Hospital suspends over 100 employees for not getting COVID vaccine

Carlos Danger

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We all knew this was coming, but I really didn't think it would happen until the vaccines had received full FDA approval.

As someone who is not the least bit anti-vax (I was one of the first in line to get the COVID vaccine when it came available to me) but believes strongly in the principles of autonomy and self-determination, I really hope the lawsuit is successful.

The population which is susceptible to severe COVID is discrete and the focus should be on vaccinating them, not on forcing young healthy people to be vaccinated against their wishes.
 
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ffemt8978

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We all knew this was coming, but honestly I didn't think it would happen until the vaccines had received full FDA approval. I hope the lawsuit is successful.
Kind of what I was thinking. Mandating an experimental and emergency use vaccine as a condition of employment seems to be pushing it.
 

EpiEMS

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but believes strongly in the principles of autonomy and self-determination, I really hope the lawsuit is successful.
What about the employer's rights? How's this different from mandating flu vaccines?
Mandating an experimental and emergency use vaccine
The connotations of emergency use and experimental are really not so close to what is going on here - it's not like the vaccines aren't tested or aren't subject to rigorous study, they are just tested and produced in parallel & the study periods are a bit shorter (but at this point, they've been out for so long that the difference is meaningless)...
 

Akulahawk

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What about the employer's rights? How's this different from mandating flu vaccines?
My employer (and most that I've had) have a policy where you either wear a mask while at work during flu season OR you get that year's flu vaccine. IOW: Opt in and you don't have wear a mask, opt out (for any reason, they don't care) and you must wear a mask. What's different is in this particular case there is no "opt out" provision. Basically opting out = you're fired.
 

EpiEMS

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My employer (and most that I've had) have a policy where you either wear a mask while at work during flu season OR you get that year's flu vaccine. IOW: Opt in and you don't have wear a mask, opt out (for any reason, they don't care) and you must wear a mask. What's different is in this particular case there is no "opt out" provision. Basically opting out = you're fired.

Seems like a reasonable policy. I must say, though, given the risks of COVID to the unvaccinated - particularly health care workers regularly at risk of exposure - to be vaccinated. In this case, and indeed, much like the flu, there is a litany of compelling rationale for an employer to try to protect the employee: ensuring available staffing, protecting the employer from liability, protecting patients, etc.
 
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ffemt8978

ffemt8978

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What about the employer's rights? How's this different from mandating flu vaccines?

The connotations of emergency use and experimental are really not so close to what is going on here - it's not like the vaccines aren't tested or aren't subject to rigorous study, they are just tested and produced in parallel & the study periods are a bit shorter (but at this point, they've been out for so long that the difference is meaningless)...
The connotations of experimental and emergency use are absolutely a factor here. These vaccines have not completed a full FDA approval process, nor do we know if there will be any long term or late acting side effects.

Are you willing to let your employer mandate that you participate in an experimental or emergency use procedure in the name of the employer's rights? Think carefully before answering that, because you may find yourself being shoved down the proverbial slippery slope.

This would be no different than requiring the flu vaccine except that the COVID vaccines have not received final FDA approval yet. Then again, I've never ran across an employer who requires a flu vaccination as a condition of employment.
 
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ffemt8978

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Seems like a reasonable policy. I must say, though, given the risks of COVID to the unvaccinated - particularly health care workers regularly at risk of exposure - to be vaccinated. In this case, and indeed, much like the flu, there is a litany of compelling rationale for an employer to try to protect the employee: ensuring available staffing, protecting the employer from liability, protecting patients, etc.
"Litany of compelling rationale for an employer to try and protect the employee"

And the road to Hell is paved in good intentions.

Where do you draw the line? May an employer require you be a non-smoking, non-drinking, 4 day a week exercising, body fat percentage of less than 2%, genetically screened for minimal risks to cancer? All of these things carry risks to employer staffing availability, and all have been viewed as "the greatest threat" to a person's health at one time or another.
 

Carlos Danger

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What about the employer's rights? How's this different from mandating flu vaccines?
Well, I never agreed with mandating flu vaccines, either. And what rights of the employer are we even talking about? The right to to attempt to avoid the staffing challenges that could potentially arise as a result of some employees potentially becoming ill? If we are being honest, from the perspective of the employer, that is mainly all that this comes down to. The idea that that outweighs the autonomy and self determination of every one of their employees is pretty remarkable, IMO, and we should really consider the logical extensions of that.

