Mandated vaccines for workers in health care settings has been both celebrated and attacked here and nationally, with opponents warning mandates will lead to large-scale resignations and exacerbate an already dire workforce shortage.
It's unclear how many New Hampshire nursing students have left their programs over mandates. Rep. Tim Lang, a Sanbornton Republican whose “vaccine freedom" bill prohibits public institutions like the state's universities from mandating a vaccine, said he knows of at least 18 nursing students who've withdrawn from their programs. (The law does not include private schools.) Lang has suggested hospitals offer a testing option instead, but that won't be allowed under the Biden administration's new mandate.
Of the nursing programs that responded to Bulletin messages, the Community College System declined to say whether students had left the program, citing student privacy, but acknowledged it's been an issue; Plymouth State University said no students have withdrawn; and the University of New Hampshire said it is not aware of any vaccine-related issues.
The concerns raised by nursing students in New Hampshire and nationally range from the vaccine's unknown long-term effects; its fast approval; suspicions the drug companies are motivated by profits, not public health safety; and opposition to mandates.
They are not persuaded by assurances from nearly all public health and government officials of the vaccine's safety. Nor do they believe officials' warnings that they are being misled by unproven claims and misinformation.
Nursing student Michelle Hammond said she is one of at least four students who left the nursing program at Lakes Region Community College because of vaccine mandates. She was two semesters shy of graduating from a program she began 15 years ago. Hammond is not opposed to all immunizations and got the flu vaccine last year. She said her resistance to a COVID-19 vaccine grew after she felt health care providers – including hers – didn't take her concerns seriously.
“I love being a nurse. It's like being a mom all the time," Hammond said. “Ethically, I just don't know if I want to be in that environment where doctors are ignoring the possibility that there are side effects related to the vaccine. We've been trying this COVID vaccine long enough to see there are problems."
Nicole Lheureux, 13 weeks pregnant, said she will leave her program at Plymouth State University if her two clinical sites do not give her a medical exemption. Among other concerns, she said she's worried the vaccine isn't safe for her unborn child given that it has not been approved for children under 12. And Jennifer Tuthill, who withdrew from her program at River Valley Community College in Claremont, doesn't believe the vaccine went through sufficient testing. “There were not even animal trials on these vaccines," she said. “We are the trial. We are the science experiment."
All said they felt like their nursing programs did too little to advocate for them.
Nursing programs said they are limited in how much they can intervene because unlike their state colleges, the sites that provide their students hands-on clinical experiences are not prohibited from mandating COVID-19 vaccines. And those sites said their vaccine policies will apply to students and staff.
That means students doing their clinical work within the Dartmouth-Hitchcock Health System must be vaccinated by Sept. 30. North Country Healthcare will require vaccines as of next month, as will Concord Hospital, which also owns Franklin Regional Hospital and Lakes Region General Hospital. In announcing the mandate, North Country Healthcare CEO Tom Mee said: “The data continues to reinforce the safety and effectiveness of the COVID-19 vaccines, including the mitigation of new and emerging threats such as the Delta variant. To that end, we confidently know more than ever that vaccination is the best way to end this public health crisis."
Shannon Reid, spokeswoman for the Community College System, said they are aware the vaccine mandate has become an issue at some clinical sites.
“The colleges can't dictate the terms under which hospitals and other health care provider sites allow individuals to work in their facilities and the ways in which these facilities seek to safeguard patient safety," she said in an email. “We are doing our best to work with students on a case-by-case basis, in ways that support their beliefs, individual circumstances, and educational aspirations."
The vaccination rate among health care workers nationally is estimated to be between 75 and 80 percent, but reliable data can be hard to find for most settings. And while the unvaccinated percentage may seem small, the numbers are not. New York is considering using the National Guard to replace the 16 percent of unvaccinated health care workers who don't have their first vaccine dose by a Monday deadline, The New York Times reported Saturday. That's about 70,000 workers.
Currently, nursing homes in all states must report staff vaccination rates to the federal government; according to a state-by-state map from the federal Centers for Medicare and Medicaid Services, many New Hampshire nursing homes report more than 75 percent of staff are vaccinated, but several report rates below that. Beginning in October, staff vaccination rates must also be reported by hospitals.
What's harder to find are vaccination rates among just nurses because data is often not broken down by position. In July, the Centers for Disease Control and Prevention reported that among long-term care facilities, just 56.7 percent of nurses had been vaccinated compared with 75.1 percent of physicians. The rate was much higher – 88 percent – among 4,912 nurses who responded to a recent survey by the American Nurses Association.
