Mandating vs Leading in COVID-19 Vaccinations

In May 2021, the University of Pennsylvania announced that all employees and clinical staff would be required to be vaccinated against COVID-19 by September 1, 2021. The school and its medical facilities employee over 46,500 individuals and constitute the largest business to date in the US to make vaccinations a mandatory condition for employment. Houston Methodist announced a similar mandate for all of its 26,000 employees in April. It is suggested that other hospital systems, as well as universities and colleges, will soon follow.  

At the time of the press release, approximately 70% of the University of Pennsylvania’s staff had been fully vaccinated, leaving 11,000 employees with the decision of whether to accept the vaccination or seek employment elsewhere. There will be exemptions for medical or religious reasons that are like those for the influenza virus vaccinations. Staff will be required to apply for a COVID-19 exemption in the same way they were required to apply for an influenza virus exemption. 

What would be the impact in a skilled nursing facility if a similar mandate was required for all staff members?  Many facilities experienced shortages of staff even before the pandemic, and the difficulty in filling vacancies has not abated despite large portions of the country reopening and lifting restrictions.  It is likely that the approach that the University of Pennsylvania has taken would exacerbate an already tenuous employment picture at nearly every long-term care facility in the country. 

Attempts to encourage vaccinations are most likely to be successful using a personal approach to determine staff concerns to identify knowledgeable individuals who can allay the specific issues by employees—whether they involve concerns over fertility, experimentation, the long-term effects of vaccinations or other questions.  To encourage vaccinations, patience and leadership will be required, as well as the identification of people in the community who are experienced in vaccination effects. Religious leaders who are sources of influence can also be used as a tool to encourage these vaccinations.  

Perhaps mandating vaccinations will be effective for an organization such as the University of Pennsylvania, but such a policy would likely be devastating or skilled nursing facilities. 

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