Hospitals have long required vaccines for their employees. Is the Covid vaccine different?

Dr. Kordisch receives the Covid vaccine
RN Ravin Hulin administers a Covid vaccine to Dr. Foster Kordisch, among the first physicians in Lafayette to receive it. Photo by Jamie Orillion

More than 80 nurses and hospital employees filed suits Monday against Ochsner Lafayette General and Our Lady of Lourdes, challenging the hospital systems’ vaccine requirements. The suits, which seek injunctions against both institutions, claim the hospital systems’ recent COVID-19 vaccination requirements unlawfully violate employees’ individual rights “to decide whether to obtain or reject medical treatment” as enshrined in Louisiana’s constitution. 

Late-breaking Thursday afternoon, a district court judge threw out the suit against OLG, saying it is a private employer and that the mandate is neither unlawful nor unconstitutional. The Lourdes suit will be heard Friday. 

Similar challenges on federal civil liberties claims have failed in other parts of the country, but at the heart of the suits is the contention that with Covid vaccines, hospitals have done something new and overreached on civil liberties. 

Ochsner and Lourdes have vigorously defended their mandates, arguing they are a commonsense means of protecting their staff and the public. It’s a familiar public health argument. Vaccine mandates were issued in the early 19th century to fight smallpox, and were met with resistance then, too. 

“We have always had mandates in high-risk environments,” says Dr. Britni Hebert, a Lourdes affiliated physician and vaccine advocate. 

Hebert believes these requirements help hospitals ensure they can continue to provide care to those who need it in Acadiana, especially given the facilities’ tremendous backlog of postponed surgeries. Protecting hospital resources has been a common refrain throughout the pandemic. 

The Covid vaccine requirements differ from other policies on the books. At Ochsner Lafayette General, for example, all employees are encouraged to get their annual flu shot; however, if a staff member decides to forgo it, OLG spokeswoman Patricia Parks Thompson says, they can still clock in, provided they remain fully masked for the duration of their shifts. 

That’s not an option for the Covid vaccine. The COVID-19 vaccine mandates, by contrast, require all staff to be fully vaccinated — by Nov. 30 for Lourdes and Oct. 29 for Ochsner. Any employee who forgoes this vaccination and can’t provide medical or religious exemptions for it will face suspension and be barred from returning to work until they are fully vaccinated. 

Masking up isn’t enough, and that is indeed a higher bar for staff that has clearly drawn resistance. 

Both COVID-19 and the flu share much in common when it comes to symptoms: fever, cough, headache, fatigue. The two can present in individuals asymptomatically, and both are transmissible before symptoms present. 

Of course, Covid isn’t the flu. This new vaccine requirement and the consequences associated with forgoing it reflect the comparative severity of COVID-19, especially with respect to its impact on healthcare workers’ ability to stay in the fight. 

As the lawsuits contend, getting the Covid vaccine doesn’t necessarily prevent transmission. Breakthrough cases, while less common by comparison, do happen, as demonstrated by the Delta variant surge that ballooned hospitalizations until recently. 

Dr. Hebert stresses that vaccines aren’t designed to stop transmission, but to reduce individuals’ chance of contracting a virus. 

“The flu shot doesn’t keep you from transmitting the flu,” Hebert clarifies. “It reduces the risk that you will get sick in the first place, have to call out, reduce the medical resources available to your community, and [increase] the workload on your co-workers.”

A similar logic is at play behind the hospital requirements and the Covid vaccine. 

Hospital employees who contract the coronavirus remain infectious longer than those with the flu. Folks who come down with the latter tend to remain contagious for around a week, whereas people with COVID-19 can continue to infect others for anywhere from 10 to 20 days after a positive test

This translates to more sick days and staffing shortages for hospitals. At one point during the height of the latest surge, the local Ochsner hospitals reported that 139 employees were out sick with Covid in a single day, according to Patricia Thompson. Statewide, as of April, 77 healthcare workers have died of the coronavirus.

And unlike the flu, those who recover from Covid infections run the risk of suffering long-haul symptoms that could further impair their ability to provide care for their patients for months after they’re back on their feet.

Covid is also tremendously expensive to treat. A Covid infection costs the average person about four times more than being hospitalized for the flu. These costs are traceable both to the amount of time a sick person takes to stabilize enough to get discharged and the kind of treatment they require while admitted. For the flu, treatment comes down mostly to IV fluids; for Covid patients, the medical staff and equipment, like ventilators, required to treat infection gets expensive fast.

The flu costs our country around $10.4 billion annually in medical expenses. By contrast, the American Hospital Association calculated a $206 billion dollar loss for U.S. hospitals and health systems in the first four months of the pandemic alone.

These disparities in impact are reflected in both Ochsner’s and Our Lady of Lourdes’ new policies on the Covid vaccine. In a release following the suit’s filing, Ochsner Lafayette General says it “stand[s] firmly behind the science and data that demonstrates the safety and efficacy of COVID-19 vaccination.” 

They also note that their mandates conform to the latest federal guidance requiring all facilities that accept Medicaid and Medicare to mandate employee vaccination against COVID-19.

So far, it doesn’t appear the mandates have caused major walkouts. Last week, Ochsner Health — the largest healthcare system in the state — reported 81% of its 30,000 employees were vaccinated and just 150 to 200 had requested exemptions.

Historically, vaccine mandates have been shown to work. Health researchers attribute requirements to rising rates of vaccinations among school kids and all but eliminating the spread of childhood diseases like measles. 

And that’s why they’ve become common public health tools. 

“Whether that be in the healthcare setting, or living in a dorm in a college setting,” Hebert says. “There have always been vaccine mandates, because what is good for the person is good for the community.”