Rural hospital COVID-19 vaccination rates remain stubborn despite surge linked to delta variant

COVID-19 vaccine
A new survey of rural health leaders found that 75% report their facility does not have a COVID-19 vaccine mandate. (Getty/Hector Pertuz)

Vaccine hesitancy among rural health facilities remains rampant even as providers faced a major surge of COVID-19 due to the more transmissible delta variant, a new study finds.

The study, released Monday by the Chartis Group, also found that nurse staffing shortages are contributing to suspensions in care in vulnerable communities.

Chartis spoke with rural hospitals across the country from Sept. 21 to Oct. 15 and found that 44% of respondents said 50% to 69% of professionals in their facility were fully vaccinated. That is an improvement on an earlier survey conducted in March and April of this year, where 37% of respondents said 50% to 69% of professionals were vaccinated.

“While there has been some positive movement, the overall picture hasn’t really changed since earlier this year,” the report said. “That tells us that vaccine hesitancy and resistance remains strong, which may present significant challenges for hospital leadership with a federal vaccination mandate on the horizon.”

The lack of mandates in facilities may have also been a contributing factor in the lower vaccination rates.

Chartis found 75% of respondents reported their facility doesn’t have a mandate, but some state-specific laws that prohibit any mandates could play a role in this decision.

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So far, 41% of all hospitals have implemented some type of vaccine mandate for staff, the study added.

The lack of rural facility mandates comes as a federal vaccine mandate is on the way. The Centers for Medicare & Medicaid Services released a final rule earlier this month mandating each facility to get eligible staff fully vaccinated by Jan. 4 or risk losing participation in Medicare and Medicaid.

But 10 rural states have challenged the healthcare worker vaccine mandate in court. The states argue that the mandate could exacerbate staffing shortages currently roiling facilities.

However, Chartis’ survey also found myriad other factors are contributing to the staffing shortage.

A massive majority of the facilities surveyed (98.5%) reported facing some type of shortage.

The most difficult role to fill was nursing staff, with more than 95% of facilities having trouble getting nurses. Another 66% reported trouble finding ancillary service positions.

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“Pandemic burnout and retirement are significant factors in the current nursing crunch, but so too is the opportunity to move to a more financially lucrative position at another hospital,” Chartis said. “In our survey, 41.5% of respondents said better-paying jobs was the No. 1 reason behind nursing departures this year.”

Hospitals across the country are facing staffing shortages, but rural facilities, in particular, are facing a major crunch and have had to curtail care. Chartis found 30% said a nurse staffing issue resulted in facilities suspending services, and 22% said they are considering such a move.

The most common procedure suspended by such facilities was surgical procedures, with 48% putting inpatient, outpatient and elective surgeries on pause.

“Access to services is already a significant barrier for rural communities, and the pandemic’s impact on staffing—particularly nursing—threatens to amplify this issue for communities that are already vulnerable,” the report said.