With healthcare workers at increased risk of contracting infectious diseases and transmitting them to vulnerable populations, the question of whether senior living and care facilities should mandate that staff members receive a COVID-19 vaccination has been the subject of a fair amount of debate lately. 

In response to this debate, a JAMA opinion piece released last week examines whether vaccine mandates are lawful and ethical and whether they could boost vaccine uptake.

“Healthcare institutions owe both legal and ethical duties to staff and patients to ensure a safe environment,” the authors wrote. “Additionally, because vaccines prevent hospitalizations, their wide use in healthcare settings may reduce worker shortages.”

They noted, however, that even among health workers, COVID-19 vaccine mandates could be counterproductive, given the stress of working during a pandemic. Instead, the authors suggest that operators allow for nonmedical exemptions to help reduce health worker concerns over mandates.

They further clarify that mandating COVID-19 vaccines under the Food and Drug Administration’s emergency use authorization — which is what both the Pfizer BioNTech and Moderna vaccines currently are approved under — is legally and ethically problematic. Experts say the two vaccines likely will receive full biologics licenses in the coming months, however. 

The JAMA article largely is in line with guidance released last month from the Equal Employment Opportunity Commission, which states that employers can require proof of COVID-19 vaccination from employees — with some exceptions.