As of January 2020, health care workers in New Jersey were required to be immunized against the flu, a measure public health leaders stress is particularly important during the ongoing coronavirus pandemic.
But some employees said they are frustrated that the new vaccination requirement does not allow them to opt out for religious reasons, as they have in past years, before the state passed the law designed to reduce the spread of the flu in hospitals and health care facilities.
Several hospital workers said the mandate, which only allows for medical exemptions, forces them into an unfair dilemma. “I am now at a crossroads. Do I stand for my religious beliefs or go against and give in just to keep my job?” Bayliss Perry, a hospital department secretary, said in an email to NJ Spotlight News.
A lose-lose decision
“I love my job and the people I work with (and) this has by far been the best experience working with such a great team,” Perry wrote. But the mandate “forced her to choose” between the vaccine, which she said would “violate my body and religious beliefs,” and a job that enables her to provide for her family, Perry said.
Many health care providers have offered flu shots to their staff for years and employees are encouraged to get immunized at least once a year. This year vaccines are seen as even more important for health care workers and the general public, given the continuing threat of COVID-19. The federal Centers for Disease Control and Prevention reports more than eight in 10 health care workers were vaccinated last fall, including 93% of those in hospitals.
Some of the workers who contacted NJ Spotlight News also expressed concerns about a COVID-19 vaccine, now under development, which could be available early next year. Health care workers are among the groups that federal and state leaders have suggested should be a priority for immunization once a vaccine is approved, given their role on the coronavirus front lines.
“I don’t trust it (and) I would never get it, not as a health care worker, not as an individual citizen,” hospital nurse Maria Villalonga said of a COVID-19 vaccine. Villalonga, who has worked at the same facility for nearly 30 years, said she worries that the new flu shot law will set a precedent that will also lead to coronavirus vaccine requirements.
Nothing beats vaccine, advocates argue
Public health advocates argue that vaccines are one of the most effective ways to stop the spread of disease, protecting the individual, their family and their friends and colleagues. When caring for sick patients is part of their work, it is even more important, experts note. Health care workers are at risk of exposure to a range of diseases and can also be the source of infection to others, as they were in the early COVID-19 outbreak at nursing homes in Washington state.
According to the New Jersey Immunization Network, vaccination among health care personnel can decrease patient mortality by 40% to 50% and reduce employee absences by 20% to 30%. State and hospital officials remain concerned about potential staffing shortages, should coronavirus hospitalizations rise again in the months to come.
“We were at a critical shortage of hospital employees on any given day during the COVID peak” in April, said Sandy Cayo, a nurse and vice president at the New Jersey Hospital Association, which has posted resources about the new flu vaccine law on its website. “That can be a concern if we’re getting down in the numbers (of staff) and we see the peaks we did this spring.”
Gov. Phil Murphy signed the legislation in early January that requires hospitals, long-term care facilities and other health care organizations to set up vaccination programs for their staff or ensure they could be immunized elsewhere. The health care facilities must also track and report compliance. During this time, the State House was overrun by “vaccine choice” advocates who were protesting separate legislation to eliminate religious exemptions to school vaccine policies, which eventually stalled.
Medical exemptions allowed
The flu vaccine law does permit health care workers to apply for a medical exemption, through a form the state Department of Health shared with health care providers earlier this month as part of its guidance on the new mandate. In addition, under the law those who are not immunized must wear masks and take other infection-control precautions or be reassigned away from direct patient care. The statute also allows hospitals to adopt other related policies, but does not mention religion directly; the DOH guidance is also silent on this matter.
Hackensack Meridian Health, which employs at least one of the individuals who raised concerns about the flu vaccine mandate to NJ Spotlight News, will continue to honor past requests for religious exemptions, “in order to ensure that we are meeting the needs of all team members,” spokesperson Mary Jo Layton said. Fewer than 1% of the system’s 36,000 employees were exempted last year, so the impact on staffing is slight, she said.
“If team members were granted an exemption last year, we are not requiring them to apply for it this year. The exemption remains in effect,” Layton said. The health care system is also “committed to protecting the safety and health of our patients, visitors and each other through our mandatory influenza vaccination policy,” she said.
It is not clear what other hospital systems will do, but NJHA is encouraging efforts to reduce the impact of flu — which led to 25,000 hospitalizations last winter — especially given the backdrop of the pandemic. COVID-19 shares some of the same symptoms as influenza.
“We want to make sure our hospitals and health care facilities aren’t unnecessarily overburdened with the flu this year,” said NJHA’s vice president of communications, Kerry McKean Kelly. Nearly 217,00 state residents have been diagnosed with COVID-19 since March, including well over 14,400 who have died, according to state statistics. “It just makes sense, if you can prevent a respiratory illness this winter, you should do it,” she said.
Assemblyman Herb Conaway (D-Burlington), a doctor and lead sponsor of the new flu vaccine mandate law, said requiring all health care workers to be immunized against influenza is “forward leaning with respect to patient safety.”
Religion should not guide choices
The fact that no religious exemption was included in the final draft of the legislation, “That was not an oversight,” Conaway said. Religious beliefs “should have nothing to do with decisions about vaccines,” he said.
Those seeking an exception feel otherwise, of course. Villalonga — one of five workers to contact NJ Spotlight News directly, some asking to remain anonymous — said she believes that God made her immune system strong enough to fight off common germs and protect her over time. Villalonga also called for aggressive hand washing, cleaning and mask wearing — things that are already being done to protect against COVID-19.
“How can I be forced to choose between keeping my job or violating my religious beliefs?” Villalonga wrote. “My religion gives me the spiritual foundation and virtues that make me the caring and loving nurse I am and the exceptional dedicated employee.”
While hesitant to speak publicly about their concerns or identify their employers, some of the hospital workers concerned about the flu vaccine mandate said there were dozens, if not more than 100 others, in their situation.
“I know there are a lot of employees in the health care system that feel the same, but they are afraid to speak up because this is how they survive and feed their families,” Perry said. “I know because I am one of them, but I chose to speak out for the ones that don’t have a voice.”