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V.A. Issues Vaccine Mandate for Health Care Workers, a First for a Federal Agency


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WASHINGTON — The Department of Veterans Affairs will require 115,000 of its frontline health care workers to be vaccinated against the coronavirus in the next two months, making it the first federal agency to mandate that employees be inoculated, government officials said on Monday.

The move comes as concern is growing that the substantial portion of the population that has not been vaccinated is contributing to the rapid spread of the highly contagious Delta variant. While it was a sharp departure from the Biden administration’s reluctance to embrace mandates, it was part of a broader shift in which New York City, many hospital chains and some private employers are deciding that the time has come to make being vaccinated a requirement.

“I am doing this because it’s the best way to keep our veterans safe, full stop,” Denis McDonough, the secretary of veterans affairs, said in a telephone interview on Monday. The department is one of the largest federal employers and is the biggest integrated health care system in the country.

The mandate will apply to workers who are “the most patient-facing,” Mr. McDonough said, including doctors, dentists, registered nurses, physician assistants and some specialists. Beginning on Wednesday, those health care workers will have eight weeks to get fully vaccinated or face penalties including possible removal, he said.

Jen Psaki, the White House press secretary, reiterated the Biden administration’s position on Friday that mandating vaccinations was a decision for private sector companies and local communities. But the decision at the department reflects a growing consensus among private sector employers, health care centers, and state and local governments to test the legal waters on vaccine requirements as cases rise sharply around the nation.

On Monday in New York, Mayor Bill de Blasio announced that all municipal workers would be required to be vaccinated against the coronavirus by the time schools reopen in September or face weekly testing. The measure, which will apply to about 340,000 city workers, including teachers and police officers, follows a similar mandate for the city’s public health care workers.

President Biden could legally require members of the military to get vaccinated, but so far he has declined to exercise that power. Military officials, while frustrated by a refusal among some service members to be vaccinated, have said their hands are tied until the vaccines receive formal approval from the Food and Drug Administration.

Mr. McDonough said he had informed the White House of his decision.

Scores of hospitals and health care systems have compelled their employees to get vaccines, and recent court decisions have upheld employers’ rights to require vaccinations. In June, a federal judge in Texas dismissed a lawsuit brought by employees of Houston Methodist Hospital who challenged the hospital’s coronavirus vaccination requirement.

Last week, a federal judge ruled that Indiana University could require students to be vaccinated as well. On Monday, a group of nearly 60 health care organizations released a statement in support of mandates for health care and long-term care workers.


Denis McDonough, the veterans affairs secretary, has expressed fears in recent weeks that centers with low vaccination rates are risking the health of veterans seeking care. Credit…Oliver Contreras for The New York Times

In recent weeks, there have been coronavirus outbreaks among staff members at Veterans Affairs health care centers in Little Rock, Baltimore, Orlando and Chicago, causing staff shortages and forcing the department in some cases to take emergency measures.

Roughly 70 percent of workers in department health care centers have been fully vaccinated, which is above the national average but not enough to satisfy officials in light of the dangers to veterans, who tend to be older, sicker and possibly more vulnerable to illness. “Our clinicians are arguing that we do need a higher number than that,” Mr. McDonough said.

He has repeatedly expressed fears in recent weeks that centers with low vaccination rates are risking the health of veterans seeking care. He said he did not know if any veterans had been sickened by workers in health care centers. To date, 146 department workers and 12,679 veterans, including 4,237 inpatients, have died from coronavirus-related complications.

Understand the State of Vaccine Mandates in the U.S.

College and universities. More than 400 colleges and universities are requiring students to be vaccinated for Covid-19. Almost all are in states that voted for President Biden.Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get the Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force. In N.Y.C., workers in city-run hospitals and health clinics will be required to get vaccinated or else get tested on a weekly basis.Can your employer require a vaccine? Companies can require workers entering the workplace to be vaccinated against the coronavirus, according to recent U.S. government guidance.

Like many state and local governments, the department recently struck a deal with its employee union to offer workers four hours of paid administrative leave if they prove that they have been fully vaccinated. “That was a meaningful step,” Mr. McDonough said. “But I think now given again what we are seeing as it relates to the trend lines in the disease, this is the next meaningful step.”

Other nations are looking at mandates generally to increase vaccine acceptance. In France, Parliament approved a law this week requiring a “health pass” that shows proof of full vaccination, a recent negative test or a recent Covid-19 recovery to enter restaurants or bars and for long-distance travel.

Greece mandated vaccines for all hospital workers in mid-July and barred access to indoor restaurants, bars and movie theaters for the unvaccinated, spurring protests. Italy is also moving forward with a vaccine mandate.

Department of Veterans Affairs workers will be able to appeal vaccine mandates based on medical or religious reasons and receive due process, and it is possible that others will resist. “I don’t know what to expect here,” Mr. McDonough said. “What I know is basically this is the most important step for us to take in terms of enhancing veteran patient safety.”

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