AUGUSTA — Maine is joining the growing list of states requiring all health care workers to be vaccinated against COVID-19 as the highly contagious delta variant drives up cases and hospitalizations.

Gov. Janet Mills announced Thursday that all hospital and nursing home staff, as well as dentists, EMS personnel and other health care workers, will be required to receive their final vaccine dose by Sept. 17. Mills said the “aggressive but achievable” timeline means all should be fully vaccinated against the viral disease by Oct. 1.

“With this requirement, we are protecting our health care workers, we are protecting their patients, including our most vulnerable people, and we are protecting our health care capacity,” Mills said in a virtual news conference. The new mandate adds COVID-19 to a half-dozen other mandatory inoculations for health workers in Maine.

Maine and much of the nation are experiencing another surge in COVID-19 cases and hospitalizations largely among unvaccinated individuals largely because of the more contagious delta variant. The Maine Center for Disease Control and Prevention reported 235 new cases and two additional deaths Thursday.

Roughly 80 percent of hospital staff and 73 percent of workers in nursing homes in Maine are fully vaccinated, according to filings with the state.

“That’s pretty good progress but we can and must do better,” Mills said, adding that it is “simply imperative that they take every precaution they can against this dangerous virus.”

MORE THAN 150,000 WORKERS

Segments of Maine’s health care industry were already moving in that direction. The state’s two largest hospital networks, MaineHealth and Northern Light Health, as well as Millinocket Regional Hospital, had already announced plans to require that all staff receive the COVID-19 vaccine.

But the mandate will now apply to more than 150,000 workers statewide at hospitals, clinics, group and nursing homes, dental offices, EMS agencies and other licensed health care facilities, according to state estimates.

The administration is using emergency rulemaking to expand the list of vaccinations already required for health care workers – a list that already includes inoculations against measles, mumps, rubella, chicken pox, Hepatitis B and influenza, or the common flu.

The expansion of the vaccination mandate to include COVID-19 will be controversial among some, however. Dozens of people testified against the Maine CDC’s addition of the flu vaccine last year, arguing such mandates violate workers’ personal and constitutional rights to control their own bodies. At the time, some workers even suggested they would leave their jobs rather than be forced to receive a shot.

Asked about concerns the new mandate could exacerbate staffing shortages at hospitals or nursing homes, Mills said she believes applying the requirement across the health care sector will dissuade people from leaving their jobs.

“Quite frankly, if everybody does this – and we are requiring all licensees to do it – there won’t be many places to go,” Mills said. “People won’t be able to quit their job and go to another job as readily because all health care licensees will be required to have everybody vaccinated.”

JOINING A SMALL GROUP

Maine will join a handful of other states – including California, Washington and New York – that have imposed a vaccine mandate on some or all health care workers. Each state is carrying out the policies differently, however.

New York, for instance, is only requiring employees at state-run health care facilities to be vaccinated. In California, all health care employees as well as teachers will have to show proof of vaccination or submit to regular COVID-19 tests. Washington is not offering regular testing as an alternative but will allow workers to opt out for religious reasons.

In Maine, health care workers will only be able to claim medical exemptions to the COVID-19 vaccine, not religious or philosophical reasons for opting out. That is the same policy for the six other vaccinations already required for health care workers in the state.

“To add those exemptions (for COVID-19) would be a change – and not a change that we wanted to make, given how important keeping our health care workforce safe is as well as keeping hospitals safe for patients,” said Dr. Nirav Shah, director of the Maine CDC.

The Maine State Nurses Association, which represents nurses at many of Maine’s larger hospitals, said the union supports accommodations for both medical and religious reasons.

“(The association) agrees that vaccination is a critically important part of a comprehensive public health program for infection control,” read a statement from the Maine State Nurses Association and the National Nurses Organizing Committee. “We strongly believe all eligible people should be vaccinated, while respecting the need for medical and religious accommodations. Science shows that a multiple-measures approach to infection control is the most effective, and vaccination is just one, albeit critical, component.”

Other important measures, the groups said, included protecting health care workers with single-use PPE, safe staffing levels, routine testing, adequate ventilation and “universal masking” in facilities.

Karen Harrington, a registered nurse from Clinton, was among those who testified in November against the Maine CDC rule change requiring health care workers get the flu vaccine. Harrington reacted to Gov. Mills mandate Thursday evening by saying she plans to leave the nursing profession entirely, a decision she anticipates other nurses will make.

