CT hospitals see increase in religious exemptions for COVID vaccines

At Bristol Health, a small independent health system with 1,800 employees, 98% of workers were vaccinated by the September 15 deadline. But while the hospital’s mandate to get vaccinated against COVID has pushed the majority of unvaccinated people to get vaccinated, it has also resulted in an increase in the number of workers enjoying religious exemptions.

Bristol this year approved 46 requests for COVID vaccine exemptions, of which 39 were granted on religious grounds. It also granted 26 exemptions for the flu shot this year, including 23 for religious reasons. In short: Bristol has approved nearly twice as many religious exemptions for the COVID vaccine than for the flu vaccine.

Unlike companies in other industries, all hospitals in the state have the unique ability to look to influenza vaccinations as a benchmark in exemption requests and approvals. In 2011, the Connecticut Hospital Association recommended that hospitals adopt influenza vaccination mandates, and all Connecticut hospitals currently have influenza vaccination mandates, spokeswoman Jill McDonald Halsey said.

The comparison between coronavirus and influenza vaccines is not perfect, as the production process may differ on a key point: some COVID vaccines are produced using fetal cell lines, while influenza vaccines are not derived from fetal cell lines. Some people opposed to abortion on religious grounds have cited the use of fetal cells as a reason for not getting the vaccine – even in flu vaccine cases where the argument has no bearing, research shows .

As they considered requests for exemptions, hospital officials must have questioned “whether or not this is a serious religious belief versus a mere reluctance to vaccinate,” said Christine Laprise. , Head of Human Resources and Operations at Bristol Health.

Bristol is not alone in seeing a spike in requests and approvals for religious exemptions for COVID vaccines. In interviews with The Connecticut Mirror, Yale New Haven Health and Hartford HealthCare reported seeing the same trend in their numbers. The Connecticut Hospital Association has also heard anecdotal reports of an increased number of religious exemptions at all levels in Connecticut hospitals, said Paul Kidwell, senior vice president.

“Certainly the number of religious exemptions requested for the COVID vaccine is much greater than the same number of exemptions requested for the influenza vaccine on an annual basis,” he said.

At Yale New Haven, requests for exemptions have multiplied medically and religiously, but more so for religious reasons, said Dr. Ohm Deshpande, deputy clinical director of Yale New Haven Health. The criteria for seeking medical exemptions for COVID vaccines are more stringent than those in place for religious exemptions, he added.

Officials have approved around 600 total exemptions for the COVID-19 vaccine, many of which are religious, while he has authorized around 500 total exemptions for the flu vaccine, Deshpande said.

“We have seen a significant number of requests,” he said. “Quite a few of them were turned down.” Of 855 requests for religious exemptions for COVID vaccines, 449 were approved and 416 denied, according to figures provided by spokesman Mark D’Antonio. Yale New Haven did not explain how many of the roughly 500 exemptions for the flu vaccine were religious or how many were denied.

Yale New Haven offers an appeal process for those who are denied an exemption, and “quite a few go through it,” Deshpande said.

The health system has about 30,000 employees and 95.83% were partially or fully vaccinated on Tuesday.

At Hartford HealthCare, around 1,000 employees have requested exemptions so far, the majority for religious reasons, said Dr. Ajay Kumar, executive vice president and clinical director. Kumar declined to be more specific in an interview on Tuesday because the system’s tenure deadline had not yet passed.

The number represents an increase over the number of flu exemption requests the system typically sees. In 2020, Hartford HealthCare approved 573 flu exemption requests, and 25% were for religious reasons, spokeswoman Tina Varona wrote.

“There is certainly a difference between the exemption requests for the COVID vaccines and the flu vaccine,” Kumar said.

Overall, 98% of the 34,000 employees and contractors were vaccinated at Hartford HealthCare on Thursday morning.

The three hospitals said they saw no trend in the positions held by employees seeking religious exemptions.

