A study underscoring the need to continue to protect older adults from COVID-19 comes as one state appears close to banning COVID-19 vaccine mandates by private employers, including senior living communities.
The Texas legislature passed SB 7 Tuesday, and it is expected to be signed into law by Gov. Greg Abbott (R). The bill offers no exemptions for healthcare facilities and includes a $50,000 fine for employers who punish workers who refuse the shot, as well as potential lawsuits by the state attorney general based on complaints filed with the Texas Workforce Commission. Along with employees, the bill would cover unpaid volunteers and contractors.
Employers would be allowed to require unvaccinated employees and contractors to wear personal protective equipment, including masks, or to enact other “reasonable” measures to protect vulnerable people, including other workers, visitors and residents at healthcare facilities.
In September, Texas lawmakers adopted SB 29, a ban on local governments requiring masks, vaccines or business shutdowns in response to COVID-19.
In submitted comments on the bill, Texas Health Care Association President and CEO Kevin Warren said that long-term care facilities suffered the brunt of the COVID-19 pandemic, adding that the virus didn’t start in facilities, but rather was brought in by employees and visitors. The association represents assisted living and skilled nursing providers.
“The Texas Health Care Association has previously taken and maintains the position that providers should have the right to determine their own position on whether to require vaccinations for their staff,” Warren wrote. “If a provider chooses to mandate the vaccine for its employees, then we will support their position as we would providers that choose not to mandate.”
Alyse Meyer, vice president of advocacy for LeadingAge Texas, raised concerns in submitted comments that a blanket prohibition on COVID-19 vaccine mandates by private employers would place its members at risk of violating staff vaccination requirements that could be reimplemented by the Centers for Medicare & Medicaid Services.
“Without clear language addressing this possibility or an exemption for contracted healthcare providers, members could be left with the choice of violating Medicare and Medicaid conditions of participation, thereby risking reimbursement and the ability to serve Medicare and Medicaid beneficiaries,” Meyere wrote.
Supporters of SB 7, the latest bill, said the legislation would protect an individual’s right to make private medical decisions without fear of retribution, further saying that healthcare facilities should not be exempted and that the healthcare industry should be held to the same standard as any other industry.
SB 7 sponsor Sen. Mayes Middleton (R-Galveston) called the bill the “strongest ban on COVID vaccine mandates in the nation — where no Texan will ever have to choose between their job and having to get the COVID vaccine again.”
Older adults remain at highest risk
Meanwhile, a recent study published in the Canadian Medical Association Journal underscores the need to continue prioritizing older adults for COVID-19 vaccination.
The study found that more than 80% of children and adults aged fewer than 50 years in the Lower Mainland, British Columbia, had been infected with SARS-CoV-2 by July and had a low risk of severe outcomes, but more than 40% of adults aged 80 or more years had never been infected with SARS-CoV-2 and had the highest risk of hospitalization and death.
Between July and December 2022, the risk of hospitalization for COVID-19 was about one in 30 new infections for those 80 and older, 10 times higher than the risk among children 5 and younger. The authors wrote that hospitalization risks are anticipated to be greater among the unvaccinated and lower among previously infected groups, with the lowest risk among those both vaccinated and previously infected.
“First-ever SARS-CoV-2 infections among older adults may still contribute substantial COVID-19 burden, reinforcing the importance of their continued prioritization for vaccination and their consideration in healthcare system planning,” lead investigator Danuta Skowronski, MD, of the BC Centre for Disease Control and the University of British Columbia, said in a report.
