Employee vaccination status: To badge or not to badge — health system leaders share thoughts

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Throughout the COVID-19 pandemic, health systems have evaluated policies and guidelines for employees regarding stickers on badges, or badge reels, to identify a worker's vaccination status. Some organizations provide this as an option for workers, while others don't. Here, healthcare leaders discuss their strategies and reasons for their decision.

Optional stickers

At Nebraska Medicine, a two-hospital system based in Omaha, more than 9,000 employees have the option of wearing a sticker on their badge indicating they've been vaccinated against COVID-19. 

The sticker became optional in July because system leaders wanted to allow vaccinated employees more freedom regarding masking in certain situations, said Michael Ash, MD, executive vice president and chief transformation officer for Nebraska Medicine.

"At that time, we had loosened our masking requirement in nonpatient care areas. If you were in an area that had cubicles or small meetings in your office with five people or less based on size of space, you could go without a mask, [if vaccinated]," Dr. Ash said. "The sticker goes right on the badge — and it's optional — but it bought you some freedom in the context of you could go without masks in those nonclinical areas."

He said workers also reported more patients and patient families were expecting to know the vaccination status of caregivers, and a lot of staff wanted to celebrate that they were vaccinated, regardless of the system's masking requirements. Stickers were mailed to vaccinated employees' homes in July, and unvaccinated employees received a letter encouraging vaccination.

Since the mailing of the stickers, Nebraska Medicine has announced a COVID-19 vaccine mandate requiring that employees receive their final dose by Oct. 8, with exceptions for medical and religious reasons.

As of Sept. 7, more than 90 percent of Nebraska Medicine employees were fully vaccinated. Those who do not receive their final dose by Oct. 8 or obtain an exemption by that deadline will be suspended for two weeks. If they still have not complied by Oct. 22, they must resign or face termination. 

Even with the mandate, the sticker remains an option at Nebraska Medicine. 

At UF Health Jacksonville (Fla.), vaccinated employees also have the option of wearing a sticker on their ID badges. The sticker says, "Haley hero," in honor of Leon Haley Jr., MD, who unexpectedly died in a jet ski accident July 24 at age 56. Dr. Haley had been CEO of UF Health Jacksonville since 2018 and was instated as dean of the University of Florida College of Medicine-Jacksonville in 2017. 

Badge reels 

Marshfield (Wis.) Clinic Health System gives employees the option of identifying vaccination status via badge reels.

The nine-hospital system, which has more than 12,000 employees, in July started offering black ID badge reels as an option for employees to indicate they are fully vaccinated. As of Aug. 11, About 8,000 Marshfield employees had requested the black ID badge reels, although some employees may not have asked for the reels because they use clips or other devices to display their name badges, said health system spokesperson Jeff Starck. 

"All employees are required to be vaccinated by Nov. 15, coinciding with our annual flu vaccine requirement," Mr. Starck told Becker's. "The name badge program was initiated before we made the decision to require the vaccine. At the time when badges were available, the numbers of cases and hospitalizations were decreasing, allowing us to loosen some of our guidelines. In particular, giving the opportunity for employees to meet in-person if they chose to wear a badge indicating they were vaccinated. Since that time and with COVID-19 surging across Wisconsin, we've had to tighten our guidelines, recommending most, if not all meetings, be virtual to avoid large group contact."

Mr. Starck said the badge reel program is still active, but with all employees required to be vaccinated, it may take on a different meaning as the system identifies any policies specific to employees who received a vaccine exemption. 

As of Sept. 14, about 80 percent of Marshfield employees were fully vaccinated, including more than 99 percent of physicians.   

"With the school year now started and the surge of COVID cases we're seeing in central Wisconsin, we hope our unvaccinated staff will soon begin the COVID vaccination process instead of waiting until the deadline. The required flu vaccination also will present an opportunity for unvaccinated employees to get the two vaccinations at once," said Mr. Starck.

'Assume everyone is vaccinated'

Yale New Haven (Conn.) Health has never provided stickers for employee badges to indicate COVID-19 vaccination status. 

However, the system has a vaccine mandate, requiring employees to be inoculated by Oct. 1, with limited exemptions. As of Sept. 7, about 400 of the system's 30,000 employees had been granted exemptions. 

"Our expectation is everyone is vaccinated, and everyone wears a mask in any of our healthcare facilities. That's something we will be very clear to our patients and the public about because as healthcare providers, we think it's important for our staff to be safe and provide a safe environment for patients and their families," said Tom Balcezak, MD, chief clinical officer for the system.

When considering the badge or sticker issue, Yale New Haven Health ultimately decided against it based on employee feedback, Dr. Balcezak said.

"Similarly to flu, we don't have a badge or sticker saying they got the flu shot. That's something we have talked for some time about, but between employee feedback and HR and some of the senior leadership, we thought it was not a great idea," he said. "Virtually everyone is vaccinated, so our expectation is everyone should assume everyone is vaccinated because there's going to be a testing requirement for those with an exemption. We're going to have universal masking continuing anyway. So, we weren't sure what the benefit of creating a COVID vaccine sticker or badge, what advantage there would be to it."

Dr. Balcezak said there were also concerns about rolling out stickers and badges, given the divide among certain groups about mandates.

"Even in Connecticut, which is one of top vaccinated states, there is a subsegment of population that has made this a hot-button issue. When we start pushing things like mandates, people become entrenched very quickly, and it changes the entire conversation" he explained. "We believe that adding stickers and badges will only further drive people apart. There is even a concern about weekly testing for the very few employees who received vaccine exemptions. Some are saying, 'If we need to be tested weekly then everyone should be.' So pressing additional mandates, at some point, becomes counterproductive.” 

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