As the delta variant continues to surge, nearly 1,500 hospitals across the country have mandated that employees be vaccinated against Covid-19, but some states have enacted laws barring either Covid-19 vaccination mandates or so-called "vaccine passports," Katheryn Houghton writes for Kaiser Health News. Health care leaders are worried about potential staffing shortages.

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Mandates to-date

According to Houghton, nearly 1,500 hospitals, comprising about a quarter of all U.S. hospitals, currently require Covid-19 vaccinations. These mandates are meant to keep employees from spreading the disease and mitigate staffing shortages that could stem from staff infections, quarantines, and an overwhelming number of Covid-19 patients.

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In July, almost 60 major medical organizations announced support for mandated Covid-19 vaccinations among health and long-term care workers. Some states have also taken action, Houghton writes, with California requiring health care workers be fully vaccinated, and Massachusetts Gov. Charlie Baker (R) ordering most nursing home workers to get vaccinated by Oct. 10.

According to Houghton, hospitals with vaccine mandates are enforcing them. For instance, Houston Methodist fired or accepted the resignations of more than 150 unvaccinated employees in June. And Trinity Health, a Catholic health system with 117,000 workers across 22 states, has said unvaccinated employees without an exemption will be fired.

But unlike Houston Methodist, according to Houghton, Trinity Health may not be able to enforce its mandate in all its locations: The health system has a presence in Oregon, which is one of several states where vaccine mandates are banned.

'Your health care decisions are private'

According to the National Academy for State Health Policy, at least seven states have enacted laws preventing vaccine mandates or vaccine passports, which provide proof of vaccination. According to Houghton, many of those laws do include exemptions for health care facilities—but not all of them.

For instance, Montana prohibits employers—including hospitals—from discriminating against workers based on vaccination status. Under the law, employers can't require vaccinations, and employees aren't required to report their vaccination status, Houghton writes.

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According to Houghton, those who support the law say these health care decisions are personal and should not be mandated. For example, Jennifer Carlson, a Republican representative in Montana, said, "Your health care decisions are private, they’re protected by the constitution of the state of Montana."

'I cannot imagine passing any worse law than that'

Many health care leaders have voiced concerns about such laws, particularly in Montana, where—at the start of August—Covid-19 hospitalizations doubled compared with two weeks prior and about 90% of the hospitalized patients were unvaccinated.

"I cannot imagine passing any worse law than that," John Goodnow, CEO of Benefis Health in Great Falls, said. "Imagine if that would have been passed back when we were fighting polio, or smallpox before that."

According to Houghton, Benefis Health had planned to mandate vaccination for its 3,400-person staff back in April, before state lawmakers passed the bill preventing the hospital from doing so.

Greg Tierney, CMO of Benefis, added that he's concerned about potential resentfulness between vaccinated and unvaccinated health professionals as their workload rises with the increasing caseload. Already, according to Houghton, hospital leaders in Billings are hosting weekly town halls to answer workers' vaccine questions and debunk myths—in addition to actually providing care for Covid-19 patients.

Separately, officials at Logan Health—located in northwestern Montana, where just 34% of the population is vaccinated—said existing staffing shortages are worsening due to staff becoming infected or having to quarantine.

"Wearing a mask whenever you're in our facilities, that helps, but being able to vaccinate everyone would help more," Logan CMO Doug Nelson said, adding that his organization would consider a staff vaccine mandate if the state would allow it. (Houghton, Kaiser Health News, 8/10)