The connotations of emergency use and experimental are really not so close to what is going on here - it's not like the vaccines aren't tested or aren't subject to rigorous study, they are just tested and produced in parallel & the study periods are a bit shorter (but at this point, they've been out for so long that the difference is meaningless)...
The vaccines have not completed the FDA approval process - full stop. Emergency use authorization is not the same thing. And if completing the full FDA approval process isn't really that important, then why do we require it at all for any drug that shows the promise of safety and efficacy in early trials? Why not allow individuals (or employers, in the case of your position) to assess the safety of drugs on their own using data from independent, third party testing agencies? I know that is a significant digression from the topic at hand, but I think it's a fair question. Is full FDA approval important, or not?

Getting this vaccine out into the communities quickly and encouraging VOLUNTARY USE after all preliminary investigations indicated that it was effective and safe made perfect sense when thousands of people were dying per day with no end in sight. But the COVID emergency is over in the US. New cases have been falling steadily for many weeks now, as have severe cases and fatality rates. About half of the overall population is vaccinated and another unquantified but probably quite significant percentage has developed at least some level of natural immunity. A large majority (>70%) of the elderly has been vaccinated and that number continues to rise. Putting individualism aside for a moment, I fail to see any compelling reason at this point to attempt to coerce anyone to be vaccinated against their will.

Seems like a reasonable policy. I must say, though, given the risks of COVID to the unvaccinated - particularly health care workers regularly at risk of exposure - to be vaccinated. In this case, and indeed, much like the flu, there is a litany of compelling rationale for an employer to try to protect the employee: ensuring available staffing, protecting the employer from liability, protecting patients, etc.
Again, the population most likely to be seriously affected by COVID is discrete and well defined (the elderly and those with pre-existing cardiorespiratory conditions) and a large majority of that population has already been vaccinated and is, essentially, no longer at high risk. If members of that or any other population choose to accept the risks of not being vaccinated, why is that not an OK choice?

Have we really completely discarded all respect for the ideas of individual responsibility and self ownership?

Are we really arguing that it is just to force one group (healthcare workers who would prefer not to be vaccinated) to give up their autonomy in order to try to insulate others (members of the public who would prefer not to be vaccinated) from the potential consequences of their decisions as they exercise their own autonomy?

How is an employer liable for the personal decisions of one of their employees? If a long-time employee develops complications from smoking, would anyone consider it acceptable for them to hold their employer liable for failing to have a no smoking policy? If not, why would we hold an employer liable in the case that an employee gets COVID after choosing not to be vaccinated?

Would it really not be better to just let everyone make their own decisions on this? I think it would. I think it would not only be more just, but also simpler and easier to allow everyone to make their own decisions about their own healthcare, just like we've always been taught we should.

Education is important, obviously. Encouraging and incentivizing is fine. Mandating? No. Not at all - for several important reasons.
 
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Fezman92

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Even if it’s ruled that they can’t be fired for not getting the shot, they can still “just happen” to be fired because of at will employment laws.
 

Summit

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I think waiting until full FDA approval is the best move for any employer looking to make this conditional of employment.

I lean libertarian except for public health because herd immunity doesn't work based on pure personal liberty, nor does a concept of civilly enforced personal/fiscal responsibility work well after you've been a super spreader. If you want to be a purist libertarian about public health, well go start you own hospital where vaccinations are not required if you don't want to grant free enterprise their right to determine safety and continuity of operation interventions expected of staff who voluntarily choose to work for them.

Don't think an employer can mandate flu or COVID vaccine? What about your Measles and Mumps shots? These aren't primarily about employee protection so please stop with the silly "OMG stop forcing low risk people to protect themselves." It is about protecting patients and the public. Employees protection and staffing continuity are secondary benefits. This is very different from an employer firing your for being a tobacco user.

Further, the idea of masking mandates for those who cannot vaccinate requires employers to show who is vaccinated to other employees (that little sticker on your badge). This is only feasible for a mandated vaccine. It has been acceptable for flu because flu vaccine is yearly and variable unlike longer lasting and far more reliable protection via via vaccines like MMR and we think COVID-19 which are far more preventative against spread of disease than wearing a mask door-to-door.

Carlos while you bang your "just focus on vaccinating the vulnerable" drum, you know well that some of those most likely to have more severe courses who get vaccinated may not seroconvert and these folks are our patients. This includes patients who cannot be vaccinated. Further, those without primary risk factors for a more severe course does not exclude severe course, it just drives risk. Those people are also our patients.

FFemt he whole "long term worries" is a load of crap. Vaccines don't stay in trials for decades delaying approval until we know with extra super duper mega certainty they don't cause your big toe to fall off in 20 years. There has never been a vaccine that had unexpected severe long term adverse effects without an obvious safety signal in the short term. This is naturally expected because vaccines are meant to elicit a short term reaction and any long term effects stem directly from short term effects. We do have the better part of a century of info here. Continuing to trot out the "OMG LONG TERM EFFECTS MAYBE??????" is beneath the well educated medical professional.
 
