Position Statement: On the COVID-19 Vaccine, July 21

INTENT

The intent of this updated position statement is to emphasize that the New York State Nurses Association (NYSNA) supports the recommendation that everyone be vaccinated against SARS-CoV-2, the coronavirus that causes COVID-19 in a just, fair, and equitable manner.

Vaccines play a vital role in public health and a safe and effective COVID-19 vaccine will, at a minimum, decrease the number of people experiencing severe effects of the virus and save countless lives. But as nurses, we know, when it comes to healthcare decisions, force always comes at the expense of trust.

Vaccination is an important piece of the puzzle in ending the COVID-19 pandemic, but it is not the only piece. The most effective method to control an infectious pathogen — any infectious pathogen— is a multipronged approach. Based on our frontline experience battling the pandemic for more than a year, NYSNA members believe we must focus on education and vaccination in underserved and under-vaccinated communities, limiting everyone’s exposure by wearing well-fitting masks, maintaining social distancing, and improving ventilation in all workplaces and indoor spaces.

It is no surprise that there are spikes in COVID-19 cases at the exact moment most state and municipal guidelines on masking and social gathering were relaxed. This clearly illustrates the point that a vaccine-only strategy will continue to threaten public health.

A recent survey of our members, conducted from June to July, found several ongoing health and safety issues at New York healthcare facilities.

• Nearly 75% of respondents reported that PPE was not back to conventional guidelines
• Nearly half don’t think patient cohorting was done properly.
• Of the 35% who reported being infected with COVID, more than half were pressured to return to work early, and more than 56% still suffering symptoms more than 2 months after infection.
• Over 93% said pandemic working conditions had some or major impact on mental health.
• 83% of respondents are vaccinated.
• More than 75% believe that government authorities, including the CDC and OSHA, did not adequately protect them.

Health and safety risks at healthcare facilities must be prioritized in tandem with vaccination drives. Healthcare employers must put the lessons learned fighting this pandemic from the frontlines into practice to decrease the risk of repeated COVID-19 outbreaks. We object to employers pushing mandatory employee vaccination while simultaneously lobbying to relax PPE standards, frivolously contesting COVID-19 workers compensation claims and OSHA citations, and actively cutting corners on health and safety protocols. We object to being lauded as heroes, while simultaneously being blamed for infecting patients in order to limit institutional liability. This approach only deepens the institutional betrayal trauma that healthcare workers experience which generates mistrust and ultimately contributes to vaccine hesitancy.

Vaccination rates throughout the country remain far short of herd immunity levels, even as highly contagious coronavirus variants are driving an increase in infections. We are concerned that New York is among the top 10 states experiencing the sharpest increase in COVID-19 cases, all while relaxing public health protocols.

As we face the variants, we cannot afford to lose any more frontline nurses or healthcare workers due to vaccine hesitancy. We are already understaffed and over-traumatized by this pandemic. However, the way to build back trust and incentivize further vaccination among healthcare workers is to finally meet our broader health and safety demands, not to threaten us with the loss of a job. Having fewer nurses and healthcare workers available to battle the pandemic would be a great risk to patient safety at this time.

POSITION

It is the position of the New York State Nurses Association that:

1. The federal government must uphold a key principle of medical practice to ‘do no harm’ and use the best available science to guide vaccine policy;
2. COVID-19 vaccination cannot be relied upon as the sole intervention used for the prevention of COVID-19 transmission in healthcare settings or in communities;
3. The COVID-19 vaccine and testing must remain available free of charge with no out-of-pocket costs;
4. Patients, visitors and staff should be educated regarding COVID-19 vaccination facts and myths;
5. Successful COVID-19 vaccination programs should include educational components that address the benefits, risks, and common misconceptions of vaccination;
6. Nurses and other healthcare workers have a right to know what risks they’re facing when they report to work;
7. The mental health needs of healthcare workers (HCW) have not been adequately addressed and are a contributing factor to vaccine hesitancy. The trauma inflicted by the institutional betrayal of HCW—lowering of PPE standards, not being transparent about risk, denying testing, lowering HCW quarantine and isolation guidelines, not tracking and under-reporting HCW infection/sickness, fighting accommodation requests for the most vulnerable HCW, fighting worker comp claims—is real, breeds mistrust, and tragically continues. Additionally, the moral injury HCW experienced due to lack of resources and training contributing to losing record numbers of patients in their care and in being blamed for infecting patients, is well documented and under addressed.
8. Conventional guidelines for airborne precautions must be restored at all hospitals. New N95 respirators must be made available for every patient care session with COVID-positive patients or PUIs. PPE will not be reused unless designed/manufactured to be decontaminated and reused;
9. All health care industry demands to weaken their PPE stockpile threshold must be emphatically rejected by all levels of government. Hospitals’ 90-day PPE stockpile supply levels must be maintained and be completely transparent to the staff;
10. Fully and unequivocally acknowledge the airborne nature of COVID transmission. Masking and social gathering mandates must be restored to match the science of the airborne spread of COVID-19, and OSHA health and safety protections against COVID-19 must be made permanent;
11. All controls needed to protect healthcare workers and patients from COVID-19 exposure including administrative controls, proper screening and cohorting of patients, effective ventilation, appropriate and adequately-supplied PPE, proper donning and doffing areas, effective source control measures for staff, patients and visitors, AIIR (negative pressure) rooms, on-demand testing of healthcare workers, and workplace accommodations for those at high risk of severe illness or death, must remain in place and be, where necessary, expanded upon to protect healthcare and other workers;
12. Staffing ratios and levels for health care workers must be immediately restored on all units to pre-COVID-19 standards. No “reassignment” of healthcare workers outside of their usual units should occur without complete and comprehensive training;
13. Federal funding must be made available to ensure PPE levels, rapidly implement health and safety controls, and restore pre-COVID-19 staffing levels at public and safety net facilities that bore the brunt of COVID-19;
14. All Workers Compensation claims for COVID-19 from health care workers need to be treated with automatic presumption of acquisition at work. Healthcare employers need to accept their clear role in the spread of COVID-19 during this pandemic and pay benefits to those that risked their lives without subjecting them to inhumane hearings with their insurance lawyers. HCW who contracted COVID or in the rare case of having a long-term reaction to vaccination, need a guarantee of being provided with proper healthcare. Families that lost a HCW to COVID must be provided for;
15. Frontline HCW must have a voice and a seat at the table – immediately - beyond safety committees that are now a statutory mandate but won't be in place for months. Since the start of the pandemic, frontline staff have been advocating for the same health and safety protections that we are still advocating for—and that could have saved many lives if government agencies and hospital executives had listened to us. Frontline staff must be continuously involved in the ongoing pandemic response and planning at every healthcare facility;
16. A Healthcare Accountability Commission must be established for all healthcare workers and their employers in New York. This Commission must allow for transparency on how many healthcare workers got sick during the pandemic and tell the truth about the failures of our healthcare system. The public and the healthcare workers have a right to know what happened to their colleagues, patients, and families during COVID-19.

NYSNA will exercise our right to demand impact bargaining from employers who seek to impose mandatory vaccination policies on our members based on these principles for the safety of all healthcare workers and the communities we serve.