California vaccine prescription: most hospital workers comply

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In summary

As the state’s COVID-19 vaccination mandate goes into effect Thursday, several large hospital systems say 90% or more of their employees are vaccinated. But they don’t have to provide data to the state unless asked.

Kaiser Permanente, Dignity Health, Keck Medicine and other major California hospital systems say they are on track to meet Thursday’s deadline for the state’s COVID-19 vaccine mandate, with several citing rates of 90% or more vaccination.

California was the first state in the country to announce that all healthcare workers must be fully immunized. The ordinance, which includes doctors, nurses, technicians, janitors and other workers in hospitals, dialysis centers, doctor’s offices, nursing homes, drug treatment centers and other establishments, remains one of the strictest in the country. Only limited medical and religious exemptions are allowed.

On Tuesday, state health officials issued a new ordinance that extended the mandate to health workers in homes, hospices, centers for the disabled and centers for the elderly, but gave them given two more months to comply, until November 30.

Despite predictions that the warrant would lead to serious staff shortages, many large hospitals have told CalMatters they are confident Thursday’s deadline will not disrupt day-to-day operations. Several large hospitals – with the exception of a large supplier in San Diego – said they had only had a small number of requests for medical and religious exemptions.

However, hospitals and other health care facilities are not required to routinely report their employees’ immunization or exemption data to the state or the public. They need only report it “on request” to the California Department of Public Health. These data, if they exist, have not been made public. At the federal level, disclosure of employee vaccination rates remains optional.

“We anticipate that a relatively small number of employees will choose to terminate their employment because they have not been vaccinated.”

Dr Jeff Smith, CEDARS-Sinai Medical Center

Kaiser, who issued a company-wide vaccination requirement three days before the California ordinance was announced in early August, increased employee vaccination by 12% over the next six weeks, said said spokesperson Marc Brown. About 90% of Kaiser’s employees were fully vaccinated two weeks ago, he said.

“As the healthcare provider responsible for the care of over 12.4 million people, we have a moral obligation to do everything possible to stop this virus,” Brown said. “One of the things we can do as a health care provider is to make sure our employees and physicians are immunized. “

Stanford Health Care in Palo Alto, UC Davis Medical Center in Sacramento, and Keck Medicine and Cedars-Sinai Medical Center in Los Angeles reported that less than 6% of staff were still unvaccinated.

“We anticipate that it will be a relatively small number of employees who choose to terminate their employment due to not being vaccinated,” said Dr. Jeff Smith, executive vice president of hospital operations at Cedars Sinai. He said 97% are vaccinated and less than 2% have requested waivers.

Lack of compliance data

A lack of state data, however, makes it difficult to determine exactly how health facilities are doing, how many exemptions have been granted, or whether certain regions or sectors of workers are lagging behind.

Kaiser Permanente, the state’s largest healthcare provider, said there were “small regional differences” in employee vaccination rates at its hospitals, but declined to say where.

Dignity Health, which operates facilities throughout the Central Valley and in many rural areas of the state, did not specify how many employees have been vaccinated, only that the “vast majority” are already vaccinated or are planning to do so. ‘be before Thursday.

About 90% of Kaiser Permanente employees were fully vaccinated two weeks ago, photo by Anne Wernikoff for CalMatters

At USC’s Keck Medicine, 92% of employees are fully vaccinated and only five people have not been vaccinated or have not requested religious or medical exemptions, according to Felipe Osorno, executive director of operations.

Sutter Health – one of the largest providers in Northern California – and UCLA Health in Southern California did not respond to inquiries about fulfilling the mandate.

Some healthcare facilities said the state ordinance, which sparked internal education campaigns, made a big difference in encouraging hesitant employees to get vaccinated.

As of February, only 75% of California nurses had been vaccinated and 22% did not intend to be vaccinated, according to a survey by the American Nursing Foundation. The California Nurses Association supported the vaccination but did not approve the mandate, saying “all eligible people should be vaccinated, while respecting the need for medical and religious accommodation.”

