July 27, 2021 -- As COVID-19 cases, hospitalizations, and deaths mount again across the country, the American Medical Association, the American Nursing Association), and 54 other medical and allied health care groups released a joint statement this week calling on “all health care and long-term care employers” to require their workers to receive the COVID-19 vaccine.

This would cover everyone in health care, Emanuel Ezekiel, MD, chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and the organizer of the joint statement, says.

That includes not only hospitals, but also doctors’ offices, ambulatory surgery centers, home care agencies, skilling nursing facilities, pharmacies, laboratories, and imaging centers, he says.

The call to get vaccinated also extends to federal and state health care facilities, including those of the military health system, TriCare, and the Department of Veterans Affairs, which today instituted a mandate for its own workers.

Last week, the American Hospital Association and other hospital groups said they supported hospitals and health systems that required their personnel to get vaccinated. Several dozen health care organizations have already done so, including some of the nation’s largest health systems.

A substantial fraction of U.S. health care workers have not yet gotten vaccinated, although how many are unvaccinated is unclear. An analysis by WebMD and Medscape Medical News estimated that 25% of hospital workers who had contact with patients were unvaccinated at the end of May.

More than 38% of nursing workers were not fully vaccinated by July 11, according to an analysis of Centers for Medicare and Medicaid Services data by LeadingAge, as reported by The Washington Post. And more than 40% of nursing home employees have not been fully vaccinated, according to the CDC.

The joint statement did not give any indication of how many employees of doctor’s practices have failed to get COVID shots. However, a recent AMA survey shows that 96% of doctors have been fully vaccinated.

Ethical Commitment

The main reason for vaccine mandates, according to the health care associations’ statement, is “the ethical commitment to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being.”

In addition, the statement noted, vaccination can protect health care workers and their families from getting COVID-19.

The statement also pointed out that many health care and long-term care organizations already require vaccinations for influenza, hepatitis B, and pertussis.

Workers who have certain medical conditions should be exempt from the vaccination mandates, the statement added.

While recognizing the “historical mistrust of health care institutions” among some health care workers, the statement said, “We must continue to address workers’ concerns, engage with marginalized populations, and work with trusted messengers to improve vaccine acceptance."

There has been some scepticism about the legality of requiring health care workers to get vaccinated as a condition of employment, partly because the FDA has not yet fully authorized any of the COVID-19 vaccines.

But in June, a federal judge turned down a legal challenge to Houston Methodist’s vaccination mandate.

“It is critical that all people in the health care workforce get vaccinated against COVID-19 for the safety of our patients and our colleagues,” Susan Bailey, MD, immediate past president of the AMA, said in a news release. “

With more than 300 million doses administered in the United States and nearly 4 billion doses administered worldwide, we know the vaccines are safe and highly effective at preventing severe illness and death from COVID-19.

"Increased vaccinations among health care personnel will not only reduce the spread of COVID-19 but also reduce the harmful toll this virus is taking within the health care workforce and those we are striving to serve.”