Industry groups call for vaccine mandate for all healthcare workers, but would it work in long-term care?

Multiple national organizations have called on all healthcare facilities, including nursing homes and hospitals, to mandate the COVID-19 vaccines for all employees, volunteers and contract workers.

Exemptions could be granted to individuals medically contraindicated to all COVID-19 vaccines available in the U.S., as well as those allowed by specific federal or state laws, the groups said. 

While a mandate can help long-term care providers boost vaccine uptake among staff, it also could backfire at a time where staffing shortages continue to plague the industry, pointed out a leading expert.

“If staffing mandates are imposed without improving pay and working conditions, I worry we will put residents at risk,” David Grabowski, Ph.D., Harvard healthcare policy expert, told McKnight’s Long-Term Care News on Tuesday. 

His comments came after a multisociety statement on Tuesday recommended that COVID-19 vaccines be required for healthcare personnel. The groups represented multiple medical professions, including representatives from both AMDA — The Society for Post-Acute and Long-Term Care, and the Association for Professionals in Infection Control and Epidemiology (APIC). 

The statement explains what providers should consider when developing a COVID-19 vaccine mandate policy, and that they should also consider ways to engage stakeholders and improve vaccination rates before implementation. 

“Unfortunately, many healthcare workers have still not taken the COVID-19 vaccination, which puts them and their patients at significant risk,” Christoper Laxton, AMDA executive director, said in a statement Tuesday. “After other measures to improve vaccine uptake have not been effective, requiring vaccinations for all employees is the best way to ensure that everyone eligible will receive them in a timely manner.” 

Grabowski explained that a vaccine mandate for staff would likely have both intended and unintended consequences. He said it will definitely have the intended effect of increasing vaccinations among staff and help facilities achieve the 75% vaccination hurdle, but there will also be unintended consequences, especially for nursing homes. 

The most recent data from the Centers for Disease Control and Prevention shows that about 58% of staff in nursing homes had completed their COVID-19 vaccinations as of early July.

“Given low pay and challenging working conditions, some staff may choose to leave the facility rather than get vaccinated. Nursing homes already are struggling with a tight labor market and staff shortages. Thus, they can ill afford to lose additional staff,” Grabowski warned. 

He added that he would like to see vaccine efforts that leverage trust and relationships in terms of other ideas outside of mandates. 

“Many staff do not trust facility leadership,” he said. “Leveraging clinical and community leaders to help with vaccine messaging is one approach.”