An Arkansas healthcare CEO's 'excruciating decision' amid vaccination exemption controversy

As Conway (Ark.) Regional Health System introduced its COVID-19 vaccine mandate, officials said they noted more religious exemption requests that cited the use of fetal cell lines to develop and test the vaccines. 

What resulted was a form from Conway for employees requesting religious exemptions to confirm they do not use certain everyday medications, such as Benadryl, Sudafed and Tylenol, in alignment with their sincerely held religious beliefs. 

Here, Conway President and CEO Matt Troup discusses the attention the form has gained from the community, staff response and the latest workforce vaccination results ahead of the system's deadline.

Conway's vaccination mandate 

On Aug. 12, Conway Regional announced its COVID-19 vaccination mandate for all employees. The hospital said employees requesting a medical and/or religious exemption must complete an exemption request form, and its exemption request policy is similar to the one it has for the flu vaccine. 

Employees who do not have an exemption must have both doses of Pfizer or Moderna, or the single-dose Johnson & Johnson shot, by Oct. 8 or be suspended for three weeks. If noncompliant by Nov. 1, they will be terminated.

'Something else was going on'

"The flu vaccine is mandated. It's required, and has been at Conway for several years, so any given year may have a few religious exemptions regarding flu shot," Mr. Troup explained. "They're always pretty solid in terms of their rationale. By 'solid,' I mean they have a track record of their sincerely held belief. They don't take vaccines. They don't take supplements. Whatever it is, they can justify or validate their sincerely held belief.

"We went from two or three religious exemptions a year to 45, which told us something else was going on, and maybe they didn't understand how prevalent fetal cell use is in the testing and development of medicine, common everyday medicine. So, we wanted to make sure that staff were aware how ubiquitous this was, and secondly, to be consistent in their sincerely held belief."

The form lists 30 medications and asks employees to "truthfully acknowledge and affirm that my sincerely held religious belief is consistent and true and I do not use or will use any of the medications listed as examples or any other medication … that has used fetal cell lines in their development and/or testing."  

Few religions outright reject vaccinations, but some religious groups have raised the issue of vaccines being developed and tested on fetal cell lines, which are grown in labs based on aborted fetal cells, according to 9News, which spoke to an infectious disease expert at the University of Nebraska Medical Center in Omaha.  

"I understand why people have concerns," James Lawler, MD, the expert and a practicing Catholic, told the news station. "The bottom line is almost all the medical products we use have in some way been touched by research that's been done on fetal cell lines."

Mr. Troup said the purpose of the form is to be educational about medicines and vaccines and for employees to validate that their beliefs are sincerely held. 

Handling pushback from the community, staff 

News of the religious exemption's requirement to attest that 30 medications would not be used was widely covered in the media, garnering attention from staff members and the public. 

But pushback has come more from community members, Mr. Troup said. 

"Relatively speaking, employee response has been practically nil. More of the response has come from people in the community, some anonymous and some not. It has ranged from I'm either an abortion-loving Nazi or brilliant," he said. "It has really been very polarizing. … When we first submitted the attestation, we had about a handful of staff sign it, send it back. There were a few folks who expressed some concerns, questions, and gave us some feedback. ...Negative feedback was coming from the general community of people. Then other people from all over the country started inquiring about it."

Mr. Troup said staff morale and engagement are important for Conway, so the system focused on hearing workers' concerns and decided to grant a provisional exemption. 

This means workers requesting a religious exemption who don't sign the form would be approved but might be asked to sign the form later.  

He said several employees seeking religious exemptions have signed the form, and Conway may not be able to accommodate those who don't sign at some point.

"For many staff, we said, 'You have a fetal cell issue, religious issue, so if you don't sign that form, what we're going to say is we're granting a provisional exemption, and if you come back, or if we need to come back at some point in the future and validate your sincerely held belief, we may do that, we may not," said Mr. Troup. 

"What we found is that among a lot of staff, the issue was about concern with the vaccine, which is vaccine hesitancy, for whatever reason. I would note this is a minority of the total population. We have about 45 fetal cell exemption requests out of almost 1,800 employees. I consider that a really small number in the grand scheme of things," he said.

Mr. Troup said he understands the public interest in the system's form, but people should also know a majority of Conway workers have been excited about and accepting of the vaccine. 

"The overwhelming majority of them are supporters of this vaccine and think it's doing a lot of good for our community and for our patients," he said. 

"This was an excruciating decision to make, to make it mandatory, but we did it because we felt like it was the right thing to do, even amid internal debate about should we do it, are we going to lose staff and be able to continue operations?" he said. "I'm very proud of the fact that at the end of the day I can account for over 97 percent of our team being vaccinated or exempted."

As of Sept. 27, more than 92 percent of Conway employees were fully or partially vaccinated. Less than 5 percent had medical or religious exemptions. 

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