“Holding healthcare workers’ careers and sources of income hostage is the very definition of coercion,” Harrington wrote in an email. “I think all humans, patients or otherwise, should be allowed to freely make their own medical decisions without coercion.”

The Republican caucus of the Maine Senate also took issue with the statewide mandate, albeit in less fiery rhetoric than some Republican lawmakers have previously used about Mills’ handling of the pandemic.

“In a free nation in which people are guaranteed the right to make decisions for themselves, Governor Mills has announced that she is mandating that private citizens in private health care facilities across the state must become fully vaccinated,” Senate Republicans said in a statement. “The governor is now directing the health care decisions of Maine’s health care professionals, rather than allowing them to make their own medically-informed decisions. If the various members of Maine’s health care community believe that vaccinations are essential, they have every right to mandate them for their own employees without government becoming involved in the decisions of private organizations.”

HOSPITALS SUPPORT MANDATE

But leaders of some of those private organizations, as well as the groups that represent them in the hallways of the State House, praised the statewide mandate. The leadership of the Maine Hospital Association, for example, has been urging Mills to impose a statewide mandate on health care workers since June.

“Governor Mills’ decision to require vaccination of health care workers is another example of close alignment between the government and the health care community,” Tim Dentry, president and CEO of Northern Light Health, said in a statement. “There is a reason why Maine is among the best states for COVID care and vaccination. With the new Delta variant, we cannot stray from our course.”

“MaineHealth applauds Gov. Mills’ decision to make COVID-19 vaccination a requirement for the state’s health care workforce for the same reasons our organization chose to require vaccination for all of its care team members,” Dr. Andrew Mueller, CEO of MaineHealth, said in a statement. “The vaccines are proven safe and effective, and vaccination remains the best way for us to protect our patients and communities from this terrible pandemic.”

Vaccination rates vary widely among staff at Maine’s health care facilities, according to mandatory reports to the state.

While Maine Medical Center reports 87 percent of its staff are fully vaccinated, the figure is 66 percent at Central Maine Medical Center in Lewiston. Meanwhile, the gap among nursing homes, assisted living facilities and group homes for individuals with disabilities ranges from 100 percent vaccination to lower than 30 percent.

Some facilities are also grappling with COVID-19 outbreaks. Maine Medical Center reports that 14 staff members have tested positive in recent weeks – including some fully vaccinated clinical staff in the emergency department – while Waldo County General Hospital has identified eight cases among staff. There have been no patient infections detected from either of those outbreaks.

CASES KEEP RISING

Meanwhile, cases and hospitalizations are rising in Maine.

With Thursday’s report of 235 new cases, the state’s seven-day average of daily new cases jumped to 161.4, compared to 106.1 a week ago and 16.4 a month ago.

Since the pandemic began, Maine has recorded 72,118 cases of COVID-19. The Maine CDC also reported two additional deaths Thursday, increasing the total number of COVID-related deaths in the state to 903 since March 2020.

Hospitalizations are also rising quickly in the state along with case numbers. On Thursday, there were 67 people hospitalized statewide with COVID-19 – up seven from the previous day’s inpatient tally and up 20 since Monday. Thirty of the individuals were being treated in critical care units with half of those individuals also connected to ventilators.

“That increase is certainly not the only reason but is at least an important contextual reason why the (vaccine mandate) announcement from Governor Mills is important,” Shah said.

While that is still well below the peak of more than 200 COVID-related hospitalizations last winter, the last time Maine had more daily hospitalization was June 4, according to state data. Hospitalizations typically lag case increases by two to three weeks.

Among counties, Penobscot County had the highest one-day case increase at 64, followed by 39 in Cumberland County and 21 in York County.

The latest Maine CDC data shows that Penobscot, Waldo, Washington and Piscataquis counties now have high levels of transmission and 10 other counties have substantial levels. Under federal guidelines, mask wearing is recommended in indoor settings for all people in those counties. Only Kennebec and Sagadahoc counties have moderate transmission.

But this latest spike in cases is causing concern because roughly 39 percent of the state’s population of 1.3 million remains unvaccinated. About 160,000 of those unvaccinated individuals are children under age 12 who are still too young for shots under the current federal authorizations.

Maine continues to have among the highest general vaccination rates in the country. As of Thursday, 69.6 percent of all eligible residents and 61.3 percent of the state’s entire population were fully vaccinated against COVID-19, according to the Maine CDC. Only Vermont and Massachusetts had higher full vaccination rates.

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