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September 16, 2021
Louisiana’s largest hospital systems are requiring their employees to be fully vaccinated, but a minority of nursing staff say they are still considering leaving their jobs instead of getting the jab, citing concerns over personal liberty, lack of long-term studies, and discredited conspiracy theories.
The fourth Covid-19 wave has hit Louisiana hard, with the delta variant causing a surge in new cases that outpaced any of the waves that came before it. “The speed with which delta just took over the landscape, I don’t think we quite anticipated that,” said Dr Jennifer Avegno, director of the New Orleans health department and an ER doctor.
In recent weeks, Louisiana has had one of the nation’s highest per-capita infection rates and one of the lowest vaccination rates in the country. Less than 50% of eligible residents are fully vaccinated, according to the Louisiana health department, leaving many vulnerable to serious infection. Rural parishes in the state have much lower vaccination rates compared with parishes with larger cities such as New Orleans and Jefferson.
The overwhelming majority of patients hospitalized with serious infections in the country – 90% – are not fully vaccinated. The recent full FDA approval of the Pfizer-BioNTech vaccine was seen as a turning point in the fight against the virus in Louisiana by the state’s governor and health officials, who hoped that it would help to persuade some of those who had remained hesitant.
Ochsner Health, the largest healthcare system in the state, with 40 hospitals, 25,000 employees, and nearly 1 million patients treated in the state each year, announced that all employees would be required to be vaccinated by 29 October.
“I was really excited when Ochsner came out very early [with a requirement]. I think it makes good sense for the operation,” said Avegno. “We are already at a staffing challenge. If our healthcare workforce continues to get sick with Covid because they’re not vaccinated, then we can’t care for everyone else.”
The vaccine requirement applies to physicians, providers, nurses, and staff, including clinical and corporate workers at Ochsner Health-owned facilities. At a press conference last week, Ochsner reported that 78.4% of its staff were vaccinated.
However, a few nurses are still reluctant to get the shot and some are even willing to lose their jobs over it. The Guardian spoke with several such nurses, who requested anonymity out of fear of reprisals from their employers.
“I will not take it and if I get fired, so be it,” said Pam, an LPN employed at an Oschner family medicine clinic in Hammond, Louisiana. “I’m completely against it. If they can take this freedom away from us, what else can they take away from us?
“Where are we going down this path? If I choose not to get the vaccine, that should be my option. If it’s okay for me to get an abortion because it’s ‘my body, my choice’, then why is sticking a needle in me not also ‘my body, my choice?’”
The three vaccines authorized for use in the US were carefully tested for safety during development and have proven to be highly effective against severe disease, hospitalization and death from Covid-19. Almost 180 million people are now fully vaccinated in the US.
But Pam and Stacy, another nurse who works in her clinic who also says she plans to refuse to get vaccinated, said they believed (contrary to evidence) that the vaccines had not been fully vetted or studied. Pam, who described herself as anti-abortion and anti-mask, also believes the Johnson and Johnson vaccine contains aborted human fetal cells, despite this claim having been debunked. She said that taking it would “violate the sanctity of life” and go against her religious beliefs.
She and Stacy also touted other claims that have been disproven, but are often cited by people who are against vaccines, such as the idea that mRNA vaccines can affect your DNA despite never entering or interacting with a cell’s nucleus, where DNA is stored. “I don’t believe you should manipulate your DNA,” Pam said.
While Pam and Stacy are in the minority, vaccine hesitancy in healthcare workers is often promoted and used by anti-vax campaigners to spread misinformation. And vaccine hesitancy among a minority of nurses isn’t just confined to Louisiana.
Avegno said she’s aware of nurses who are hesitant to get vaccinated. “The majority of nurses in Louisiana I think are vaccinated; however, there’s still a significant minority who are on the fence. I know some of them, I’ve talked to them, and I think you’ll see with a mandate that many of them are probably not as stuck in their beliefs as you think,” she said.
“As a healthcare worker, you have a responsibility to do no harm to your patients,” said Avegno. “If you’re going to be someone who is entrusted with the care of patients who are vulnerable and ill, and you can’t make the choice to protect them, then you probably shouldn’t be working in healthcare.”
Pam said she knew of a few other nurses who shared her sentiments and were seeking employment in facilities that didn’t require them to be vaccinated against Covid-19, such as the North Oaks Healthcare System in Hammond, Louisiana. A friend and fellow nurse who works in the North Oaks Pediatric Clinic reached out to Pam and offered to help her find a position there so she could continue working as a nurse but avoid having to get the shot.
However, in an effort to further bolster vaccination rates across the country and contain the latest surge of Covid-19, last week Joe Biden introduced sweeping new requirements for federal workers, larger employers, and healthcare staff. These new mandates will require all healthcare staff, including nurses, to get vaccinated against the virus if the healthcare system treats patients who are on Medicare or Medicaid, covering most but not all systems in Louisiana, including North Oaks, which does accept both Medicare and Medicaid.
In a written statement, North Oaks said: “We are considering all of our options, and no final decision [on mandates] has been made at this time.” It added: “We do believe vaccination and masking prevent serious illness. At present, 67% of our staff are vaccinated.”
Avegno believes vaccine mandates are effective, citing the increased rates after requirements put in place by New Orleans in August. “One restaurant group was telling me that they had about 60 employees who had not been vaccinated and they were really worried that they’d all walk off the job,” Avegno said. “What they found was as soon as they put it into place, almost everyone decided to get vaccinated.”
Sarah, a family nurse practitioner working at an occupational medicine clinic in New Orleans, said she had gotten the shot to avoid losing her job, despite still harboring concerns and opposing vaccine mandates.
“I was basically told I had to get it,” she said. “I feel that if I was good enough to take care of you when there wasn’t a vaccine and put myself at risk and that I did catch Covid from a patient, then I should have the choice of whether I want that vaccine or not.”
Sarah said she had heard other nurses say that they’d refuse to take the vaccine if their employer required it, but that was before the Biden administration’s mandates last week. Some have reservations similar to hers and are based on personal liberty and acquired immunity, while others are full-blown conspiratorial, she said. “It’s aggravating to be lumped together with those people,” she said.
