Tuesday is the deadline for many Triangle hospital workers to be vaccinated. Now what?
Tens of thousands of workers at two of the Triangle’s big hospital systems were given until Tuesday to get vaccinated against COVID-19 or get an approved exemption.
As of Monday, hundreds at Duke Health and UNC Health still had neither.
Those who don’t make Tuesday’s deadline will trigger a process that could result in their being let go, at a time when hospitals are desperate to keep as many health care workers as they can.
“We don’t want to lose a single person; that’s never been our goal,” said Dr. Matt Ewend, chief clinical officer at UNC Health. “But we also don’t want to move away from what we think is this important mandate for the health of our patients and our coworkers.”
Tuesday’s deadline applies to 10 of UNC’s 12 hospitals across the state, including Rex in Raleigh and the Medical Center in Chapel Hill. On Monday, nearly 95% of 29,000 workers were in compliance with the mandate. Those who don’t make it will be put on probation and given six weeks to either get fully vaccinated or an approved exemption.
The consequences for Duke employees who don’t comply are swifter. They will be put on unpaid leave and given up to seven days to either get their first shot of the Pfizer or Moderna vaccine or the single shot Johnson & Johnson vaccine, said Katie Galbraith, president of Duke Regional Hospital, one of three Duke hospitals in the Triangle.
Duke said Monday that nearly 97% of 23,000 health system employees had been vaccinated or received an exemption, and that more than half of those remaining had received the first of two doses. Also still pending are people on family or medical leave and new employees, who have up to six additional weeks to fulfill the requirement.
“We feel actually pretty good about where we are,” Galbraith said. “The goal in all of this is not to lose anyone and to keep everyone safe. We want to keep our team members safe, we want to keep our patients safe and our community safe.”
The Triangle’s third big hospital system, WakeMed, also will require its employees to get vaccinated for COVID-19, but not until Nov. 12.
Vaccine wasn’t required until summer
Hospital workers were among the first eligible to receive COVID-19 vaccines when they became available in December 2020. But hospitals in North Carolina did not require their workers to get them. Most said they did not want to force people to receive a vaccine that the Food and Drug Administration had allowed only on an emergency basis.
But with the more contagious delta variant of the coronavirus fueling a second wave of COVID-19 cases this summer, hospitals reconsidered. On July 22, UNC, Duke and several other hospitals across North Carolina announced mandatory vaccination policies, as the trade group that represents hospitals in the state came out in favor of required vaccination for all health care workers.
UNC and Duke estimate that 70% or more of their employees were already vaccinated when they announced the mandates. But until then, hospitals didn’t track who had been vaccinated and had to ask workers to provide proof.
The rest either had to get vaccinated or apply for an exemption. UNC says about 5% of employees have requested exemptions in one of two categories: Medical and religious. At Duke, it’s about 6%.
Medical exemptions can vary but have been granted to people who had an allergic reaction to the first dose of vaccine. Both hospitals have also allowed pregnant women to put off getting the vaccine until after they give birth, though doctors now recommend expectant mothers get vaccinated.
The more common exemption requests are for religious reasons. Both hospital systems already had teams in place to handle requests for religious exemptions from the annual flu vaccine, which hospitals require annually. Those teams took on the COVID-19 applications.
Ewend and Galbraith said an exemption must be based on a long-standing, deeply-held religious belief. It also must be based in fact.
“It had to be scientifically and factually correct,” Ewend said. “We respect people’s right to religious freedom, but a religious belief that’s based on a scientific inaccuracy wouldn’t pass the muster.”
UNC had received 1,259 religious requests as of Thursday and had approved 859, Ewend said. A small number were still pending, he said, and the rest had been denied.
‘We will lose some folks’
Hospitals are bracing for the departure of employees who would rather lose their job than get vaccinated against COVID-19. Already, 60 workers have resigned from UNC, citing the vaccination requirement, according to spokesman Alan Wolf. As of Monday, about 1,400 employees still had not been vaccinated or obtained an exemption.
“I think we would be naive as an organization with 29,000 people to get vaccinated to think that we will get every single person vaccinated and that we won’t lose folks,” Ewend said. “I don’t think it’s crazy to say that we know we will lose some folks.”
Tom Williams, president and CEO of Johnston Health, said he’s worried about losing employees at the UNC hospitals in Clayton and Smithfield, which have been pushed to capacity this summer. But he said if the mandate saves lives, it will be worth it and that the hospitals will adjust.
“I think it’s our responsibility, and I think when you sign up to go into health care, you’re held to a higher standard, and this is a part of that higher standard,” Williams said. “We’ve got to take care of patients, and we’ve got to take care of each other”
Others note that hospitals in other states that required vaccination earlier in the year ended up losing very few workers. About 150 of the 25,000 people who worked for Houston Methodist health care system in Texas were either fired or resigned because they didn’t comply with a vaccination mandate. At Medical University of South Carolina in Charleston, only five of about 17,000 employees were let go.
“We believe we’re going to get to that point, too,” said Mary Ann Fuchs, vice president of patient care at Duke University Health System. “It’s just taking a little extra time and effort and education for our staff to help them understand the benefits of being vaccinated.”
Mandates becoming more common
Hospitals are hardly alone in requiring employees to get vaccinated. Several companies in the Triangle, including Citrix, Credit Suisse, IBM, Red Hat and SAS, have told workers they must be vaccinated before they come in to the office. Nationwide, companies such as Tyson Foods, United Airlines and Disney have adopted mandates as well.
President Joe Biden announced this month that the federal government would require employers with 100 or more workers to either mandate vaccinations or require weekly testing, though the details have not been disclosed.
Each new company or organization that requires the vaccine helps the hospitals make the case that getting vaccinated in the right thing to do, Ewend said.
Other factors have helped as well. The FDA’s approval of the Pfizer vaccine last month may have won over some who were put off by the emergency use authorization. And the severity of this summer’s surge in hospitalizations, overwhelmingly among unvaccinated people, has also been persuasive.
“For the folks who work in a health care system, they see how stressed and strained we are,” Ewend said. “You are living with it every minute you’re at work, and you’re seeing the impact of folks who are unvaccinated. And so I think that story has told itself to our workforce.”
But the mandate, and the corresponding efforts to answer each employee’s questions and help them get comfortable with vaccination, have been key, said Galbraith.
“Certainly you would like to get there without making it a condition of employment,” she said. “But if we look at where we are, from 75% to over 95% now and really closing in on that gap, absolutely it has helped.”
This story was originally published September 20, 2021 at 2:16 PM.