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Carlos Danger

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If you want to be a purist libertarian about public health, well go start you own hospital where vaccinations are not required if you don't want to grant free enterprise their right to determine safety and continuity of operation interventions expected of staff who voluntarily choose to work for them.
Great idea! However, the reality is that almost all the problems that we have with access to care and skyrocketing healthcare costs are either directly or at least partially a result of the type of top-down mandates that you seem to endorse which makes this type of innovation and choice impossible. One of the best memes ever is that of the government making it impossible to fix things and then people thinking the fact that things never get fixed is somehow evidence that more government intervention is necessary.
ICarlos while you bang your "just focus on vaccinating the vulnerable" drum, you know well that some of those most likely to have more severe courses who get vaccinated may not seroconvert and these folks are our patients. This includes patients who cannot be vaccinated. Further, those without primary risk factors for a more severe course does not exclude severe course, it just drives risk. Those people are also our patients.
No. Only half the population so far is vaccinated yet somehow new cases AND case severity AND fatality rates all continue to fall steadily. The risk of contracting COVID gets lower every day, even for those who aren't vaccinated. There are very few people who can't be vaccinated or in whom the vaccine is unlikely to be effective due to reduced immune response and we already handle those folks with special protections against respiratory disease transmission.
 

DrParasite

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I suggest everyone read up on this topic, from semi reputable sources, on the legality of mandating vaccinations:

The conservative inside me says an employer can mandate whatever they want. the liberal inside me says my body my choice.

The quasi-educated quasi-healthcare worker inside me asks is this really different than mandating vaccines for MMR, flu shots, smallpox, and requiring children to have vaccines to attend school?
 

GMCmedic

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I'm going to keep my thoughts on this short.

The vaccines are safe and effective. Employers requiring EUA vaccinations is a can of worms and absolutely should be challenged all the way to SCOTUS if necessary.
 

Summit

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Great idea! However, the reality is that
... market realities are painful to some, particularly in distorted markets? Sure. But there are tons of employers that these very few individuals can go work for if they don't like a new work requirement that 24,769 out of the 24,947 staff have found a way to be in compliance with... a policy the employer has legally asked of their employees, even if you and I disagree with it (though for different reasons). Free choice goes both ways!

No. Only half the population so far is vaccinated yet somehow new cases AND case severity AND fatality rates all continue to fall steadily. The risk of contracting COVID gets lower every day, even for those who aren't vaccinated. There are very few people who can't be vaccinated or in whom the vaccine is unlikely to be effective due to reduced immune response and we already handle those folks with special protections against respiratory disease transmission.
The people who cannot get vaccinated and or who won't seroconvert, as well as those who are higher risk, are more likely to be our patients. We don't know who these 5+% non-seroconverters for mRNA vaccines are (12% against Delta variant) and higher rates for JJ. So if an employer decides it to be an ethical imperative to have fully vaccinated staff to protect these vulnerable individuals, I think that's both ethical and legal.

What is the risk of Measles and Mumps? Prevalence of COVID-19 is higher than Measles while MMRx2 is more effective than COVID-19 vaccine. Vaccination rates are higher in the population for MMR/MR than COVID-19. I fully support requiring MMR and flu vaccines for healthcare staff. For COVID vaccines, I still think they should wait until full FDA approval.
 
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EpiEMS

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The connotations of experimental and emergency use are absolutely a factor here. These vaccines have not completed a full FDA approval process, nor do we know if there will be any long term or late acting side effects.

Are you willing to let your employer mandate that you participate in an experimental or emergency use procedure in the name of the employer's rights? Think carefully before answering that, because you may find yourself being shoved down the proverbial slippery slope.

This would be no different than requiring the flu vaccine except that the COVID vaccines have not received final FDA approval yet. Then again, I've never ran across an employer who requires a flu vaccination as a condition of employment.
The vaccines have gone through Phase 3 trials & have been used in hundreds of millions of people for months now without adverse consequences - how much more do you want? The data - at this point - is months and months and months, effectively enough for a full approval.

The employer & the employee both have rights - the vast majority of employees are at will & the job market has never been more employee friendly.

"Litany of compelling rationale for an employer to try and protect the employee"

And the road to Hell is paved in good intentions.

Where do you draw the line? May an employer require you be a non-smoking, non-drinking, 4 day a week exercising, body fat percentage of less than 2%, genetically screened for minimal risks to cancer? All of these things carry risks to employer staffing availability, and all have been viewed as "the greatest threat" to a person's health at one time or another.