When asked in the survey about their and their patients' vaccine concerns, the nurses' responses were similar to those voiced by the nursing students who've left their programs or are considering it. These included a lack of data about potential long-term effects, pregnancy risks, the vaccine's effectiveness, and uncertainty about the need to be vaccinated.
Nurses also cited concerns about conflicting media reports of the vaccine's benefits and risks, a reason many in and outside the health care field also cite for their vaccine hesitancy.
Lheureux, whose concerns include not only health risks to her baby but also an increased risk of miscarriage, relies on two sources of information: her training and the Vaccine Adverse Event Reporting System (VAERS), a database of post-vaccination symptoms voluntarily reported by providers, vaccine manufacturers, and the public.
Although some believe the database is run by an independent third party, it is co-managed by the CDC and the federal Food and Drug Administration. To search it, users must acknowledge that the reports may be incomplete, “subject to biases," and have not been verified or investigated to determine whether there is a connection between the vaccination and the reported symptom.
As of Friday, there were 2.5 million reported symptoms for the COVID-19 vaccine, the vast majority of them headache (109,259); fever (91,361); fatigue (90,122); chills (80,520); and unspecified pain (77,522). There was one report of “risk of future preganancy miscarriage."
Still, Lheureux remains unpersuaded by the CDC's warnings that COVID-19 virus – not the vaccine – puts pregnant women at greater risk for severe illness. Or that the vaccine is safe for people ages 12 and up, pregnant women included. It's not a risk she's willing to take, she said.
“This vaccine came out faster than any other vaccine in our history, and on one hand that is the miracle of modern medicine," she said. “On the other hand, we don't have a lot of information on it. I think it has more side effects than are being talked about."
Lheureux has applied for a medical exemption citing her pregnancy at her two clinical sites, both of which require staff to be vaccinated. If her exemptions are denied and she cannot find another site that does not mandate vaccinations, Lheureux said she will withdraw.
Hospitals not mandating staff vaccinations include Parkland Medical Center in Derry, Portsmouth Regional Hospital, and Frisbie Memorial Hospital in Rochester. But that is unlikely to last under President Joe Biden's new executive order mandating vaccines, with no testing option, for all health care settings that receive Medicare or Medicaid funding. (Gov. Chris Sununu and Republican lawmakers are challenging that mandate, and the lawmakers have proposed legislation blocking the mandate from being enforced in New Hampshire.)
“We are reviewing the details of President Biden's plan and will respond accordingly," said Ryan Lawrence, spokesman for Parkland Medical Center, which like the other two sites is part of HCA Healthcare. “While to this point we have not mandated that our colleagues receive the vaccination, our infectious disease experts have strongly encouraged vaccination as a critical step to protect individuals from the virus."
Leaving her program was not an easy decision for Hammond, who began her studies 15 years ago but took time off to raise her kids.
“Understand that (a lot) is unknown. I was kind of waiting and being open-minded," she said. But as she heard about others' experiences following vaccination, the more fearful she became. Hammond said those symptoms have included leg swelling, rash, and temporary paralysis. Her father-in-law suffered chest pains after receiving the vaccine. There's no proof the symptoms were caused by the vaccine, but, Hammond noted, there is no proof they weren't.
“You weigh the risks of side effects against the risk of getting sick from COVID," she said. “And the fear of side effects scares me more than the fear of getting COVID."
Tuthill, who was to graduate in December, shares Hammond's concerns about the vaccine's side effects, and like Hammond, she has received other vaccines. She's also firmly opposed to mandates and is upset the CDC and federal Food and Drug Administration have warned against other medical treatments like hydroxychloroquine and ivermectin. She also suspects the government is downplaying what she believes are legitimate negative effects of the vaccine.
Tuthill sought a medical exemption and asked her nursing program to allow her to do her clinical work online. When none of her attempts worked before she had to commit to her final semester, Tuthill withdrew rather than lose a semester's worth of tuition.
She persuaded the program to defer her enrollment for a year with hopes vaccine mandates would end by then. But she's not optimistic they will, and she believes people who share her views will continue to be dismissed.
“A lot of the stuff I am getting is not from mainstream media," she said. “A lot of what I say would be pooh-poohed because a lot of people out there are not doing their research."
New Hampshire Bulletin is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. New Hampshire Bulletin maintains editorial independence. Contact Editor Dana Wormald for questions: info@newhampshirebulletin.com. Follow New Hampshire Bulletin on Facebook and Twitter.
