Many healthcare workers at hospitals and nursing homes are choosing not to stay up to date with their COVID-19 vaccinations now that mandates are no longer in effect, especially in certain parts of the country, according to a CDC study published Nov 10.
The finding is from a CDC analysis of approximately 7.7 million healthcare personnel working in 4,057 acute care hospitals and approximately 1.6 million healthcare personnel working at 13,794 nursing homes during the 2022–23 influenza season (October 1, 2022, to March 31, 2023).
The analysis findings show that up-to-date COVID-19 vaccination coverage was 17.2% overall among the hospital workers. Coverage was highest in the Pacific region (28.9%) and lowest in the Mountain region (9.1%). There were no substantial differences by staff member type.
Among the workers in nursing homes, up-to-date COVID-19 vaccination coverage was 22.8% overall, according to the survey. Up-to-date COVID-19 vaccination coverage was highest among nonemployee licensed practitioners (28.2%) and those working in the Pacific region (40.7%). It was lowest among employees (22.4%) and those working in the South (17.5%).
"There is a need to promote evidence-based strategies to improve vaccination coverage among [healthcare personnel]," the CDC concluded. "Tailored strategies might also be useful to reach all HCP with recommended vaccines and protect them and their patients from vaccine-preventable respiratory diseases."
The CDC said CMS' reporting requirements for nursing homes may have resulted in higher coverage among healthcare personnel in those facilities. The CDC said it also worked with nursing homes to facilitate access to vaccination for patients and staff, which might have also improved coverage.
The CDC noted several limitations related to the findings, including that its report includes data reported by facilities on behalf of workers, which could have resulted in underestimates of vaccination acquired outside the facility, and that vaccination coverage could not be stratified by recent history of SARS-CoV-2 infection.
The CDC survey results follow the federal government's formal withdrawal of the COVID-19 vaccine mandate for employees of CMS-certified healthcare facilities.
The federal mandate was enacted in November 2021. Hospitals and health systems subsequently continued to roll out requirements for their workers, with some firing employees for noncompliance.
In May, HHS announced it would drop the federal COVID-19 vaccine rule, and the Biden administration issued an 82-page final rule formalizing the mandate's end.
The new final rule moves to treat COVID-19, from an oversight standpoint, more like the flu. In the new final rule, the federal government notes that hospitals and health systems may still instate their own COVID-19 vaccination requirements for workers, consistent with other federal, state and local laws. Hospitals and health systems have varied approaches to their own rules, with some organizations not requiring employees to receive the updated COVID-19 vaccine.