The national vaccine mandate for health care workers is in the federal courts, but government officials say there is proof that requirements work and do not cause a mass exodus of employees.
Philadelphia issued a vaccine mandate in August. A group of local hospitals met with officials from the Centers for Medicare and Medicaid Services last week to discuss the national rule that requires hospital employees to be fully vaccineed against Covid-19. According to the city health department, 95 percent of nursing home employees are fully protected from diseases, which is higher than the national average of 75 percent.
Vaccine protection for health care workers is once again a critical tool after several states reported increases in Covid cases and the arrival of the new Omicron variant.
One of the country's highest hospitalization rates can be found in Pennsylvania. The chief executive of one of the state's largest hospital groups said at a news conference that covid continues to rage on. He said that the intensive-care units were overwhelmed.
In Philadelphia, there were more people hospitalized in December than before Thanksgiving.
The city's hospitals and nursing homes achieved high vaccination rates without significant staff departures. The administrator of the agency said that most of the people quit at the end of the day.
Ms.Brooks-LaSure said it was important for hospitals and nursing homes to educate their workers about the benefits of the vaccine and to address safety concerns.
Many states and cities impose vaccine requirements on health care workers. According to state data, about 96 percent of hospital and nursing home workers in New York are fully vaccine-free.
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Who is eligible for a shot in each state, and where the doses have gone, can be seen.
The New York Times has a story about the effects of vaccine on the body.
According to state data, about 94 percent of nursing home employees in California have gotten vaccinations.
There have been thousands of recent cases of residents and staff in nursing homes in states without mandates, and about a third of nursing home workers are not fully vaccinations.
Conlen Booth, Crozer Health's senior director of emergency preparedness, said that the vaccine rate among workers at Crozer Health went from 65 percent to 98 percent because of the looming federal mandate. He said that staff understood that there was no other alternative.
Crozer asked infectious disease specialists to speak to employees who were hesitant, including first responders who did not usually get to speak with someone who could answer their questions. Mr. Booth said that they had never been spoken to by a doctor.
The city requirement resulted in fewer departures than anticipated. According to the Pennsylvania Health Care Association, Philadelphia nursing homes had an average of seven staff departures related to the vaccine requirement.
Philadelphia remained a cautionary tale, given that some employees did leave, according to the group's chief executive. He said that because of a widespread staffing shortage, nursing homes can't care for residents.
Some hospital executives disagreed about the best way to get their workers to be vaccine free. One administrator warned that mandates could be used to spy on people, while another defended the federal requirement.
The role of individuals who care for the public was emphasized by officials from the Centers for Medicare and Medicaid Services.
The agency's chief medical officer said at the meeting with the hospitals that health care workers have a special ethical and professional duty to protect the patients. Unvaccinated patients pose a direct and indirect threat to patient safety and population health.
The future of President Biden's vaccine mandates for health care workers and private employees in other sectors is unclear. The C.M.S. rule, which required health care providers to get their workers fully vaccined by early January or lose federal funding, has been blocked by federal judges.
The judge in the U.S. District Court for the Western District of Louisiana ruled that the agency had overstepped its authority by issuing an emergency regulation. He said that the vaccine mandate should be done by Congress, not a government agency, and that it is not clear that an act of Congress mandating a vaccine would be constitutional.
The rule is on hold while the administration appeals. C.M.S., the agency that protects the health and safety of patients in facilities certified by the Medicare and Medicaid programs, has suspended activities related to the implementation and enforcement of the rule pending future developments in the litigation.
The Supreme Court is likely to decide the issue, leaving hospitals and nursing homes between a rock and a hard place, said a lawyer specializing in regulatory issues.
The hospital and nursing home trade groups are encouraging vaccinations. Mark Parkinson, the chief executive of the American Health Care Association, said in a statement that providers should continue to prepare their policies and procedures and encourage unvaccinated staff to get their first shot.
Mr. Parkinson said his group would continue to pursue a testing alternative to prevent workers from leaving for other jobs.
Philadelphia Works estimates that hospitals are the largest employer in the city with 57,000 workers.
The work needed to convince employees to get vaccine was underscored by the city's experience.
The adoption of the mandate at the University of Pennsylvania Health System widened the gap between the vaccination rates for white and Black staff. Doctors and administrators spoke with employees of color and said they were explicit about the role race and racism played in decision-making and made a point to feature workers of color in their campaign. The system's vaccination rate went up to nearly 100 percent.
The issue of town halls was not effective according to executives, but Dr. Florencia Greer Polite thought the issue was often the all white makeup of the panels.
Michael Young, the chief executive of Temple University Health System, agreed that you have to have the right messenger. Main Line Health said it used vaccine ambassadors to talk to employees in departments like food service and housekeeping.
Ms.Brooks-LaSure said it was clear that hospital and nursing home executives had focused on addressing the concerns of the workers who were unsure about the safety of the vaccine. She wants to hear that the vaccine will be ok for her baby.
She said that these efforts were important in communities where there was distrust of the government. She said that Latino residents may be wary of government programs because of the Trump administration's attempt at a "public charge" policy that would deny immigrants legal status based on their use of government health programs.
