Maryland to require hospital, nursing home staff to get COVID vaccine

People who work in Maryland’s hospitals and nursing homes will be required to get the coronavirus vaccine or submit to regular testing, Gov. Larry Hogan announced Wednesday.

Workers at hospitals and nursing homes must get their first dose of the vaccine by Sept. 1, Hogan said. The mandate applies to not only health care workers, but everyone who works in those facilities, including administrative staff.

Hogan said it’s “simply not acceptable” for nursing home and hospital workers not to be vaccinated, because it endangers the lives of vulnerable patients and residents.

The Republican governor’s announcement comes as the pandemic, fueled by the delta variant of the virus, is on an upswing in the state and across the nation.

Shortly after the governor spoke, President Joe Biden announced that vaccines will be required for workers at nursing homes across the country that receive funding from Medicaid and Medicare, the government insurance programs used by virtually all seniors. The federal government will issue new regulations on the vaccine that could be in effect as soon as next month, the Associated Press reported.

“Vaccination rates among nursing home staff significantly trail the rest of the country,” Biden said during a televised briefing.

New COVID-19 infections, hospitalizations and deaths have climbed steadily this summer. As of Wednesday morning, 630 people were being treated for the coronavirus in Maryland hospitals.

The state’s testing positivity rate is 4.92% and nearly every part of the state is experiencing “substantial” or “high” spread of the virus, as measured by the federal government.

Several of the state’s hospital systems — including the University of Maryland, Johns Hopkins, Greater Baltimore Medical Center, LifeBridge Health and MedStar — already are requiring vaccines for its staff.

About 95% of the state’s hospital workers are employed by hospital systems that already have vaccine mandates in place, according to the Maryland Hospital Association.

Overall, 79% of nursing home staff have been vaccinated, Hogan said, but low vaccination rates at some facilities have been a persistent concern for government leaders and public health experts.

Despite the coronavirus ripping through nursing homes and killing residents in the early stages of the pandemic, there’s been a reluctance of some workers to get vaccinated.

The state started posting vaccination data for each Maryland nursing home earlier this year, then ramped up pressure by publicizing the least-vaccinated facilities in recent weeks.

A spokesman for one nursing home listed as having a low vaccination rate questioned the state’s data. Meir Preis of Oakwood Care Center in Middle River said the facility has a 65% vaccination rate among staff, compared to the rate of 40% that was listed on a slide at Hogan’s news conference. Preis said the facility is trying to sort out the discrepancy.

Preis said he couldn’t comment on the mandate yet.

The state has 227 licensed nursing homes. Nursing homes that don’t comply with the vaccination-or-test mandate or don’t report their data may face fines and penalties, Hogan said.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said in an interview that the mandate is a meaningful step, although several months late, with the delta variant wreaking havoc across the country.

“The fact that the government has to do this, I think, really lets the nursing home administrators off the hook, because they should have been doing this on their own,” Adalja said.

Adalja said the vaccine mandate and public shaming shouldn’t be necessary, because high vaccination rates give health care facilities a competitive advantage.

“The only way that you’re going to make your healthcare facilities resilient to COVID-19, especially in the wake of a more contagious variant like the delta variant, is to have as highly a vaccinated workforce as possible,” Adalja said.

Joe DeMattos, president of the Health Facilities Association of Maryland, appeared alongside Hogan and said he’s proud of nursing home workers and facilities, “but we need to take that extra step.”

“There are employees in skilled nursing and rehab centers and hospitals, employees who have been extremely resistant to get the vaccine,” DeMattos said. With the state mandate, “we’ll all do better,” he said.

The state also will work with nursing homes to test residents to see how strong their antibodies are. A pilot program to test 500 nursing home residents should be complete by Sept. 1, Hogan said.

Hospital workers have been vaccinated at a similar rate as nursing home workers, though state Health Secretary Dennis Schrader couldn’t provide an exact number on Wednesday.

Patients and families expect hospitals have done “everything in our power” to ensure safety, and that includes employee vaccinations, said Dr. Mohan Suntha, president and CEO of the University of Maryland Medical System.

“We have this responsibility that comes with the social compact that is health care,” he said.

Suntha said vaccinations have improved at the medical system since the mandate was announced this summer. Through Wednesday, about 75% of the system’s staff has gotten at least one dose.

“Our health system was similar to the entire state,” he said. “Now, in the last month since we’ve required vaccination, we’ve seen a steady uptick in vaccination as we get toward that Sept. 1 requirement.”

The governor thanked health care workers for their efforts throughout the pandemic.

“In some ways these surges feel like the worst kind of deja vu … please know that you have earned our eternal gratitude,” he said.

Some have called on the governor to take more steps to slow the spread of the virus, such as implementing an indoor mask order, mandating masks in schools, requiring vaccinations in more places or returning to a statewide state of emergency.

Hogan previously state government is requiring its workers in state prisons, hospitals, juvenile facilities and veterans’ homes to either get vaccinated or wear masks and submit to regular tests.

Asked whether he’d expand the vaccine requirement to all state government employees, Hogan said that’s not necessary yet.

“We’re not at the point where we need to mandate vaccines for the broader audience,” Hogan said.

The governor also said that he is not “at all” considering reinstating a mask mandate indoors. The U.S. Centers for Disease Control and Prevention’s recommendations, however, would call for masking indoors in most of Maryland, given the viral transmission rates.

Hogan said he’s calling on the federal government to do more to help battle the pandemic, specifically to grant full approval to vaccines and to expedite the approval of the vaccines for children age 5 to 11.

Dr. Greg Schrank, an epidemiologist at the University of Maryland Medical Center in Baltimore, said in an interview that the state should employ “all the strategies” at its disposal to curb the spread of the delta variant.

Schrank said implementing mask mandates in places such as skilled nursing facilities, and administering booster shots once the authorization comes from the Food and Drug Administration, will help mitigate delta.

But primarily, he said, states should redouble their efforts in getting unvaccinated people vaccinated.

“Large pockets remain unvaccinated, and even with breakthrough [infections], it’s the unvaccinated who are driving hospitalization,” said Schrank, also an assistant professor at the university’s medical school. “Focusing on vaccinating those groups through improved community-based programs, and mandates … would be a wise decision.”

Schrank said more data will be needed to clarify the benefit that supplemental doses can have, though for now, certain vulnerable populations will benefit from booster shots.

“There are other things we can work on,” he said. “Namely, like getting vaccine into unvaccinated people.”

Baltimore Sun reporter Christine Condon contributed to this article.