Will ASCs mandate COVID-19 vaccines for staff?

Most ASCs don't require staff and physicians to receive the COVID-19 vaccine despite mounting pressure from healthcare organizations.

Sixty-three medical professional societies signed a statement in July supporting vaccine mandates for healthcare workers. Dozens of hospitals and health systems are also requiring staff to get the vaccine; most recently, Baystate Health in Springfield, Mass., and Truman Medical Centers/University Health in Kansas City, Mo., announced mandates July 26.

Will ASCs be next? Likely it will depend on several factors, including geographic location, FDA clearance of the vaccine and hospital affiliation.

"Our centers have not yet instituted an employment requirement for COVID-19 vaccination but are paying close attention to the country's majority response as many of the large health systems trend in that direction," said Christina Holloway, administrator of ASC Bala Cynwyd (Pa.). "As clinicians, we want to offer the safest environment of care possible for those needing and choosing to integrate medical interventions on every level. The community should feel less stressed when actively pursuing any level of health management and requiring vaccines for those in practice is a realistic way to accomplish that goal."

Dann Byck, MD, of Utah Orthopaedics in Ogden, said his center recommends staff get vaccinated, but it isn't a mandate. Sixty-five percent of the staff at his center are vaccinated.

"Many people in Utah have allowed politics to influence vaccination decisions, and until the FDA formally approves the various vaccines, I do not see the policies or minds changing," he said. "However, once FDA approval is granted, I do see the COVID-19 vaccine becoming another mandatory yearly requirement. All of our local facilities have a mandatory yearly flu vaccine policy."

Pfizer submitted for formal FDA approval in May, and the FDA could render a decision in early fall. In the meantime, Dr. Byck said the pandemic continues to put stress on the center since employees who test positive must quarantine for two weeks.

Richard Rosenfield, MD, executive medical director and chief of gynecology at Pearl Women's Center and Pearl Surgicenter in Portland, Ore., had a similar experience. He said his center doesn't mandate the COVID-19 vaccine, but he would support a mandate in the future.

"Unfortunately, it seems like people need to make their own decisions about vaccines, and the misinformation out there is pretty ridiculous," he said. "We support any opportunity to reduce COVID-19 infection rates."

Craig Gold, PsyD, administrator of Virginia Center for Eye Surgery in Virginia Beach, said his center encouraged staff and physicians to get vaccinated, and 90 percent of staff did. All surgeons at the center are fully vaccinated. "We had made accommodations for employees to get their vaccine and were liberal with allowing recovery time should they have any adverse events," he said.

All physicians and employees at Manhattan Reproductive Surgery Center are fully vaccinated as well, even though the center does not require it.

"Although we strongly encouraged everyone to consider the vaccine, we did not feel that ethically we could mandate a unilateral decision like that. We did, however, prepare for what requirements would be in place for individuals who chose not to receive the vaccine," said Gabriel Figueroa, administrator of Manhattan Reproductive Surgery Center. "We have chosen to continue to test all patients that come into the facility regardless of vaccination status."

There are a few centers that have mandated staff and patient COVID-19 vaccines.

Catherin Retzbach, RN, BSN, CASC, administrator of Memorial Ambulatory Surgery Center in Sewell, N.J., said her center's staff are employed by a health system that mandated vaccines by Sept. 15. Patients aren't required to be vaccinated, but those who aren't must undergo a test at least six days before surgery.

Pacific Heights Plastic Surgery in San Francisco did institute a COVID-19 vaccine mandate for its staff and physicians July 19, and all patients entering the center must be vaccinated as well. San Francisco has reached herd immunity status, and Jonathan Kaplan, MD, the center's owner, said most prospective patients are already vaccinated.

"This is a pandemic of the unvaccinated. That's the only reason it's been able to break through in the few cases for the vaccinated patients," Dr. Kaplan said. "Far and away, most people in the hospital are unvaccinated COVID-19 cases, so we are going to do our small part [to stop the spread]. If you're coming in for a procedure, cosmetic or reconstructive, you have to be vaccinated. It keeps our employees safe and their families safe, and I think it's also safe for all the patients coming in to minimize the chances that we have a delta variant in our office."

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