Amid widespread staffing shortages, several states have delayed their mandates for health care workers to receive Covid-19 vaccine booster shots "to avoid substantial staffing issues in our already overstressed health care system."

States, cities delay booster mandates

New York on Friday became the latest state to delay its mandate for health care workers to receive Covid-19 vaccine boosters. The state's health commissioner Mary Bassett on Friday announced that health officials would delay the booster requirement that was set to take effect Monday.

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Despite the delay, Bassett emphasized that New York officials continue to view booster shots as "critical tools to keep both health care workers and their patients safe."

Over the next three months, New York officials will focus on trying to increase booster shots among health care workers and reassess the need for additional steps, including a booster requirement as a condition of employment.

Similarly, California and Connecticut recently delayed their requirements that health care workers receive a booster dose to March 1 and March 7, respectively.

In addition, several of Chicago's largest hospital chains, including Advocate Aurora Health, Northwestern Medicine, the University of Chicago Medical Center, NorthShore University HealthSystem, and Sinai Chicago, have decided not to mandate a third dose of the vaccine. 

While some hospitals have strongly encouraged their staff get a booster dose, they are not currently mandating them because it's not required by federal or local laws, Crain's Chicago Business/Modern Healthcare report.

Staffing shortages drive delaying booster mandates

Amid widespread staffing shortages triggered by the "Great Resignation," many health systems have struggled to keep up with increased patient volumes. As a result, personnel shortages were rated as hospital CEOs' top concern in 2021, and now, some health experts are voicing concern that booster mandates could trigger more resignations.

In New York, the decision to delay the mandate was driven by the fact that many workers have not yet received boosters, meaning the state's health care system would not be able to continue functioning normally with the mandate in place, the New York Times reports.

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As of Feb. 15, about 54% of hospital workers and 44% of nursing home and adult-care facility staff in New York had received booster doses. Among the state's health care workers, 28% said they were willing or waiting to be boosted, the Wall Street Journal reports.

In total, Bassett said roughly three-quarters of New York health care workers have "received or are willing to receive their booster," but booster uptake varies widely among types of health care workers. For instance, about 95% of hospice workers report that they have been or are planning to be boosted, but only 51% of nursing home workers say the same.

"[T]he reality is that not enough health care workers will be boosted by next week's requirement in order to avoid substantial staffing issues in our already overstressed health care system," Bassett said. "That is why we are announcing additional efforts to work closely with health care facilities and ensure that our health care work force is up-to-date on their doses," she added.

According to Margo Wolf O'Donnell, an attorney specializing in employment law at Benesch Friedlander Coplan & Aronoff, many hospital systems have decided not to enforce booster mandates because "[t]he hospital systems, like other employers—because of the labor shortage, they are following the CDC guidance."

"In some instances, they don't want to exceed what is required in order to ensure there is enough staffing to meet the needs of the patient population right now," O'Donnell added.

Separately, Amanda Sonneborn, a lawyer at King & Spalding, said, "I am doubtful if you will see [new mandates], based on the fact that much of the government is rolling back requirements, not adding new requirements."

Still, many health care workers have chosen to get boosted regardless of mandates. For instance, James Kerridge, the assistant chief nursing officer at Sinai Chicago, received his booster shot in November and said that he encourages his co-workers to get it as well. 

"We have an obligation as health care professionals to recommend that people get vaccinated and boosted," Kerridge said. "But the organizational leader in me understands that mandates can be tricky." (Davis, Crain's Chicago Business/Modern Healthcare, 2/18; Chen, Axios, 2/19; Astor, New York Times, 2/19; Vielkind, Wall Street Journal, 2/19)