While activists have protested the Mills administration’s mandate that health care workers be vaccinated against COVID-19, most in Maine are complying and getting their shots. And, so far, only a small number have resigned over the mandate.

Three of Maine’s four major health care systems are reporting that 90 percent or more of their employees are now fully vaccinated, based on a survey late last week by the Portland Press Herald/Maine Sunday Telegram. And the reduced likelihood of workers becoming ill and missing work has tempered concerns about losing employees who refuse to be vaccinated.

One hospital system, Central Maine Healthcare in Lewiston, has a slightly lower vaccination rate and has expressed more concern about the potential loss of workers later this month.

Gov. Janet Mills’ mandate officially took effect on Friday. But the hospitals and other health care providers have been given until Oct. 29 before the state will enforce the mandate as a requirement of providers’ medical licenses.

Because it takes two weeks for those who get the Johnson & Johnson vaccine to be considered fully vaccinated, workers have until Oct. 15 to get the J&J shot and be in compliance. The other two vaccines approved for use in the U.S., Pfizer and Moderna, require a two-shot regimen spaced three and four weeks apart, so it’s already too late for workers to get those vaccines and be in compliance by the end of the month.

Employer mandates are becoming more commonplace across the country in an attempt to boost vaccination levels during the ongoing  COVID-19 surge caused by the highly contagious delta variant. Maine has experienced record numbers of cases and hospitalizations in recent weeks as the delta variant has swept through unvaccinated populations.

Dr. Lynne Tetreault, a Saco pediatrician, said she supports the mandate and believes getting vaccinated is “part of the job requirement” when people go into the health care field. In addition to COVID-19 vaccination, Maine health care workers must be immunized against influenza, hepatitis and other communicable diseases.

“It’s part of being in the health profession, to be protected against diseases because you are exposed to them more than the general population,” Tetreault said. She said all of her pediatrician office’s approximately 15 employees are vaccinated against COVID-19 and had gotten their shots before the mandate was announced in August. “It makes sense to protect yourself, protect patients, protect each other and all work together to try to end the pandemic.”

Emily Nixon, one of the organizers of the Coalition For Healthcare Workers Against Medical Mandates, stands in the rotunda of the Maine State House in Augusta before a special legislative session Wednesday. Joe Phelan/Kennebec Journal

But Emily Nixon, a MaineHealth nurse and founder of the Coalition for Healthcare Workers Against Medical Mandates, said she believes the mandate “exacerbates an already dangerous staffing shortage in Maine health care facilities.”

“Forcing a medical procedure of any kind under threat of termination is coercion,” said Nixon, who has organized protests against the mandate and expects she will be fired because she refuses to get the COVID-19 vaccine.

Nixon is among a small minority of health care workers in Maine who are willing to leave their jobs over the mandate. Two pending lawsuits aim to overturn the mandate, including one in U.S. District Court that argues there should be a religious exemption – Maine allows only a medical exemption to the vaccine – and another in state court that claims the mandate is unconstitutional.

At Northern Light Health, 92.9 percent of its workforce is fully immunized, said Paul Bolin, senior vice president and chief human resource officer of the system, which includes Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland.

“We are making continued progress, and we look for that number to increase,” Bolin said. “We are working with staff who continue to have questions or hesitancy.”

Bolin said there are some employees who are still hesitant because they are getting misinformation about the vaccine, so one of the strategies is to have vaccine experts talk to employees to “dispel rumors” about the vaccines. The vaccines are safe and effective, and have been approved by federal regulators.

Coalition For Health Care Workers Against Medical Mandates protesters hold signs as people walk through the rotunda to start a special legislative session Sept. 29 at the Maine State House in Augusta. Joe Phelan/Kennebec Journal

So far, 89 Northern Light employees have resigned over the mandate out of 12,500 employees, or less than 1 percent of the total workforce.

MaineHealth, the hospital network that includes Maine Medical Center in Portland and seven other hospitals in Maine, is reporting 94 percent have already complied with the mandate. It reported that 60 out of 23,000 employees have resigned and listed the mandate as one reason they left their jobs.

MaineHealth’s vaccination rate has increased from 84 percent before the mandate was announced in mid-August to 94 percent as of last week. Doctors have a 99 percent vaccination rate in the MaineHealth system.

MaineGeneral Medical Center in Augusta has a 90.2 percent compliance rate so far for its 4,500 employees, and 55 employees have resigned or indicated they will resign over the mandate.

Central Maine Healthcare, the parent company of Central Maine Medical Center in Lewiston, has 86 percent of its workforce of 3,500 currently vaccinated. Seventy employees have either already resigned over the mandate or submitted their resignations.

