The Boston area’s major hospital systems are requiring employees to receive a COVID-19 booster shot as a condition of employment, as evidence builds for the importance of a third dose to protect against the Omicron variant.
Mass General Brigham, Beth Israel Lahey Health, Wellforce (the parent company of Tufts Medical Center), and the Dana-Farber Cancer Institute informed employees Tuesday that they must present documentation of a booster shot within the next several weeks. Boston Children’s Hospital said Tuesday that it also intends to require booster shots but had not yet worked out details such as the deadline for compliance.
“In the face of Omicron, boosters have become almost a necessity, particularly for those of us vaccinated more than five or six months ago,” said Dr. Megan L. Ranney, academic dean for the Brown University School of Public Health. Rhode Island Hospital, where Ranney works as an emergency physician, has not required boosters but Ranney said she would welcome such a directive.
“The booster is especially necessary for health care workers,” Ranney said. Even mild cases of COVID-19 can keep people out of work for days or weeks. “It has a huge domino effect on our ability to provide safe and adequate care to patients,” she said.
In deciding to mandate boosters, hospital leaders followed data from other countries as well as the experiences of their patients, said Dr. Sharon Wright, chief infection prevention officer at Beth Israel Lahey Health. “We, like the rest of the country, are seeing that patients who are boosted are mostly not winding up in the intensive care unit or having severe outcomes,” Wright said.
The Omicron wave will likely have passed by the time all staffers are boosted and the shots have had time to take effect, Wright noted. “But we’re not out of the pandemic,” Wright said.
In making this move, the hospitals follow in the footsteps of universities, including Emerson College, Boston College, Northeastern University, and Brown University, which have already mandated boosters for students and staff.
In Massachusetts, about half the people eligible for boosters have received them; nationwide it’s only about a third.
Boosters were originally recommended, amid some controversy, when it became clear last summer that the immunity from two doses of vaccine starts to wane after a few months. The matter took on greater clarity – and urgency – with the arrival of the Omicron variant in November, which can evade immunity from both infection and vaccination. But studies have shown that a booster shot restores much of that immunity, reducing hospitalizations and deaths.
The Centers for Disease Control and Prevention recommends COVID-19 vaccine booster doses for everyone 16 and older. On Tuesday it shortened the interval between the second dose of the Pfizer vaccine and the booster to five months, down from six. And this week, the US Food and Drug Administration authorized boosters for children ages 12 to 15 years, a move the CDC is expected to review on Wednesday.
Although the CDC has not included boosters in its definition of “fully vaccinated,” in practice they are often seen as necessary for true immunity, said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital.
“It has become clear to everybody that for mRNA vaccines [made by Pfizer and Moderna], these are really three-dose vaccines,” he said. Kuritzkes recently was notified by the Metropolitan Opera that it would honor his tickets to an April performance only if he had received a booster shot.
“In the midst of the current Omicron epidemic, we really should be encouraging everyone to get boosted,” he said.
The four hospital organizations that issued the booster mandate Tuesday had also been the first out of the gate with a COVID-19 vaccine requirement for staff in June. Other hospitals eventually followed their lead.
The Massachusetts Health & Hospital Association “fully supports the updating of mandatory vaccination policies to include booster shots,” said Steve Walsh, president and CEO, in a statement. “As we navigate the single most difficult period of this crisis, healthcare organizations need every tool at their disposal to remain safe and stable. The science is clear: boosters are an essential part of the equation.”
UMass Memorial Medical Center is “not requiring yet but recommending” boosters, spokeswoman Debora Spano said in an e-mail. Likewise, Boston Medical Center and South Shore Health are urging staff to get boosters while not requiring it.
The booster question arises as hospitals in Massachusetts are seeing their beds fill up, even as staff members are sidelined with COVID-19 infections. On Monday, emergency providers warned they are becoming “overwhelmed” by a COVID surge after December holiday gatherings spread the virus.
At Mass General Brigham, the state’s largest health care provider, employees will be required to receive their booster shots by March 1. Those who became fully vaccinated after Aug. 1, 2021, will be required to get a booster shot by June 30.
“It is essential that we take this action to ensure the safest clinical environment for our patients and their families and our employees,” Anne Klibanski, the president and CEO of Mass General Brigham, said in a statement.
Beth Israel Lahey Health said it is changing the definition of fully vaccinated to include a booster dose “in an effort to ensure we are doing everything we possibly can to protect our patients and our staff.” Employees will be required to receive the booster dose by March 1.
Wellforce, a health system that includes Tufts Medical Center, Tufts Children’s Hospital, and MelroseWakefield Healthcare, said in an e-mail to staff that it expects to set a spring deadline for obtaining a booster but had not yet chosen the date.
“The science is clear that boosters help solidify an individual’s protection against COVID-related hospitalization and severe illness,” Mike Dandorph, president and CEO of Wellforce, and Michael Wagner, Wellforce’s chief physician executive, said in the e-mail.