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Maryland hospital workers face deadlines for COVID vaccinations; thousands could be out of the job

Despite a high rate of compliance, hundreds of workers at the University of Maryland Medical System may have run afoul of the mandate by the state’s largest hospital system for them to be vaccinated by Monday.

The system reported a vaccination of over 99% by the middle of last week. But that leaves close to 200 employees and more than 200 contract or irregular workers who will have to leave their jobs if they don’t show proof of their first shot or receive an exemption on medical or religious grounds.

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Across the state, there could be 3,200 unvaccinated medical and support staff, according to hospital industry estimates, potentially giving up their jobs at a time when hospitals could use all the help they can get.

The number represents a small portion of the 107,000 people who work directly for the state’s hospitals, which all have mandates with their own timelines.

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Hospital officials have said the mandates ensure that more workers stay on the job and not out sick or in quarantine. But the distribution of workers who do leave isn’t likely uniform across facilities and could put certain short-staffed hospitals or departments under stress.

“Deadlines are approaching for those hospitals that will terminate unvaccinated employees who do not have an approved exemption,” said Bob Atlas, president and CEO of the Maryland Hospital Association. “Hospitals have been hard at work to address vaccine hesitancy and holdouts are shrinking fast.”

Atlas said hospitals are committed to vaccine requirements “to protect their patients and staff,” even though the systems face a severe staffing crisis.

Nurses have particularly been short in Maryland and across the country because demand has increased. Some are quitting or retiring, but others are being scooped up by high-paying temp agencies.

Across the state, nearly 95% of hospital workers have received at least one dose, according to the hospital association. An additional 2% to 3% have been approved for medical or religious exemptions.

Among the state’s general population, data shows just over 67% have received at least one dose of vaccine.

There are no statewide mandates, but Gov. Larry Hogan required all health care workers to be vaccinated by Sept. 1 or be regularly tested. But many systems, including the University of Maryland system, already had committed to mandates and decided to eliminate the testing option.

Nursing homes also fall under Hogan’s order. About 89% of 34,000 workers in 227 skilled nursing and rehabilitation centers have gotten at least their first dose of vaccine, according to the Health Facilities Association of Maryland.

That leaves about 3,738 workers unvaccinated, though they can be tested regularly. An unknown number also received exemptions.

At hospitals, doctors have been the most vaccinated group and support staff the least, according to the hospital association. Hospitals in more rural areas on the Eastern Shore and Western Maryland have lower vaccination rates, mirroring their communities.

Vaccine hesitancy and refusal have become national issues, exacerbating staffing shortages particularly in low-vaccination states.

President Joe Biden in September ordered vaccinations for employees of larger companies and workers in health care facilities that collect Medicare and Medicaid payments, including hospitals.

Surveys show mandates appear to be effective, though not with everyone.

About a quarter of workers now say their employer required a COVID-19 vaccine, up from 5% in June. But 5% of adults say they have left a job due to such a requirement, according to the Kaiser Family Foundation.

About a fifth of workers said they want their employer to require vaccinations, and about half say they don’t want a mandate.

In the country’s hospitals, about 40% have enacted mandatory vaccinations, according to the American Hospital Association.

Nancy Foster, the association’s vice president of quality and patient safety policy, said regions with lower vaccination confidence may not be able to set requirements given the risk of losing more staff that could cripple their operations.

“Hospitals all over the country are experiencing staff shortages, so to further lose staff is a consideration,” Foster said. “In addition, we’re seeing in some states, the legislatures or governor has taken action that would preclude them from mandating a vaccine.”

She said some facilities are waiting for the federal mandates to go into effect, which could happen in the coming days, making the rules consistent everywhere. For now, as in Maryland, some hospitals are close to full compliance while others would lose more staff.

“The number may be small as an overall percentage, but if it represents a sub-portion of a particular department or caregiving unit, it can really harm a hospital’s ability to provide that kind of care,” said Foster, adding that at least one U.S. hospital in a remote area had to stop providing maternity services due to a staffing shortage caused by a vaccination mandate.

“That meant pregnant women were driving a substantial number of miles away to give birth. Hospitals are very conscious of that and are working hard, and are aware of and keeping track of those who are not yet vaccinated, and working hard not to lose them.”

Other hospital systems in Maryland say they have high rates of vaccination, but uptake is not universal.

Nearly 98.5% of employees at LifeBridge Health, parent of Sinai Hospital and others, are compliant with the system mandate to be vaccinated to receive an exemption.

“We continue to talk with fewer than 150 individuals — most of whom are nonclinical staff — who have not received the vaccine or who have not received a religious or medical exemption,” said Sharon Boston, a system spokeswoman. “Those who are noncompliant as of Nov. 1 are being placed on unpaid leave, and we continue to work with those team members and do all we can to get them in compliance and back to work.”

The grace period ends Dec. 1, with all employees expected to be vaccinated or in compliance with a medical or religious exemption that includes weekly testing.

Johns Hopkins Medicine and MedStar Health, two other large hospital systems in the state, have not disclosed their compliance rates.

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