Marisa Peryer, Contributing Photographer

The Yale New Haven Health System has begun issuing warnings of termination to the roughly 300 employees who refused to get vaccinated against COVID-19 before the Oct. 1 deadline passed.

Last summer, Yale New Haven Health made the decision to require COVID-19 vaccines for all of its employees. Healthcare workers were given the opportunity to receive their vaccinations for free at local YNHH clinics. Now that the Oct. 1 deadline for inoculations has passed, YNHH has started issuing warnings and preparing to terminate the roughly 300 employees who had yet to submit proof of vaccination as of Friday. 

“The problem is, we’re not in a business where we can sacrifice public good for personal concern,” said Thomas Balcezak, the Chief Medical Officer of YNHH. “Our job is to take care of people and one of the most important things in taking care of people is that we ensure that we do so in a way that keeps those people and their families safe. And we just have decided that we simply cannot do that if our staff are not vaccinated.”

According to Balcezak, YNHH announced its decision to proceed with a vaccine mandate for all of its employees at a July 9 town hall. The town hall was followed by a formal written communication on July 12, which gave employees a timeline for completing their vaccination requirements. Since July 12, YNHH has operated 90 vaccination clinics through which employees could schedule vaccine appointments or show up to the clinic without prior notice.

For the employees who chose to receive one of the two-dose mRNA vaccines, Pfizer or Moderna, the deadline to get the first dose was Aug. 31. The vaccines take more time to qualify someone as immunized since they require two doses and several weeks’ worth of waiting time between doses, according to Balcezak. 

“Most of my friends and colleagues have been receptive to vaccinations,” Elizabeth Garibaldi, a nurse practitioner at YNHH, wrote to the News. “I believe that the vaccine is a good step towards prevention [of] COVID-19, but overall everyone should have their own choice whether or not they want to be vaccinated. I have seen people be skeptical towards the vaccine. It is understandable to be skeptical. … These vaccines are mRNA vaccines that do not interfere with our DNA in any way.” 

Starting the first weekend in September, Occupational Health Services began offering the single-dose Johnson & Johnson vaccine in pop-up clinics at all Yale New Haven Health sites, in addition to second-dose clinics for the mRNA vaccines. The clinics afforded employees with an additional opportunity to receive a vaccine before the deadline.

The last day YNHH offered vaccines to its employees before the deadline was Sept. 30, Balcezak told the News. As of Friday, Oct. 1, the deadline for vaccination, 300 employees had not submitted evidence proving their vaccination status and had not been approved for an exemption or deferral, according to Balcezak.

“We’re really trying to encourage people, […] as you can see from the time frame I outlined,” Balcezak said. “We’ve been very clear. We’ve been very communicative. We’ve been consistent, but we’ve tried to do so in a way that is transparent, non-punitive. It’s not our desire at all to have anyone leave our organization, so we’re trying to provide as many opportunities for people to become compliant. What we will not do, however, is change our policy.”

As the deadline approached, the hospital began instituting different warnings for its employees. During the week of Sept. 27, employees who had not received one or both doses of the mRNA vaccines or the single dose of the J&J vaccine received verbal warnings from Human Resources. This week, the 300 unvaccinated employees will receive a formal written warning. YNHH will start suspensions without pay for non-compliance next week, on Oct. 11. Finally, employees who have not complied with the mandate by Oct. 18 will be terminated, according to Balcezak. 

Robert McLean, New Haven Regional Medical Director of Northeast Medical Group of Yale New Haven Health, echoed Balcezak’s sentiment about transparency.

“[The] YNHH system announced several months ago the policy mandating COVID vaccines for its health care workers, and so this is no surprise,” McLean — the 2019-20 president of the American College of Physicians — wrote in an email to the News. “Employees have been given ample time and opportunity to comply. And this requirement is quite consistent with many health care delivery systems across the country. And from my standpoint as a physician and an employee of Northeast Medical Group, the ambulatory network of YNHH, it is most definitely the right decision.”

Balcezak added that employees who change their minds and get vaccinated after termination on Oct. 18 can return to their jobs “with open arms” and that there is not a limit to how long this policy will be upheld.

According to Balcezak, around 700 employees applied before the Aug. 1 deadline and were granted exemptions or deferrals to the mandate. This figure included about 70 medical deferrals and 300 approved exemptions for religious reasons, with the remainder coming from medical exemptions. Almost 300 applications for religious exemptions were also denied. 

The YNHH website also outlines the COVID-19 vaccination policy for all employees of the hospital system. The requirements allow for medical and religious exemptions by application. 

Individuals may request a COVID vaccination exemption or deferment (to a later date) for a medical reason or sincerely held religious/spiritual belief,” reads a July 22 bulletin on the website. “The process, criteria and forms are available on Employee Self Service.” 

There are three types of exemptions, according to Richard Martinello, Medical Director of Infection Prevention at Yale New Haven Health. The first is a medical exemption, such as an allergic reaction to a component in the vaccine. The second is a religious exemption. The third is a medical deferment.

“We allow religious exemptions for those who have sincerely held religious beliefs that would preclude them from being vaccinated, and we have a process for adjudicating that,” Martinello told the News. “The deferment has been for those who are either pregnant or breastfeeding, and it allows them to defer receiving the vaccine until either the pregnancy and/or the period of breastfeeding was complete.” 

He also noted that this policy was put in place before the Centers for Disease Control and Prevention gave clear guidance in August recommending vaccinations for pregnant women. 

According to Martinello, there are slight variations among vaccination policies in hospitals across the state of Connecticut. However, the Connecticut Hospital Association came out with a memorandum on June 24 that recommended that all hospitals in the state make vaccination a requirement for staff, while allowing for medical and religious exemptions.

Yale New Haven Health employs over 30,000 healthcare workers. Of those, the strong majority were vaccinated before the mandate was enacted.

“The vast majority of people who are in healthcare recognize it’s the right thing to do,” Balcezak said. “We spend an awful lot of time talking about the few who are making noise, but the vast majority of our employees not only got the vaccine, they are very active in trying to get their colleagues who have not yet been vaccinated to get it as well.” 

Balcezak also mentioned that employee exhaustion due to the pandemic is a real problem. 

According to him, the vast majority of YNHH recognize the importance of vaccination and are tired of treating patients whose illness could have been avoided.

“They’re tired. They’re tired of this pandemic. They’re tired of taking care of patients that don’t necessarily have to be ill because there is a vaccine,” Balcezak said. “The vast majority of patients that are still being admitted with COVID are unvaccinated people, and they’re tired.”

Yale New Haven Health now offers booster doses of the Pfizer vaccine to eligible individuals. 

Selin Nalbantoglu covers the School of the Environment as a beat reporter for the SciTech desk. Previously, she covered breakthrough research as an associate beat reporter. She is a sophomore in Saybrook College.