Health care systems and their employees in other parts of the country are confronting similar mandates. And, if the experience of those already required to comply with vaccination mandates is an indication of what will happen in Maine, almost all workers will get their shots.

Members of the Coalition For Health Care Workers Against Medical Mandates sit in the balcony to watch the special legislative session Sept. 29 at the Maine State House in Augusta. Joe Phelan/Kennebec Journal

At Novant Health in North Carolina, one of the first health care systems in the nation to have its mandate go into full effect, 99 percent of employees in its 35,000-worker system complied, resulting in 175 employee terminations.

Mandates are also moving people to get vaccinated outside of the health care industry.

Less than 1 percent of United Airlines’ workers have been fired for refusing to get that company’s mandated COVID-19 vaccine, and Tyson Foods is reporting 93 percent compliance so far with its mandate. California just announced on Friday that all students 12 and older and all school staff must be vaccinated against COVID-19, starting next year.

The Biden administration is requiring that all employers with 100 or more workers have them get vaccinated or submit to weekly testing, and that the military and much of the federal workforce become immunized. The employer mandate has not yet gone into effect, but rules on how to implement it are expected to be released later this fall.

Liz Hamel, vice president and director of public opinion and survey research at Kaiser Family Foundation, a national health policy think tank, said that mandates are a “mixed bag” in terms of how popular they are, but acceptance of mandates has improved from 61 percent against them in June to a 50 percent disapproval rating now.

“The mandates are not wildly popular. Half of workers say they don’t want employers to require it,” Hamel said. “But the mandates are one piece of the puzzle in what can increase the vaccination rate.”

Coalition For Health Care Workers Against Medical Mandates protesters hold signs Sept. 29 as lawmakers walk toward the House chamber to start a special legislative session at the Maine State House in Augusta. Joe Phelan/Kennebec Journal

Aside from increasing acceptance of mandates, making more people eligible for shots will also help in the fight to contain the virus. The Pfizer vaccine is expected to be approved for ages 5-11 by Halloween or shortly thereafter, which would make an additional 100,000 people eligible for vaccination in Maine.

Public opinion about COVID-19 vaccination in general has also shifted more in favor since December, when Kaiser Family Foundation first started polling the topic. Those who say they would “wait and see” has dropped from 39 percent of respondents to 7 percent. The percentage of people who say they will refuse the vaccine has stayed steady at about 12-15 percent, Hamel said.

But faced with a mandate, it’s unclear what people will do because most of the employer mandates have not yet kicked in, Hamel said. According to the latest survey, 19 percent of workers say their employer has a COVID-19 vaccine mandate.

“Employer by employer there does seem to be evidence in favor of mandates, especially in health care settings where large employers are increasing vaccination rates by putting mandates in place,” Hamel said. “We are seeing stories out of individual employers that people are complying.”

Maine already has one of the highest vaccination rates in the country, with 65 percent of the state’s 1.3 million population fully vaccinated.

But with the health care industry already grappling with a workforce shortage, the mandate will make maintaining a sufficient workforce difficult, said Dr. John Alexander, chief medical officer at Central Maine Healthcare.

“With nearly 300 unvaccinated team members on top of over 500 positions we are currently recruiting to fill with permanent staff due to workforce shortages and shifts in the labor market brought on by the pandemic, we face a staffing crisis,” Alexander said. “This leaves our ability to meet all the needs of the communities we serve seriously impacted when enforcement of the state mandate begins at the end of October.”

But officials with MaineHealth have said that staff hours lost to unvaccinated workers falling ill with COVID-19 are likely worse than the expected shortages from workers leaving their jobs as a result of the mandate.

“We are not anticipating any disruptions to our services as a result of this policy,” said John Porter, spokesman for MaineHealth. Porter said improved vaccination rates would be “highly beneficial” to employees, patients and the community at large and that it’s unknown if the vaccine mandate will have a “statistically significant” impact on the MaineHealth workforce. The system currently has 2,600 openings, Porter said.

Bolin, of Northern Light Health, said they are working hard to retain staff because “our ability to offset or supplement our workforce will be very limited.”

Nixon said she’s being forced out of her job and that “Maine will lose other seasoned health care workers as a result of this mandate.”

But Tetreault, the Saco pediatrician, said that health care workers have been on the front lines “living with this virus” and seeing the “devastating effects day in and day out,” and so a mandate is necessary.

“It does seem like the right thing to do,” Tetreault said.

Note: This story was updated Monday, Oct. 5, to correct the percentage of Northern Light employees who have resigned over the mandate.

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