Religious exemptions from vaccine rules more common among public officials

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Yehyun Kim :: ctmirror.org

A protester holds a sign at the Connecticut State Capitol.

Health workers in state agencies are pushing for medical or religious exemptions from immunization warrants at a higher rate than health care workers outside of government, data shows – an imbalance that some say begs the question whether the state grants exemptions too easily.

Typically, 10-12% of healthcare workers in most executive agencies get tested for COVID after requesting an exemption, instead of getting the vaccine. By comparison, about 2% to 6% of health workers at the state’s top hospitals test for COVID after requesting exemptions instead of being vaccinated, a CT Mirror survey of nine hospital systems found.

Among the cases that have been tried, about 95% of the 200 health workers from public bodies who requested a religious exemption obtained one, and 100% of the roughly 20 people who requested a medical exemption obtained one, according to the reports. data provided to the CT Mirror by the COO’s office. In contrast, Hartford HealthCare and Yale New Haven Health said they approved about half of the religious exemption requests filed, The Mirror previously reported. Among small hospitals, Connecticut Children’s has approved about 70% of religious exemptions, while Middlesex Health has approved about 90% as of November 10.

Although the data collected represents a limited sample, the numbers raise concerns about state policies on approving religious exemptions to its vaccine tenure, said Arthur Caplan, professor of bioethics at Langone School of Medicine. New York University.

“We don’t want to speculate on our employees’ personal reasons for filing exemptions,” wrote Lora Rae Anderson, director of communications for the COO’s office.

An employee’s motivation to request an exemption is only one factor influencing the numbers. Equally important is whether the state accepts the request.

Anderson declined to say whether the data indicated a concern about the state’s exemption approval process. The Ministry of Mental Health and Addiction Services and the Ministry of Children and Families have asked him about the exemptions.

“It can be worrying that they (executive agencies) are losing staff in a tight labor market. So making it more flexible with testing options may be one way to avoid that, ”Caplan said.

The Mirror previously reported that Whiting Forensic had “serious staff shortages”.

“We haven’t lowered health standards because of potential shortages,” Anderson wrote. “Our agencies have been working on contingency plans and we continue to make public health in our workplaces a high priority.”

Testing rates higher in public health care

The most recent vaccination rates for healthcare workers by state agency are from last month. The COO’s office plans to share vaccination figures for state employees on a monthly basis, and the next data release is expected before Thanksgiving.

Most state employees must get vaccinated or agree to weekly testing to stay in compliance with Governor Ned Lamont’s COVID vaccine mandate, which went into effect on September 27. Connecticut Valley Hospital and Whiting Forensic – are under a more restrictive mandate that does not allow them to choose weekly COVID tests instead of getting vaccinated. Instead, healthcare workers must seek religious or medical exemptions from the vaccination mandate in order to follow the testing route.

Healthcare workers typically can’t do their jobs remotely, and a stricter mandate for them helps keep patients and the workplace safe, said Ted Doolittle, the state’s healthcare advocate.

Although non-health workers from government agencies could choose to test instead of vaccination and health workers from those same agencies must be approved to do so, both groups performed weekly testing at similar rates, according to the report. data released last month. In other words: health workers have to overcome more hurdles to perform a weekly test, but they were only slightly less likely than their counterparts in the same state agency to do so.

It is not known how many healthcare worker exemption requests are still pending, Anderson said. Some non-care workers in state agencies have submitted exemptions although they do not need approval to perform weekly testing. Fewer than 100 total exemption requests are pending, but Anderson could not indicate how many of them were submitted by healthcare workers.

“We plan to continue processing them as soon as possible,” she wrote. Employees awaiting a decision are running weekly tests in the meantime, implying that vaccination and non-compliance rates could rise over the next few weeks if the state rejects some pending exemption requests among workers in the city. health.

“Exemptions are reviewed by the human resources and labor relations office, and contacts with agencies and individuals will be made as necessary,” Anderson wrote.

The religious exemption request form requests a personal statement and a self-reported vaccination history. Applicants are encouraged to provide documentation of their beliefs and are required to explain why they have received vaccines in the past if this is the case. Agencies can then follow up to discuss the request and request “additional supporting documents,” the form says.

The medical exemption has more stringent requirements – it requires a medical provider to verify that an applicant’s health issues count as contraindications for the COVID-19 vaccine. Physicians, Physician Assistants and Advanced Practice Registered Nurses are permitted to complete the form.

High approval rates for religious exemptions are “indicative of being too lax, especially towards vulnerable people,” Caplan said. Even in the case of children, who tend to be less severely affected by COVID-19, children with disabilities can have much worse outcomes than those who do not, he added. In general, people have “a great vulnerability if they are institutionalized,” he said.

Although the exemption processes differ from hospital to hospital, some hospitals have requested attestations from religious leaders as part of the application process, The Mirror previously reported.

In recent weeks, the CT Mirror has requested their data from 13 hospital systems, ranging from the state’s largest, such as Hartford HealthCare and Yale New Haven, to smaller hospitals such as Bristol Health and Middlesex Health. Nine provided the Mirror with exemption data and 10 provided the Mirror with non-compliance numbers. In general, health care workers in the state are tested at higher rates than those outside of the government.

Some hospital systems still had pending requests, while others did not; Hartford HealthCare hired new staff last month and as a result some have made new applications, but the numbers are low, said Dr Ajay Kumar, clinical director of Hartford HealthCare.

All hospitals that reported non-compliance figures gave figures below 2%, while state agencies reported higher percentages of non-compliance. The combination of higher testing rates and higher non-compliance rates results in generally lower vaccination rates among health workers in state agencies compared to hospitals.

The state will not publish data at the facility level

The state plans to include aggregate exemption figures as part of its data release later this month. It will not be a question of breaking down the figures by establishment.

Unlike state acute care hospitals, public facilities like Solnit, Connecticut Valley Hospital, and Whiting Forensic are not subject to federal measures that would require healthcare providers to disclose facility-level immunization rates, according to Connecticut Hospital Association spokesperson Jill McDonald Halsey. UConn’s John Dempsey Hospital is an acute care hospital and would therefore be covered by these requirements, she added.

Advocating for the rule, policymakers argued that patients have a right to know vaccination rates to enable them to make informed choices about their medical care and level of risk. Generally speaking, the Connecticut Department of Public Health expects that hospital immunization data will eventually be made public by the federal government, wrote Chris Boyle, a spokesperson for the agency, although DPH no could not say whether state health facilities would be covered. The Centers for Medicaid and Medicare did not respond to questions.

“We are currently releasing agency-level data to ensure that our staff information remains safe and secure, including bringing our agencies with fewer than 100 staff together,” Anderson wrote in late October.

“I will always side with the patient’s right to be aware of any risk they are facing so they can make a thoughtful decision about whether they want to accept that risk,” Doolittle said.

In a July interview with the CT Mirror ahead of the state’s vaccination mandate announcement, DCF Deputy Commissioner Michael Williams estimated that 80% of Solnit staff were vaccinated, based on a voluntary self-declaration of employees. “Our healthcare workers in our facilities understand that, I think they understand it. I know that the union they are part of has also been helpful in moving this forward… So we’ve really had the success of the people taking advantage of it. vaccine, ”he said.

“We take patients and the safety of our staff very seriously, which is why progressive discipline is applied when employees do not intend to comply with a mandate for testing or vaccination, and those who are. tested positive for COVID-19 follow isolation and quarantine. protocols, ”Anderson wrote.


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