mandatory for Title 38 VA health care personnel — including physicians, dentists, podiatrists, optometrists, registered nurses, physician assistants, expanded-function dental auxiliaries and chiropractors — who work in Veterans Health Administration facilities, visit VHA facilities or provide direct care to those VA serves. VA is taking this necessary step to keep the Veterans it serves safe. Each employee will have eight weeks to be fully vaccinated.”

“We’re mandating vaccines for Title 38 employees because it’s the best way to keep Veterans safe, especially as the Delta variant spreads across the country,” McDonough said. “Whenever a Veteran or VA employee sets foot in a VA facility, they deserve to know that we have done everything in our power to protect them from COVID-19. With this mandate, we can once again make — and keep — that fundamental promise.”

The press release went on to say that “The department’s decision is supported by numerous medical organizations including the American Hospital Association, America’s Essential Hospitals and a Multisociety group of the leading Infectious Disease Societies. The American Medical Association, American Nurses Association, American College of Physicians, American Academy of Pediatrics, Association of American Medical Colleges, and National Association for Home Care and Hospice also endorsed mandating COVID-19 vaccination for health care workers. In recent weeks, VA has lost four employees to COVID-19 — all of whom were unvaccinated. At least three of those employees died because of the increasingly prevalent Delta variant. There has also been an outbreak among unvaccinated employees and trainees at a VA Law Enforcement Training Center, the third such outbreak during the pandemic.”

Further, the statement said, “All VA employees are eligible to be vaccinated at no personal expense at any of our facilities. Employees will also receive four hours of paid administrative leave after demonstrating they have been vaccinated. Information in these FAQs or clinician and Veteran videos has details about the vaccine, its safety and effectiveness. The safety and wellbeing of our Veterans and personnel is paramount.”

A significant percentage of healthcare workers in the U.S.  have refused vaccination. In a June 28 report, WebMD Health News’s Brenda Goodman and Andy Miller wrote that “In fact, nationwide, 1 in 4 hospital workers who have direct contact with patients had not received a single dose of a COVID-19 vaccine by the end of May, according to a WebMD and Medscape Medical News analysis of data collected by the U.S. Department of Health and Human Services (HHS) from 2,500 hospitals across the U.S. WebMD and Medscape set out to make a map of health care workers at hospitals around the U.S. who have not yet been vaccinated against COVID. Seems simple enough. It isn’t,” they wrote in late June. “Among the nation's 50 largest hospitals, the percentage of unvaccinated health care workers appears to be even larger, about 1 in 3. Vaccination rates range from a high of 99% at Houston Methodist Hospital, which was the first in the nation to mandate the shots for its workers, to a low between 30 percent and 40 percent at some hospitals in Florida.”

Justice Department makes statement about employer vaccine mandates

Meanwhile, POLITICO’s Nick Niedzwiadek and Myah Ward wrote on Monday afternoon that “Justice Department lawyers say that federal law doesn’t stop private businesses or public agencies from mandating Covid vaccines, according to an opinion released on Monday just hours after the Department of Veterans Affairs became the first federal agency to mandate inoculations for some of its employees. The opinion from the department’s Office of Legal Counsel, dated July 6, opens the door for more businesses to require the shots for U.S. workers as Covid spreads among the unvaccinated, and comes two months after the Equal Employment Opportunity Commission released guidance saying U.S. employers could require all employees physically entering an office space to get the vaccine,” Niedzwiadek and Ward wrote.

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