Nurses are among the most vaccinated groups at Stanford Health, according to David Jones, director of human resources. “We haven’t seen this problem with our nurses. Our nurses are one of our most vaccinated groups with approximately 97% ”compared to the rate of 95% for all staff.

Nurses’ opposition to vaccination warrants has become a lightning rod throughout the pandemic, with some people staging protests in California and across the country. In New York City, nearly 3,000 workers rushed to get vaccinated a week before the state’s Monday deadline, but lawsuits and worker protests have shaken health systems, forcing officials to State to prepare to bring in the National Guard and other emergency personnel if too many people remain non-compliant.

“Previously, we have seen a drop in vaccination rates among cleaning and cafeteria staff, which significantly overlaps the Latino and Black populations. “

Felipe Osorno, medicine keck

State and federal immunization mandates have helped close the gap in immunization disparities among Keck’s health workers, which mirror those of the general population, Osorno said. About 99% of Keck’s doctors are vaccinated, but other groups of employees are less likely to be fully compliant.

“Previously, we have seen a drop in vaccination rates among cleaning and cafeteria staff, which significantly overlaps the Latino and Black populations,” Osorno said.

Statewide, 29.7% of Latinos are vaccinated against 39.4% of the eligible population. Among African Americans, 5.7% are eligible for the vaccine but only 4.2% have been vaccinated, according to state data.

“This is for me one of the saddest statistics to come out of the pandemic – the continuing disparity in immunization between blacks and Latinos,” Osorno said. “Being a Latino myself is horribly painful.

Education campaigns and one-on-one conversations with Keck employees concerned about side effects and other issues have helped increase the cleaning staff vaccination rate from 25 to 80 percent.

The state order does not apply to dental offices, although they must comply with a previous order that allows employees to undergo regular COVID-19 testing in lieu of vaccination, California Dental said. Association.

Recall shots likely won’t affect the warrant – for now

The state deadline comes a week after the federal government authorized Pfizer booster injections for those working in high-risk settings, including healthcare.

Although the CDC has indicated it will not yet change its definition of “fully vaccinated” to include three injections instead of two, California agencies are monitoring federal recommendations and have released a nationwide vaccination plan. State, Health and Human Services Secretary Dr Mark Ghaly said last week. .

“We are preparing and examining what this will mean for the 2.5 million healthcare workers in California and examining how it affects the immunization requirements for so many of these people,” Ghaly said.

At this time, there are no plans to adjust the statewide vaccination order, according to the California Department of Public Health, especially since those who received the Moderna or Johnson and Johnson are not eligible for a recall.

“All we’ve heard so far is that boosters would probably be optional,” Osorno said.

Pockets of opposition remain

In parts of the state where masking and vaccination protests are rampant, hundreds of employees have submitted requests for exemptions. In San Diego, 700 Sharp HealthCare employees have requested religious waivers and 100 have requested medical waivers, according to COO Brett McClain. Two weeks ago, about 88% of Sharp’s staff were fully immunized. Later, at Scripps Health, 571 employees requested waivers and 93% are fully or partially vaccinated, a spokesperson told CalMatters.

“Almost 90% of (requests) currently are generally in the direction of someone who identifies as a Christian … The exemption requests also indicated religious opposition to the use of stem cells in the creation of vaccines. , although the COVID-19 vaccine does not contain stem cells.

There is enough reluctance to worry Sharp administrators faced with increasing patient numbers and shrinking staff due to pandemic burnout. The turnover of some nursing departments has doubled in the past six months, McClain said.

“My concern is that we have about 20,000 employees and we still have about 1,000 employees who have not been vaccinated and have not requested an exemption,” McClain said. “We’re running out of time for sure. ”

These employees have said they will leave the state or leave health care, he said, but President Joe Biden’s broad mandate to vaccinate large employers and federal contractors will make it increasingly difficult. for the unvaccinated to find other employment.

“It will be almost every employer in the country,” Osorno said with Keck Medicine. “It’s not just us. We believe a lot in vaccination, but it is something that (workers) are going to be faced with everywhere. “

Our healthcare reporting is supported by the California Health Care Foundation, the Blue Shield of California Foundation, and the California Endowment.


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