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Some Health Care Providers Hesitate to Issue COVID-19 Vaccine Mandates

Natalie Krebs/Iowa Public Radio News
Kari Gates, a registered nurse in Des Moines, opposes COVID-19 vaccine mandates for health care employees and said she is ready to quit her job at a hospital if she is not granted a religious exemption.

On a recent Friday afternoon, dozens of people gathered outside Broadlawns Medical Center in Des Moines. They were holding signs saying things like "freedom of choice" and "my body, my choice."

Kari Gates was one of the protest's organizers leading chants against the hospital's recently-announced vaccine mandate for its employees.

She’s a registered nurse at another large Des Moines hospital that’s requiring all employees to be vaccinated this fall. She wouldn’t say which one. But Gates said she opposes all employee mandates.

"Because, you know, medical freedom is very important. You should always be able to decide, you know, what goes into your body, what is done to your body," Gates said.

Gates said she’s applied for a religious exemption, and if she doesn’t get it, she’s ready to quit.

"I'm not stopping. I feel very strongly about this. And I know a lot of people in this group — all these people behind you — feel the same way," she said. "So hopefully hospitals think about that, because I think that they might lose a lot of employees."

As the latest wave of COVID-19 infections sweeps the state, those who are unvaccinated are now the most likely to get severely ill.

Credit Natalie Krebs/Iowa Public Radio News
People stand outside Broadlawns Medical Center in Des Moines to protest the medical center's recent COVID-19 vaccine mandate for employees, as the center reports its ICU is at capacity.

This has pushed some of the state’s major health care providers, like UnityPointMercyOne and Broadlawns, to issue vaccine mandates for employees.

But others said they can’t risk losing staff who are hesitant to take the vaccine.

"We are stressed like the other hospitals throughout the state," said Jim Kammerer, the chief administrative officer for Great Rivers Health in eastern Iowa.

Kammerer said he fears his hospitals could lose as much as a quarter of their staff, including hard to replace specialists, to facilities nearly like the University of Iowa Hospitals and Clinics, which doesn’t have a vaccine mandate. That would mean hiring expensive contract staff.

"You have to hire traveling companies and those rates, those traveling rates, what you're paying per hour for traveling nurses, is the highest I've ever seen in my 26 years," Kammerer said.

Gov. Kim Reynolds has opposed vaccine mandates, but pressure is increasing at the federal level.

Last week, President Joe Biden announced he plans to require vaccinations, or weekly testing, for all employees of companies with at least 100 people.

This comes just three weeks after Biden announced his intention to require all nursing home staff to be vaccinated nationwide.

Brent Willett, the president of the Iowa Health Care Association, which represents most of Iowa’s nursing homes, said he opposes this plan.

"There's an extraordinary amount of anxiety out there among nursing home providers because they are already in the midst of the most profound staffing shortage and crisis that the sector has ever seen," he said.

Willett said this month he asked the Biden administration to include all health care workers under the mandate so they’re unable to jump to another facility without a requirement.

He said he’s also asking for an option for employees to undergo rigorous testing instead, as well as for more resources to fund aggressive vaccine education campaigns and hire temporary workers to fill openings for staff who do quit due to the new requirements.

"Vaccine hesitancy is a very complex problem, and it requires a comprehensive suite of solutions to overcome it," Willett said.

Department of Human Services Director Kelly Garcia told the State Board of Health last week that the agency has made progress increasing vaccination rates for staff at its six state-run facilities using educational campaigns with State Medical Director Caitlin Pedati.

"What we've seen resonate best are those personal conversations, so we really tailored small group settings," Garcia said. "We asked Dr. Pedati to come and join us. We asked a union leader to come and join us to talk about why he got vaccinated, and then individuals sharing their personal story as to why."

Garcia said the department is still waiting on federal guidance as to whether its facilities will fall under the federal nursing home vaccine mandate.

But some experts said with high rates of infections and community spread overwhelming the state’s hospitals again, Iowa is at the point where mandates are necessary to stop the spread of the virus.

As of last week, just 61.4 percent of the state's 12 and older population was fully vaccinated, according to the state Department of Public Health.

"We can manage it. That's the goal, and we're not there," said Lina Tucker Reinders, the executive director of the Iowa Public Health Association. "And to get there we need more people to get vaccinated. And so if vaccine mandates are what it takes to get us there, then that's the tool we have."

Lavanya Vasudevan, an assistant professor of Family Medicine and Community Health at Duke University, said her research has shown vaccine mandates not only do work, but can even boost people’s confidence in it.

"At the very basic level vaccine mandates convey not just the importance of vaccination, they also convey confidence in the safety and efficacy of the vaccine," she said.

Vasudevan said it’s important to issue mandates now before respiratory virus season picks up in the colder weather.