Aging Services Leaders Increasingly Join Call For COVID-19 Vaccine Mandates

Senior care advocacy group LeadingAge on Monday became the latest organization to call for vaccine mandates among long-term care providers, encouraging its members to make the shots a condition of employment.

The push comes as COVID-19 cases rise, linked to the delta variant and lagging vaccination rates among nursing home workers.

Roughly 83% of new U.S. COVID cases are delta variant infections — states have seen daily cases surge more than 25% the past two weeks, compared to the previous two-week period, according to an NBC News report.

Meanwhile, the national rate of nursing home staff vaccination is 61.51%, according to the Centers for Medicare & Medicaid Services (CMS).

“As COVID-19 variants emerge and proliferate, we can start saving more lives today by ensuring staff are fully vaccinated,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement. “By mandating these highly effective vaccines, they will be doing everything possible to deliver safe, quality care to the older adults and others they serve.”

Increasing Mandate Pressure

The Society for Post-Acute and Long-Term Care Medicine (AMDA), along with the American Hospital Association (AHA), made similar calls to mandate the vaccine among health care workers.

Public health agencies will continue to decide what the appropriate course of action should be based on local case numbers.

“It’s interesting, because even in the states that have prohibition against vaccine passports, as they’re referred to, or the states in which they’ve eliminated mask mandates, there’s still an understanding that the health care setting is different,” said Sarah Swank, counsel with Nixon Peabody LLP’s Health Care practice and former senior in-house counsel for two national health care systems. “Public health officials need to make decisions about what’s safe in those settings.”

California, for one, on Monday announced it is requiring proof of COVID-19 vaccination, or weekly testing, for state and health care employees, according to an Associated Press report.

The Department of Veterans Affairs became the first federal agency to mandate vaccines for its frontline health care workers on the same day.

The private sector is feeling the vaccine mandate push too, with public figures like New York City Mayor Bill De Blasio urging employers to “go as far as you can go right now” in order to get staff vaccinated.

“Private entities have the right to make a lot of choices. They have a lot of freedom, they can set their own rules. Each private sector employer needs to do what they believe is right, but I would strongly urge a vaccination mandate, whenever possible, or as close to it as possible,” De Blasio told reporters during a press briefing Monday. “At minimum, requiring all your employees to get vaccinated or to do weekly testing.”

New York City is similarly requiring that all municipal workers will be required to get vaccinated by mid-September or face weekly COVID-19 testing, according to media reports.

In addition to its standalone statement, LeadingAge also signed a separate joint statement with more than 40 other health associations calling for mandatory vaccines, citing already existing vaccine requirements for influenza, hepatitis B and pertussi.

Vaccinations as a Local Problem

Nursing home staff vaccination rates vary widely depending on each state — Hawaii has the highest vaccination rate at 85.4%, while Louisiana has the lowest, sitting at 43.17% as of July 11.

A CDC investigation of skilled nursing facilities in Mesa County, Colo., linked lagging vaccination rates in the state to an increase in COVID-19 infections and deaths, AP reported.

At one facility, 16 fully vaccinated residents became infected with COVID-19 and four died; full findings from the two-month investigation are due to be released in an upcoming Morbidity and Mortality Weekly Report published by the CDC.

Currently, 66.72% of nursing home staff in Colorado are vaccinated according to CMS data, falling somewhere in the middle compared to other states.

About 82% of residents are fully vaccinated and 67% of staff at LeadingAge member facilities are fully vaccinated. LeadingAge represents more than 5,000 nonprofit aging services providers, including nursing homes.

Mandates and the Staffing Crisis

Few operators have mandated the COVID-19 vaccine as a condition of employment, despite organizations like the Equal Employment Opportunity Commission (EEOC) saying employers can legally require the shots.

Some administrators fear a staff exodus on top of a worsening skilled nursing facility worker shortage, while a few have gone ahead to mandate the vaccine for employees.

In a June survey of 616 nursing homes conducted by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), 94% said they are experiencing a staffing shortage. Three-fourths of surveyees said their workforce challenges have magnified compared to 2020.

Still, Charlotte, N.C.-based operators Atrium Health and Novant Health on July 22 announced they would be including COVID-19 vaccination as a term of employment.

Novant even set a deadline, telling employees they need to be fully vaccinated by Sept. 15.

“With the new Delta variant being far more potent than the original virus, we view it as essential that each of our teammates receive their vaccination to protect themselves, their families and the people in their care,” Atrium Health said in a statement. “These new variants are contributing to a 200% increase in hospitalizations – and, among our patients, 99% of those hospitalized in recent weeks have been those who are unvaccinated.”

“We view this vaccine no differently than our requirement for our teammates to get an annual flu shot, as well as be vaccinated for measles, chicken pox and other infectious diseases,” Atrium added in its statement.