Maryland hospital workers are now largely vaccinated, even if many COVID patients are not

The University of Maryland Medical System, the state’s largest hospital network, announced Friday that 98% of its doctors and other clinical workers had abided by system and state mandates to get vaccinated against COVID-19 or receive an exemption.

Officials considered that “significant progress,” along with the vaccination of 96% of the staff of roughly 29,000 in the extended system, including physician offices and urgent care centers.

Other hospital systems said they, too, have made big gains in vaccine coverage among workers, including Johns Hopkins Medicine and LifeBridge Health.

All Maryland hospitals agreed in principle in June to require the vaccination of workers, though on different timelines. Then Gov. Larry Hogan ordered that hospital workers get at least one shot by Sept. 1 or be tested regularly.

Some systems, such as the University of Maryland’s, set an Oct. 1 deadline when they would drop the option of testing. Employees who did not get a shot or an exemption on medical or religious grounds are now on unpaid leave and have 30 days to comply or resign.

Across the Maryland system, the number of those still not complying exceeds 1,100 people, and the total number refusing in all hospitals could be much higher.

But industry officials believe the number represents a tiny fraction of full-time hospital workers in the state (about 107,000) and the far larger workforce that staffs related doctors’ offices, urgent care centers and other facilities.

The University of Maryland Medical System was the first to publicly report a rate of compliance.

“In health care, keeping our patients and colleagues as safe as possible is our first and highest responsibility, and the overwhelming body of scientific evidence tells us that vaccines are one of the most effective tools we have to prevent infection, hospitalization and death from COVID-19,” said Dr. Mohan Suntha, the system’s president and CEO.

“Over the next 30 days, we will work with those unvaccinated team members who are now on administrative leave to get them vaccinated and back to work as soon as possible,” he added.

The high degree of vaccination uptake stands in stark contrast to the patients in the hospitals with COVID-19, who are overwhelmingly unvaccinated. There were 776 people hospitalized Friday, many times the number from earlier this summer, but below a peak in January of 1,952.

About 64.6% of the U.S. population and 70.3% of Maryland residents have been at least partially vaccinated.

State and hospital officials made a major push to encourage vaccinations among health care workers in Maryland, including those in nursing homes. That’s where the most COVID-19 deaths were recorded initially.

Nursing facilities, which also fall under Hogan’s vaccine order, had an average vaccination rate of 79% before the mandate. Most facilities have made gains, said Joe DeMattos, president and CEO of the Health Facilities Association of Maryland, which represents many nursing facilities.

He said the vaccination rate was 86% at 218 of 227 facilities, with uptake slower in smaller, more rural centers.

The Maryland Department of Health has taken to announcing every week which facilities have the highest and lowest rates, and as of Monday, there were three that have half or fewer of their staffs vaccinated. The department says it’s working on a similar list of hospital vaccination rates.

The shots protect not just vulnerable patients and residents, but the health care workers putting themselves in harm’s way to care for those infected. Many sought vaccinations in December 2020, when health care workers were among the first to be offered vaccines. More did so during the nine months since, but holdouts remain.

Subsequently, mandates have become common on university campuses, in business offices and in health care settings, with the backing of many public health experts.

At least 14 Maryland colleges and universities required students and many employees to be vaccinated before the fall semester. School officials say the majority had complied.

There have been legal challenges in Maryland and elsewhere, but mandates for vaccines, against the influenza virus for example, have been largely held up by courts and widely adopted in school, health care and other settings. Anecdotal reports in the media from several states show that such requirements are pushing more people to get vaccinated.

More than 214 million Americans have been given at least one dose of COVID-19 vaccine with side effects that are normally mild and not long-lasting, compared to the effects of catching the coronavirus. Deaths in the country from COVID-19 area are approaching 700,000 after more than 43 million infections.

Some have argued that the COVID-19 vaccines are different because they are new, and until recently not fully approved by the U.S. Food and Drug Administration. But public health experts say the COVID-19 vaccine has been shown to be highly safe and effective.

Dr. Lisa Maragakis, senior director of infection prevention for the Johns Hopkins Health System, said there have been extensive efforts to educate health workers and others about the safety of the COVID-19 vaccine.

And though Johns Hopkins also was having success in vaccinating staff, she said she supports mandates to increase uptake even more — just ask officials did with the influenza vaccine.

“We have the experience of knowing that we did everything we could to answer questions, cajole, provide the vaccine for free, make it widely available, and we only got so far,” she said.

“We know from influenza that we got to 80%, maybe 85%, but when it was mandated, you’re really insuring everyone is vaccinated unless you get an exception,” she said. “We’re taking the same approach with the COVID vaccine and letting the science guide us.”

Johns Hopkins hasn’t said yet exactly what its COVID-19 vaccine compliance rate is, though it also dropped the option for workers to be tested instead of getting a shot. MedStar Health, another large hospital system in the state, also has not revealed a compliance rate.

Maragakis said there are few medical reasons to avoid the vaccine, with the biggest being an allergy to a vaccine component.

At LifeBridge Health, which operates Sinai and several other hospitals and many other facilities, vaccinated employees and those with exemptions make up more than 94% of the staff, spokeswoman Sharon Boston said. System leaders are working with the remaining 5% to get them vaccinated and “have not announced plans” for those without exemptions, she said.

Bob Atlas, president and CEO of the Maryland Hospital Association, said the number of workers out of compliance with mandates is not affecting hospital operations, though there is a general workforce shortage. He said the mandates are helping far more than hurting because they ensuring workers are on the job and not out sick or in quarantine.

He said vaccine uptake grew across the state after the mandates.

“It’s clear the mandates are working,” Atlas said. “I hear from most hospitals that their rates are in the 90s.”

He said rates are “extremely high” among physicians, nurses and other clinicians; there are more shortfalls in support staffs. Geographically, Atlas said, he knows of no outliers among the hospitals, but said the vaccination rates likely correlate with overall community vaccination rates. He also said the majority of hospitals went beyond Hogan’s order and required vaccinations without an option for a worker to undergo regular testing instead.

The hospitals are not giving up on the workers who have not complied.

Suntha, the Maryland system chief, said the uptake shows that the staff “took seriously their collective responsibilities” and largely got vaccinated.

“Now, it’s part of our collective responsibility to continue the conversation and not stand in judgment,” he said about bringing back those workers who still need vaccination. “We need to continue the dialogue about our values.”