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End of the Injection Mandate: Ramifications for Hospitals

June 7, 2023

It is safe to assume that most people do not have a positive impression of the word “mandate.” The very concept is anathema to the average American as it runs counter to our revolutionary spirit and the sensibilities of our founding document. We assert that we are a free people, living in “the land of the free,” and so to be told that we are under some sort of mandate is akin to feeling forced against our will. There is something visceral in our reaction to the word.

Back in 2021, researchers at Harvard Business School seemed to agree with the above sentiment, writing the following:

Mandates feel like a violation of autonomy, which is one of the five most important intrinsic drivers of threat and reward in the brain. Autonomy is a feeling of being in control and having a choice. When we have choices, we experience natural rewards of feeling positive. Research shows that even affording a little autonomy can go a long way: When employees at one company were given the opportunity to choose how to decorate their workspaces, their productivity increased up to 25 percent. On the flip side, when we perceive choices being taken away, we feel stronger reactions of frustration all the way to anger, which can significantly diminish our ability to focus, not to mention collaborate.

It is, therefore, no wonder that a certain segment of the population recoiled back in 2020 upon being told that they were under a federal mandate to submit to a certain medical procedure or risk losing their livelihood.

A Sore Spot

There is no doubt that one of the major contributors to the ongoing nurse shortage crisis being felt by many U.S. hospitals is the federal mandate, issued under the Biden Administration, that requires all healthcare workers within facilities that participate with Medicare or Medicaid—which accounts for nearly every acute care hospital in the country—to be injected with substances that include controversial mRNA technology. Lawsuits from concerned workers who felt the mandate violated their personal rights, beliefs, conscience, science, etc., reached the U.S. Supreme Court. However, in a 5-to-4 decision last year, the federal mandate was upheld. The impact of this decision, no doubt, caused perhaps thousands of nurses to leave the profession.

Last July, the American Bar Association (ABA) wrote an article in which they cited a survey conducted by the American Nurses Association (ANA) in late 2021. The ANA represents 4.2 million nurses, and the survey of their membership revealed the following:

  • Though 81 percent said they were comfortable getting the vaccine, only 59 percent said they supported the vaccine mandate.
  • Two-thirds (66 percent) said that Food and Drug Administration (FDA) approval of the vaccines would not change their minds.
  • 58 percent were not certain of the vaccine’s immunity and effectiveness.
  • 84 percent of those not vaccinated declined because they essentially questioned the safety of the injection.

While we may never know how many nurses left their hospital positions solely due to the injection mandate, their departure certainly contributed to a lack of available nurses in many of America’s first-line facilities. The good news is that the underlying cause of their resignations or terminations looks to be going away.

Lifting of the Mandate

The Washington Examiner, in addition to other news outlets, is reporting that the Biden Administration is lifting the COVID injection requirements two years after enacting them. The mandate, which affected some 10.4 million workers in the U.S., will end later this summer. The White House published an official statement on May 1 ordering the end of COVID-related injection mandates for federal workers, effective May 11—the last day of the public health emergency (PHE). That same release stated that rules would later be promulgated detailing the date and circumstances for the ending of the mandate related to health workers in Medicare and Medicaid facilities. Those rules have now been made available.

On May 31, the Centers for Medicare and Medicaid Services (CMS) issued a pre-published version of its 82-page final rule, which sets forth the timeline for the ending of the injection mandate. The final rule was officially published in the Federal Register on June 5. The rule would go into effect 60 days later. The rule states that the government would continue to rely on data reporting to monitor the virus’ evolution and effect on residents and staff.

The American Hospital Association (AHA) released the following analysis of the final rule:

The rule withdrew the COVID-19 health care staff vaccination requirements including removing the requirement for COVID-19 vaccination policies and procedures for health care staff. CMS’ quality measures assessing the proportion of health care workers who are vaccinated for COVID-19 remain in place.

The question now becomes: how will the lifting of the mandate impact the nurse shortage currently affecting many of our nation’s hospitals? Will a significant percentage of nurses who left their positions due to the mandate consider returning to duty this August? If so, hospitals may find themselves in better shape from a staffing perspective in the months ahead.

With best wishes,

Chris Martin
Senior Vice President—BPO

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