New Federal COVID-19 Vaccination and Testing Requirements

Requiring All Employers with 100+ Employees to Ensure their Workers are Vaccinated or Tested Weekly

The Department of Labor’s Occupational Safety and Health Administration (OSHA) is developing a rule that will require all employers with 100 or more employees to ensure their workforce is fully vaccinated or require any workers who remain unvaccinated to produce a negative test result on at least a weekly basis before coming to work. OSHA will issue an Emergency Temporary Standard (ETS) to implement this requirement. This requirement will impact over 80 million workers in private sector businesses with 100+ employees.

Requiring COVID-19 Vaccinations for Over 17 Million Health Care Workers at Medicare and Medicaid Participating Hospitals and Other Health Care Settings

The Centers for Medicare & Medicaid Services (CMS) is taking action to require COVID-19 vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement, including but not limited to hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. This action builds on the vaccination requirement for nursing facilities recently announced by CMS, and will apply to nursing home staff as well as staff in hospitals and other CMS-regulated settings, including clinical staff, individuals providing services under arrangements, volunteers, and staff who are not involved in direct patient, resident, or client care. These requirements will apply to approximately 50,000 providers and cover a majority of health care workers across the country. Some facilities and states have begun to adopt hospital staff or health care sector vaccination mandates. This action will create a consistent standard across the country, while giving patients assurance of the vaccination status of those delivering care.

Requiring Vaccinations for all Federal Workers and for Millions of Contractors that Do Business with the Federal Government

Building on the President’s announcement in July to strengthen safety requirements for unvaccinated federal workers, the President has signed an Executive Order to take those actions a step further and require all federal executive branch workers to be vaccinated. The President also signed an Executive Order directing that this standard be extended to employees of contractors that do business with the federal government. As part of this effort, the Department of Defense, the Department of Veterans Affairs, the Indian Health Service, and the National Institute of Health will complete implementation of their previously announced vaccination requirements that cover 2.5 million people.

Calling on Large Entertainment Venues to Require Proof of Vaccination or Testing for Entry

The President’s plan calls on entertainment venues like sports arenas, large concert halls, and other venues where large groups of people gather to require that their patrons be vaccinated or show a negative test for entry.

See synopsis of full plan at https://www.whitehouse.gov/covidplan/ 

 

COVID-19 Updates (09/10/2021)

Mu COVID Variant That May Resist Vaccines Found in 49 U.S. States

“Nebraska is the only state in the United States to have not detected a case of the Mu variant of COVID-19, which may render vaccines less effective. Since being first identified in Colombia in January, the Mu variant has spread to 41 countries, including the United States. Most prevalent in Hawaii and Alaska, the variant accounts for less than one percent of cases in the U.S., but its potential to be more transmissible or resist vaccines and natural immunity have health officials keeping tabs on the mutation.” Read full article on Newsweek website.

ANA Urges HHS to Declare Nurse Staffing Shortage a National Crisis

“The American Nurses Association (ANA), representing the interests of the nation’s 4.2 million nurses, urges the U.S. Department of Health and Human Services (HHS) to declare the current and unsustainable nurse staffing shortage facing our country a national crisis. In a letter to HHS Secretary Xavier Becerra, ANA calls for the Administration to acknowledge and take concrete action to address the current crisis-level nurse staffing shortage that puts nurses’ ability to care for patients in jeopardy.” Read full letter on Nursing World website

Breakthrough Infections Twice as Likely to Be Asymptomatic

Medscape Medical News reports, “People with breakthrough COVID-19 infections are two times more likely to be completely asymptomatic and are about two-thirds less likely to be hospitalized, compared with those who are unvaccinated, according to a new observational study. Individuals infected with COVID-19 after receiving their first or second dose of either the Pfizer, Moderna, or AstraZeneca vaccine experienced a lower number of symptoms in the first week of infection, compared with those who did not receive a COVID-19 vaccine, reported the authors of the report in The Lancet Infectious Diseases.”

 

Moderna Covid-19 booster may come later than Pfizer and a 3-dose regimen may be best, Fauci says

By John Bonifield, CNN

Updated 10:57 PM ET, Sun September 5, 2021

Booster doses of Moderna's Covid-19 vaccine may be delayed from rolling out the week of September 20 as planned, Dr. Anthony Fauci said Sunday.

Fauci, President Joe Biden's chief medical adviser, said that while the administration's plan had been to roll out booster doses of both Pfizer and Moderna at the same time, that may not happen.

