Public Health

How 2 health systems succeeded with vaccine requirements

Jennifer Lubell , Contributing News Writer

Vaccine requirements work, stresses AMA President Gerald E. Harmon, MD. “They result in more people getting vaccinated. Now is the time for the public and private sectors to come together, listen to the science and mandate vaccinations so we can defeat the COVID-19 pandemic.”

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Implementing such a requirement is not without it challenges, despite the wide availability of vaccines. Under the pressure of labor shortages, some major hospitals have dropped their vaccine requirements.

Other health systems are staying the course, taking further steps to encourage boosters as Omicron surges. Health system leaders in several U.S. regions dispensed their strategies to engage and successfully vaccinate staff and communities during an episode of the “AMA Moving Medicine” video series.

In 2021, the AMA and 60 other organizations came out in support of COVID-19 vaccine requirements for health care workers.



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Robert Hart, MD, chief medical officer of Louisiana-based Ochsner Health, looked at who was getting sick from COVID-19 and saw the writing on the wall.

“If you go back to the hospitalizations, many of those hospitalizations were in people who were unvaccinated,” he said. Ochsner sent a clear message early on that vaccine requirements were the right thing to do from a safety, quality and community perspective.

Weighing the data and the evidence, Adnan Munkarah, MD, executive vice president and chief clinical officer of Henry Ford Health System, realized that “just asking” people to get vaccinated wasn’t enough to boost immunity and protect the community. “This is when we made the decision to mandate.”

Such a requirement isn’t much different than requiring staff to get a flu shot, noted Michael Anderson, MD, chief medical officer of Virginia Mason Franciscan Health. Read more about the Seattle-based health system’s strategy to vaccinate its employees.

The health systems had to balance hard stop deadlines with respecting people’s needs.

Setting a deadline of Sept. 10, 2021, Henry Ford laid out clear guidelines for medical and religious exemptions. “Everybody who worked with us was expected to get vaccinated: part-time, full-time staff, contingent staff, our medical students, nursing students, our volunteers, as well as our contractors. We “tried to take every single path and venue that we can have to connect with our employees,” said Dr. Munkarah.

Ochsner gave its staff several months to prepare for an Oct. 30 deadline. This bought some time to educate people through open forums, said Dr. Hart. “We were trying to answer questions about the vaccine, the value of the vaccine, the safety of the vaccine, how it could protect us. So, I think we did an awful lot to try to bring people along with education and really just trying to individualize.”

In addition to big Zoom meetings, Ochsner brought in infectious disease physicians to meet with individuals to answer questions one-on-one behind closed doors.

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Ochsner, prior to its requirement, had about a 50% vaccination rate. “We had a long way to go,” said Dr. Hart. Since the requirement, its vaccination rate has reached 98%.

“It is very, very clear that vaccines are making a dent,” said Dr. Munkarah, whose health system achieved a 100% vaccination rate.

Both health systems are encouraging boosters, although a requirement is not in cards, at least not yet. Boosters will help over time, “but we can't take our eye off the ball of getting those that are unvaccinated at all to go ahead and get vaccinated,” said Dr. Hart.

AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.