The governor’s gamble: Weighing the potential costs of Mills’ healthcare worker vaccine mandate
On August 12, Maine Governor Janet Mills issued an emergency rule change through the state Department of Health and Human Services (DHHS) that requires anyone employed by “designated health care facilities” to be “fully vaccinated” for COVID-19 by October 1. This gives those workers who have thus far declined a COVID-19 vaccine about a month to get their final shot, since two weeks following the final dose is what it takes for one to be considered “fully vaccinated.”
This made Maine the fourth state to issue a similar mandate, following California, Oregon, and Washington. New York Governor Andrew Cuomo made his own decree on Monday, making New York the fifth state to impose similar rules.
Of the lot, Washington, New York and Maine do not allow health care workers to opt for regular COVID-19 testing instead of taking a vaccine. Washington and Maine also do not allow philosophical or religious exemptions to their mandates. The only exemptions will be granted for those whose doctors deem COVID-19 vaccination “medically inadvisable.”
Ordered without public comment or legislative oversight, the new rule inserts the currently emergency-use-authorized (EUA) vaccines for COVID-19 into the existing required vaccination schedule for Maine health care workers under DHHS rules. The department added vaccinations for influenza to the schedule last year. It applies to those who work in “designated medical facilities” like nursing homes, surgery centers and hospitals, but the new rule regarding COVID-19 vaccination includes workers of dental offices and emergency medical services (EMS) personnel as well.
Dental and EMS providers are regulated by separate state boards than those governing medical licensure, and thus are not required to be vaccinated for the other diseases included within the DHHS vaccine schedule, such as mumps, measles, hepatitis B, and as of last year, influenza. In other words, only health care workers are subject to the entire rule, whereas dental office workers and EMS personnel are only required to take a COVID-19 vaccine.
Ultimately, this mandate is both unnecessary and counterproductive to the stated goals of the Mills administration. Mills and Dr. Nirav Shah, head of the Maine CDC, base their rationale on the dubious assumption that the Delta variant is more dangerous than other strains of SARS-CoV-2, the coronavirus that causes COVID-19. They also back up this policy with the claim that up to one-in-four people infected develop so-called “Long COVID.”
Citing the increasing prevalence of the Delta variant and the notion that all Mainers “have a right to expect” that every individual who provides healthcare in Maine is vaccinated, Governor Mills issued this order with little regard for the potential consequences. Her statements at the August 12 press conference outlining the new mandate speak for themselves.
Responding to a reporter’s question about how the policy might affect the ranks of Maine’s health care workers, Mills answered that, because of the universality of the mandate, “there won’t be many places to go” to work in-state for those holdouts. Because the entire medical sector is included in her mandate, Mills is banking on the hope that medical professionals won’t leave their industry, or the state, for another job.
This is a gamble for Gov. Mills. It may pay off when it comes to nurses, doctors, and those who have spent years training and working to build a career in the healthcare field, even though Maine faces a shortage of medical professionals in the near future. The aspect of this policy that should worry the administration is the potential burden on local EMS.
State data show about 20-25% of state healthcare workers are still unvaccinated for COVID-19. The data include facilities like ambulatory surgery centers, but not EMS providers. Based on early reports, it seems as though a wide disparity exists within some departments affected by Mills’ new mandate.
For instance, heads of two Washington County ambulance services say that 40-50% of their staff has not taken a COVID-19 vaccine. They warn that this could lead to longer wait times for emergency services in one of the state’s most rural and medically underserved counties.
Just in the last week, ambulance drivers, fire chiefs, and EMTs from across Maine have expressed their displeasure with the new rule, imploring the governor to reverse her position before they incur staffing issues over and above the current shortages for both EMS and fire departments, affecting the quality of services they provide to the public.
Oxford County lost 14% of its firefighters from 2010 to 2020. This was a problem before the pandemic. Tommy Morris, president of the Hancock County Firefighters Association, wrote to the Maine Monitor regarding the state’s EMS personnel shortage stating that “the burden this poses to emergency responders and emergency response infrastructure across the state would put countless Mainers at risk in the years ahead if left unattended.” These comments were published just three days after Mills announced the vaccine mandate.
About half of the fire departments in the state are licensed EMS and thus subject to the new rule. They are staffed with more volunteers and fewer career members than the national average, with more than 93% of Maine fire departments composed of mostly volunteers.
Given the hot market for workers, what’s keeping Maine EMTs and firefighters from walking off the job? Only time will tell if the governor’s mandate pays off, or if it will result in worse healthcare and emergency services for some Mainers.