Fauci said vaccine maker Pfizer has submitted its information to the US Food and Drug Administration and "things look like they're ready to go," Fauci told CNN's Jim Acosta.

He said Moderna might be a little bit behind that, and if it is, rather than seeing a simultaneous rollout of both products, Moderna could be rolled out a week or two later.

"I don't think that is a major issue there, but we would have liked to have seen it happen all together, simultaneously. But ultimately the plan will be implemented, as was put forth," Fauci said.

Fauci said the plan is contingent first on the companies submitting the appropriate data to the FDA, and second, getting FDA approval and then a recommendation from the US Centers for Disease Control and Prevention's vaccine advisers.

Fauci said ultimately, it may turn out the proper Covid-19 immunization regimen is three doses.

"What we're observing now -- not only here in the United States but in other countries, including Israel and the UK -- (is) that the durability of the protection tends to wane, particularly in the context of the Delta variant," Fauci told CNN.

He explained how such waning can lead to both breakthrough infections and breakthrough infections that lead to hospitalizations.

"You look at the evidence from the cohorts here in the United States, there's no doubt that there is a diminution in the efficacy of the vaccine against infection, namely symptomatic infection. There's a slight suggestion in a couple of the cohorts that it also is true for a diminution of protection against hospitalization -- not profound, but the suggestion when you look at the data is there," he said.

"However, when you look at the Israeli data, and they are about a month or so ahead of us in every aspect of this -- vaccinations, boosters, etc. -- the data from the Israeli studies are that there's a rather substantial diminution in protection against infection and an unquestionable diminution in the protection against hospitalization."

Fauci said the good news is that data from Israel shows booster doses offer "profound" protection against infection and hospitalization.

"Importantly, their data also show that when you give those boosters you reconstitute, to an even higher level than before, the protection against both infection and hospitalization," Fauci said. "The boosters really jack up the response very, very high, and we hope that that response would be durable."

 

CDC Experts May Not Back Widespread COVID-19 Boosters

“A Centers for Disease Control and Prevention (CDC) advisory panel [last] Monday indicated it could take a substantially different approach to booster doses of COVID-19 vaccines than the one proposed by the Biden administration. Members of the CDC's Advisory Committee on Immunization Practices (ACIP) said the evidence on boosters is not clear and indicated it would likely consider a risk-based approach that would prioritize residents of long-term care facilities and health workers rather than all eligible Americans at once.”

Read more in this article from The Hill.

 

Colorado requiring vaccinations for health care workers

The Hill / Celine Castronuovo

The Colorado Board of Health on Monday voted to implement a vaccine mandate for workers at hospitals, nursing homes and other state health care facilities following a request earlier this month from Gov. Jared Polis (D). 

The board members voted 6-1 in a virtual meeting that all employees, direct contractors and other staff at the roughly 3,800 health care facilities licensed in Colorado must receive their first dose of the vaccine by Sept. 30, according to local ABC affiliate KMGH

Under the measure, which is expected to be finalized by the state health board in October, all health care workers must be fully vaccinated no later than Oct. 31. 

The vaccine mandate will apply to staff members at general hospitals, rehabilitation centers, community health centers, assisted living facilities and other similar locations across the state, The Colorado Sun reported

According to the Colorado Department of Public Health and Environment, roughly 30 percent of health care workers at these facilities are currently unvaccinated. 

Polis in an Aug. 17 letter to the state Board of Health called for a vaccine requirement among health workers due to the rising surge in COVID-19 cases, largely attributed to the spread of the highly contagious delta variant. 

“The pandemic we face today is largely a pandemic of the unvaccinated,” the governor wrote, echoing previous statements on the recent surges from federal health officials. 

“The State can meet this challenge by getting more people vaccinated and protecting those most at risk,” Polis added. “The vaccine is a safe and proven tool to curb the spread of COVID-19 and save lives.”

The governor pushed for the vaccine mandate among health workers following “conversations with both senior living industry leaders, patient advocates and leaders in healthcare.”

“It’s critical that all personnel who are capable of bringing the deadly virus into facilities where our vulnerable populations are in their custody be fully vaccinated in order to save lives,” he added at the time. 

However, opponents to the mandate who spoke at Monday’s board meeting argued that the requirement could fuel staffing shortages, with some workers saying that getting the COVID-19 vaccine should be a personal choice. 

The vote Monday makes Colorado the latest in a series of states to adopt similar vaccine requirements for health workers. 

Both California and New York moved earlier this month to require staff at health care facilities to be fully vaccinated, as well as Illinois, which also implemented a similar mandate for teachers at public schools.

 
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