As parents of a pandemic baby, we find that life has revolved around diapers, nursing, and protecting our son from COVID-19, since he is too young to be vaccinated.
Once our pediatrician began scheduling him for another round of the dozen vaccines that protect children from diseases that used to kill millions each year before their first birthday, we were shocked to learn that several nurses in our doctor’s practice were not vaccinated.
How can this possibly be the case nearly a year after highly effective COVID-19 vaccines were approved and have saved thousands from illness and death?
We vividly remember being interviewed by our doctor before our son’s birth and being told in no uncertain terms that we would not be accepted into his practice if we were not willing to follow the child immunization schedule recommended by the Centers for Disease Control and Prevention.
Since we are public health practitioners who have worked on child immunization for decades in countries from Namibia to Moldova, we chuckled at his repeated stern reminders; our pediatrician was preaching to the choir.
So why are some nurses in his office not vaccinated? Because neither the state nor the federal government is imposing a vaccine mandate on small private practices, and the doctors in them are worried about losing nurses and other ancillary personnel if they force their health care workers to be vaccinated.
An informal survey among friends revealed that our experience is not uncommon — many pediatric practices do not have fully vaccinated staff. While the pediatricians we spoke with were unhappy that not everyone is vaccinated, they said that nursing shortages are acute and that their small independent practices could not afford to lose nurses and still operate. And so they have decided that this best serves the overall interests of their patients, despite the avoidable risks.
At this point in the pandemic, allowing unvaccinated health care workers to treat children is not acceptable. The American Academy of Pediatrics reports that the number of new pediatric COVID cases remains high, with 27 percent of the weekly nationally reported cases occurring in children. In Massachusetts, 30 percent of confirmed cases over the last two weeks were in children. Although few children die from COVID, studies have found that up to one-third of infected children experienced long-haul COVID, whose long-term effects are still unknown.
Mandates have been found to work well in increasing vaccination rates among health workforces, without significant attrition, as recent experience across the country has just shown.
The major hospital systems in Massachusetts have set vaccine mandates for their workforce, and Governor Charlie Baker has done the same for long-term health care facilities and home care workers, but he has not extended it to health workers in pediatric practices. The mandates have not caused a catastrophic exodus of health workers, and the system has not collapsed, as initially feared — 90-97 percent of employees across Mass General Brigham, Boston Medical Center, and Beth Israel Lahey Health have complied with the requirements ahead of the Oct. 15-31 deadlines.
Baker needs to close the loophole for licensed health workers who are outside of the current mandates but still work with vulnerable populations, including children. This includes health workers at the more than 100 independently owned community-based pediatric practices located throughout Massachusetts that care for more than 200,000 children.
Other parts of the country are ahead of us on this. Vaccines are compulsory for federally qualified health center pediatric practices in all states and for all pediatric care — network-based and independent practices — in California, Colorado, Maine, New York, and Washington, D.C.
The Massachusetts Nurses Association itself believes that its members are “ethically, morally, and professionally obligated to work collectively to reduce further harm to members, patients, and communities … from COVID-19 . . . and supports requiring FDA-approved COVID vaccinations for health care workers.”
The most often-cited reasons behind vaccine hesitancy, such as fears of side effects, the safety of the vaccine, and infertility have been disproven. The FDA-approved vaccines are safe, are highly effective against hospitalization and death, and do not cause infertility.
The governor must act now to ensure that children, especially those too young to be currently vaccinated, are protected by those entrusted with caring for their health and well-being by requiring COVID vaccinations for all licensed health workers in the state. Our baby, and all others like him who are too young to be vaccinated, deserve it.
Shan Soe-Lin is managing director of the Boston-based Pharos Global Health Advisors and a lecturer in global health at the Jackson Institute for Global Affairs at Yale University. Robert Hecht is the president of Pharos Global Health Advisors and a clinical professor of epidemiology at the Yale School of Public Health.