Joan Carson R.N. administers a dose of Covid-19 vaccine at a Vermont Department of Health clinic in Winooski on Feb. 2, 2021. Photo by Glenn Russell/VTDigger

At least five hospitals across the state are requiring some or all of their employees to be vaccinated, a VTDigger survey found. 

The five are Brattleboro Memorial, White River Junction VA Medical Center, Northeastern Vermont Regional Hospital, Mt. Ascutney Hospital and Dartmouth-Hitchcock Southwestern Vermont Region, which offers care through Southwestern Vermont Medical Center in Bennington.

Others โ€” including the University of Vermont Health Network, a system with more than 600 licensed beds in Burlington alone, and its affiliated Central Vermont Medical Center โ€” have not yet decided what policy, if any, to impose. Health network spokesperson Annie Mackin said earlier this week that she expects a decision in the coming days.

In a statement Tuesday, the network said it was โ€œactively moving toward the goal of having our entire workforce of nearly 15,000 employees and physicians in Vermont and northern New York vaccinated against Covid-19.โ€

โ€œWe are taking a thoughtful and intentional approach toward next steps, including whether we will institute a mandatory vaccine policy for all our workforce, and plan to make a decision in the near future,โ€ Mackin said.  And, she said, the vast majority of the hospitalโ€™s 7,000 clinical and patient-facing staff have already been vaccinated.

Gifford Medical Center in Randolph and Rutland Regional Medical Centers are also undecided, officials said this week. 

The vaccine mandate discussions come at a time when many hospitals nationwide are grappling with similar dilemmas fueled by rising Covid-19 cases.

Gov. Phil Scott signaled his support Thursday for facility-specific decisions on vaccine mandates.

The governor โ€œsupports hospitals, long-term care facilities and other health care providers requiring their employees to be vaccinated, or mandated masking and weekly testing for the unvaccinated,โ€ said Scottโ€™s press secretary, Jason Maulucci, in a statement Thursday. โ€œWe are currently exploring the possibility of state action, including in certain state-run facilities, but no decisions have been made at this time.โ€

VTDigger confirmed with the Vermont Department of Mental Health that employees at the state psychiatric hospital in Berlin arenโ€™t required to be vaccinated.

Numerous medical associations have also favored vaccine mandates in hospitals. 

The Vermont Medical Society, which represents about 2,400 doctors and physiciansโ€™ assistants, announced Tuesday it had signed on to a joint statement urging health care employers to mandate vaccinations. 

โ€œIn Vermont, we are seeing the weekly data correlating our high vaccination rates with low rates of hospitalization and death, even in the face of increasing cases,โ€ said the medical societyโ€™s president, Simha Ravven, chief medical officer of the Burlington-based Howard Center. โ€œWe cannot let our state go backwards in our fight against the new Delta strain, and vaccinating all health care workers will continue to save lives in Vermont.โ€

โ€œI think we need to be role models,โ€ said Meredith Roberts, executive director of the Vermont chapter of the American Nurses Association. โ€œWe need to exemplify what we expect. If weโ€™re good role models and weโ€™re showing that, yes, we are vaccinated, this is the approved way, itโ€™s the most ethical way to show (patients), โ€˜Look I did it, and Iโ€™m not turning into a mutant.โ€™โ€ 

The Vermont Association of Hospitals and Health Systems has not yet commented on the matter publicly, and association representatives did not respond to requests for comment this week.

Other professional associations are supporting vaccine mandates in medical facilities. The New Hampshire Hospital Association, for instance, has released a statement in support of vaccine mandates.

Workforce implications

But vaccine mandates are proving a thorny issue in a pandemic thatโ€™s already squeezing medical staff. Hospital leaders in the Green Mountain State have thus far been cautious with policies that may alienate their own workforce in this highly vaccinated state.

โ€œAt the end of the day, thereโ€™s no specific risk that weโ€™re looking to mitigate,โ€ said Kevin Robinson, spokesperson at Rutland Regional Medical Center, a 144-bed hospital. โ€œIs it worth the potential upset among staff that a mandate causes? Those are things that have to be weighed in the context of a vaccine mandate.โ€

In other states, particularly those with significant Delta variant spikes, mandates have sparked lawsuits, protests and opposition among some health care workers.  

Dartmouth-Hitchcock, which is based in Lebanon, N.H., and has two hospitals in Vermont, said earlier this week that, by Sept. 30, all employees are expected to be vaccinated โ€œas a condition of employment.โ€

Management at Northeastern Vermont Regional Hospital, a 25-bed medical center in St. Johnsbury, is balancing employee wishes with public health by making the mandate contingent on full vaccine approval by the Food and Drug Administration. 

โ€œWe want to be mindful of the employees who may be hesitant,โ€ said hospital spokesperson Betty Ann Gwatkin. โ€œWe care about how our employees feel. But we are also a health care institution and patients are the whole reason weโ€™re here, so itโ€™s patients first.โ€

The vaccines, which now have emergency authorization, are slated to move through the regulatory hurdles quickly. The FDA has accelerated the approval process and anticipates approving the Pfizer vaccine in early September. Biotech company Moderna is slated to file for FDA approval for its vaccine in the coming weeks.

Still evaluating

Other institutions in Vermont are reluctant to impose sweeping policies.

Brattleboro Memorial Hospital, a 61-bed facility, put a limited mandate in place, focusing only on new hires. Management is still evaluating additional requirements on existing staff, hospital spokesperson Gina Pattison said in an email Wednesday. 

Pattison did not answer follow-up questions about the rationale behind the policy, but said hospital administrators would use guidance on the issue from the Centers for Disease Control and Prevention. 

The federal government, for its part, isnโ€™t planning to impose a nationwide vaccine mandate, but clinical staff at Veterans Affairs hospitals are required to be vaccinated, the agency announced last month. The policy extends to all VA facilities and clinics, including the 74-bed hospital in White River Junction.

With states setting much of public health policy, federal authorities have said states and employers can put forth their own vaccination mandates. Employers and politicians are divided on the matter. New Jersey, for example, will require all health care workers in the state to be vaccinated, effective Sept. 7.

At least one Vermont hospital has skirted the issue by changing other policies. Peter Albert, lobbyist for the Brattleboro Retreat, said the largest psychiatric hospital in Vermont is requiring universal masking but isnโ€™t mandating vaccinations. 

Wendy Franklin, spokesperson for North Country Hospital, said Thursday that vaccine mandates are under discussion. 

โ€œWe do have a 90 percent employee vaccination rate for Covid vaccines,โ€ she said. โ€œWeโ€™re pretty pleased that our staff has stepped up to the plate and many new employees are vaccinating as they come in, so weโ€™re going in the right direction.โ€

Liora Engel-Smith covers health care for VTDigger. She previously covered rural health at NC Health News in North Carolina and the Keene Sentinel in New Hampshire. She also had been at the Muscatine Journal...