“It was actually surprisingly pretty consistent across the board,” Laprise said. “From your environmental service workers to a registered nurse to a medical assistant in virtually every area, we’ve had people voicing or submitting religious or medical exemptions or choosing not to go ahead.”

Some researchers and health officials wonder why more employees have asked for religious exemptions from the coronavirus vaccine than the flu vaccine.

“Rather than quitting, which most people really don’t want to do is face unemployment, loss of pensions, loss of Medicare, you would expect them to look for loopholes. So no surprise, ”said Arthur Caplan, professor of bioethics at the Grossman School of Medicine at New York University.

“You would think anyone with a religious exemption for a flu vaccine would have a religious exemption for the COVID vaccine, and vice versa,” said Ted Doolittle, the state health care advocate. “You wouldn’t expect to see a religious difference there. “

How do hospitals determine if a belief is “sincere?”

Decisions about who gets a religious exemption and who doesn’t are often made by a group of people in a hospital setting, rather than a single person.

In many cases, a chaplain or other religious affiliate will be on the panel, along with human resources officials and other administrators.

Applicants are asked to describe in writing their sincere religious beliefs and how long they have held them. The panel can ask follow-up questions.

“There are many requests for an objection to the use of fetal cell lines. In some cases, hospitals have asked if a person is currently taking drugs that have also been developed using these cell lines, ”Kidwell said. “So we’re digging a little deeper into some of the things that came out from the people asking for the exemption. “

Applicants must be clear and contextual. Exemptions can be denied if the applicant “does not take the time to actually describe the belief or why it is so firmly held,” Kidwell said.

“A long, one-sentence application that provides no information about the source of the belief, why they believe what they are doing, how long they have had this belief in this case, and why this belief goes against the grain. being vaccinated – I think that would be a reason why it could be refused or the hospital would come back and ask for more information, ”he said.

At Bristol Health, administrators sometimes request a letter from a pastor or other religious leader if the applicant is from a ward.

“It’s really an interactive process of understanding whether that individual’s belief is a serious religious belief, rather than being some sort of opinion or reluctance to be vaccinated,” Laprise said. “Lawyers also helped us in this process. “

Objections to vaccination according to religious criteria may arise from ethical objections to abortion. The Vatican issued a statement supporting the COVID vaccination.

Caplan has little patience for those who cite fetal cells as the reason for not getting the vaccine. “Almost all drugs and over-the-counter products have been tested in fetal cells,” Caplan said. “If you really took this objection seriously – if you didn’t invent yourself just to escape the vaccination – you couldn’t go to the hospital, and you couldn’t go to the pharmacy.

“I’m going to say, bluntly, these are people who cling to straws,” Caplan said.

Kidwell said he was unaware of any hospital facing challenges under Title VII of the Civil Rights Act, which protects against discrimination based on religion. Employees who believe they have been wrongly denied an exemption may first go through a hospital’s internal appeal process.

In general, religious exemptions are unlikely to be the escape route some people opposed to vaccination are hoping for, Caplan said.

Employers are obligated to accommodate religious beliefs if they do not cause them “undue hardship.” An accommodation would be considered an ordeal “if it is costly, compromises workplace safety, decreases the efficiency of the workplace, infringes the rights of other employees, or requires other employees to do more than their share of potentially hazardous work. or painful, “according to the United States. Ministry of Labour.

“An employer can always refuse a religion claim. They have to try to accommodate you, ”Caplan said. “There may be jobs where you can work from home and you don’t see anyone, and the employer will keep you, but none of those are in health care.”

Health systems that grant exemptions should have additional precautions for unvaccinated staff, such as weekly testing, Doolittle said. Some hospitals, like Hartford Hospital, are taking this step.

“People fear going to places or receiving care from people who are not vaccinated for whatever reason,” Doolittle said. “From a vulnerable person’s perspective, it doesn’t matter if it’s a religious exemption or some other philosophical or political reason for not getting vaccinated – you want people to be vaccinated. These places really should have strict mask and test mandates for anyone who is unvaccinated. “