HJAR Mar/Apr 2022

VACCINE MANDATES 22 MAR / APR 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   public entities were not the only ones imple- menting policies regarding COVID vaccina- tions or testing. Even before the CMS and OSHA mandates were published, private employers were taking action to implement mandatory vaccination policies. In October, the Arkansas legislature enacted Act 1115, which requires that any employer-man- dated vaccination policy must include cer- tain specific exemptions that allow employ- ees to demonstrate their COVID-negative status without getting a vaccination. The Governor allowed that act to become law without his signature, and the act became effective in January 2022, just as the law- suits regarding the federal mandates were being decided. CLARITY At this point, one could argue that the only thing that is clear about COVID vac- cination mandates is the lack of clarity. The CMS rule has survived and will soon be implemented with no exceptions. The OSHA standard, while not effective at this time, may appear again in the same or another form when OSHA issues a final COVID standard at some unknown future date. Althoughmost federal employees have been vaccinated, disciplinary action against those who have not is on hold as a result of the Texas federal court case. In Arkansas, any employer not covered by the CMS Rule desiring to implement a mandatory vacci- nation policy must consider the implica- tions of Act 1115 in designing that policy. SERENDIPITY Despite the confusion, contention, and lack of clarity surrounding COVID vaccination mandates, there have been some COVID-related moments of serendip- ity that suggest that the light at the end of the tunnel is, in fact, not an oncoming train. A Little Rock television station reported that the ice storm that hit most of Arkan- sas during the first week of February may have actually snapped the surge in COVID- 19 cases inArkansas. 9 Officials of theArkan- sas Department of Health suggested that the cold weather may have slowed down the spread of the virus, a welcome change from the surging numbers of the Omicron vari- ant. Staying at home and avoiding further exposure to the virus in public served as a brief weather-induced “quarantine” and may be responsible for the drop in positiv- ity rates compared to the week before the storm. On a larger scale, the AP reported last week that American hospitals facing a shortage of nurses during the pandemic are finding it easier to fill vacancies with foreign professionals, including nurses. 10 U.S. con- sulates were shut down for much of federal fiscal year 2021 and, as a result, issued very few visas to relatives of American citizens. By law, those unused visa slots now carry over to the current year and are transferra- ble to eligible workers. In a typical year, the U.S. issues 140,000 green cards to people moving to the U.S. permanently for profes- sional employment, including nursing. This year, 280,000 green cards are available, and hospitals and healthcare recruiters are hop- ing to use some of those extra spots to alle- viate the U.S. nursing shortage. While the future of the COVID-19 pan- demic is uncertain and unexpected sur- prises will continue to affect its course, health officials continue to stress the impor- tance of vaccinations as the best solution for fighting the pandemic. After two years, it remains unclear whether vaccination man- dates by any entity at any level will over- come the confusion, contention, and lack of clarity that has been their hallmark up to this point. n REFERENCES 1 CDC COVID-19 Response Team. “Geographic Differences in COVID-19 Cases, Deaths, and In- cidence — United States, February 12–April 7, 2020.” Morbidity and Mortality Weekly Report, 69, no.15 (April 17, 2020): 465-471. https://www. cdc.gov/mmwr/volumes/69/wr/mm6915e4.htm 2 Boulanger, A. “Understanding Opposition to Vaccines.” Healthline. Updated Sept. 15, 2017. https://www.healthline.com/health/vaccinations/ opposition 3 “Path Out of the Pandemic.” The White House. August 18, 2021. https://www.whitehouse.gov/ covidpla 4 Federal Register, 86, no. 212 (Nov. 5, 2021): 61555-61627. https://www.federalregister.gov/ d/2021-23831 5 CMS. Letter to State Survey Agency Directors from Directors of Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG). Reference QSO-22-07. Dec. 28, 2021. https://www.cms.gov/files/document/qso-22- 07-all.pdf 6 CMS Letter to State Survey Agency Directors (QSO-22-09). January 14, 2022. https://www.cms. gov/files/document/qso-22-09-all-injunction- lifted.pdf 7 Federal Register, 86, no. 212 (Nov. 5, 2021): 61402-61555. https://www.federalregister.gov/ d/2021-23643 8 Federal Register, 87, no. 17(Jan. 26, 2022): 3928-29. https://www.federalregister.gov/ d/2022-01532 9 Nugent, D. “Arkansas Department of Health say winter storm helped decrease COVID cas- es.” KATV. Feb. 4, 2022. https://katv.com/news/ local/arkansas-department-of-health-say- winter-storm-helped-decrease-covid-cases 10 Taxin, A. “U.S. hospitals look for nurses abroad to relieve shortage.” Arkansas Democrat Gazette. Feb. 4, 2022. https://www.arkansasonline.com/ news/2022/feb/04/us-hospitals-look-for-nurs- es-abroad-to-relieve/ “At this point, one could argue that the only thing that is clear about COVID vaccination mandates is the lack of clarity.”