Genetic screening is not permitted by law to be used against you in employment. You can absolutely make non-smoking a hiring requirement according to federal law (though not all state laws). Not sure about alcohol or exercising, but exercise/fitness can be a bona fide occupational qualification, and employers are totally allowed to have higher health insurance premiums for smokers. Employers can also require that you not smoke or drink on the job (or be intoxicated at work). Where do I draw the line? Since there are labor market frictions & inequities, I would say that anything out of your control, like genetics, should probably be protected, but other than that, it is more difficult to make a good case.

Would it really not be better to just let everyone make their own decisions on this? I think it would. I think it would not only be more just, but also simpler and easier to allow everyone to make their own decisions about their own healthcare, just like we've always been taught we should.
In theory, sure. There are lots of negative externalities, however, and in the absence of willingness to use the carrot (which would be better, but still coercive in a way), a vaccine mandate is not so crazy, particulalry for an employer when an employee has the ability to quit. It's not as if there is a disparate impact on a class, a preponderance of evidence that there is risk from vaccination*.

*We can talk precautionary principle elsewhere - I can understand that line of reasoning, but if we follow it to the letter, then we don't have any innovation.
 
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ffemt8978

ffemt8978

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The vaccines have gone through Phase 3 trials & have been used in hundreds of millions of people for months now without adverse consequences - how much more do you want? The data - at this point - is months and months and months, effectively enough for a full approval.

The employer & the employee both have rights - the vast majority of employees are at will & the job market has never been more employee friendly.



Genetic screening is not permitted by law to be used against you in employment. You can absolutely make non-smoking a hiring requirement according to federal law (though not all state laws). Not sure about alcohol or exercising, but exercise/fitness can be a bona fide occupational qualification, and employers are totally allowed to have higher health insurance premiums for smokers. Employers can also require that you not smoke or drink on the job (or be intoxicated at work). Where do I draw the line? Since there are labor market frictions & inequities, I would say that anything out of your control, like genetics, should probably be protected, but other than that, it is more difficult to make a good case.


In theory, sure. There are lots of negative externalities, however, and in the absence of willingness to use the carrot (which would be better, but still coercive in a way), a vaccine mandate is not so crazy, particulalry for an employer when an employee has the ability to quit. It's not as if there is a disparate impact on a class, a preponderance of evidence that there is risk from vaccination*.

*We can talk precautionary principle elsewhere - I can understand that line of reasoning, but if we follow it to the letter, then we don't have any innovation.
Oh, there absolutely have been adverse consequences from the Covid vaccine. There's a reason the CDC maintains this webpage: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html

Just because you choose to ignore those adverse consequences to bolster your argument does not mean other people have to ignore them...unless you feel your employer has the right to determine what risks you should take with your own body.

If the vaccine has gone thru everything required to give it its certification, then why hasn't the FDA approved it yet? This would be a slightly different argument if it was a fully approved vaccine, but its not yet. Some people have an issue with being forced to participate in an experimental vaccine roll out.

As far as your responses to my examples of things that are a risk to employer staffing levels, they were just examples and not an all inclusive list. The point was that where do you draw the line at an employer making decisions about an employee's lifestyle?
 

Summit

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@ffemt8978 Pfizer thinks they have everything required for FDA approval over a month ago. They have already applied for full FDA approval which requires submitting all of that data. Just waiting on the FDA to review. Same for Moderna... of course FDA could come back and say no, but there is no data out there suggesting a rationale for FDA not to approve that I am aware of, including the CDC page you linked to which demonstrates that these vaccines are very safe and very effective. It sucks to be an outlier. It also sucks to be a bad case of COVID/complications and to be a disease spreader. I expect full FDA approvals for Moderna and Pfizer in a few months.
 

EpiEMS

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Oh, there absolutely have been adverse consequences from the Covid vaccine. There's a reason the CDC maintains this webpage: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html

Just because you choose to ignore those adverse consequences to bolster your argument does not mean other people have to ignore them...unless you feel your employer has the right to determine what risks you should take with your own body.

If the vaccine has gone thru everything required to give it its certification, then why hasn't the FDA approved it yet? This would be a slightly different argument if it was a fully approved vaccine, but its not yet. Some people have an issue with being forced to participate in an experimental vaccine roll out.

As far as your responses to my examples of things that are a risk to employer staffing levels, they were just examples and not an all inclusive list. The point was that where do you draw the line at an employer making decisions about an employee's lifestyle?
Not of any significance to the broad rollout. Firstly, VAERS accepts anybody's submission - I can put one in right now and make any claim I like. Second, of the adverse events that have happened, these are almost all speculation at this point or of minimal risk on a population level.

The FDA approval is administrative at this point - the delays are bureaucratic, not scientific. All of the information has been submitted.

In a strong labor market like this one...there are plenty of employers out there. Nobody is forcing you to work at a particular place. Furthermore, the employer has every right to protect customers & other employees.
 
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