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Health-Care Worker Vaccine Mandate Rule OK’d for Publication

Nov. 1, 2021, 2:38 PM

An interim final rule requiring Covid-19 vaccination for health-care workers at facilities paid by Medicare and Medicaid has cleared White House review and can publish at any time.

The health-care industry has led the charge for vaccine mandates in the workplace, with many hospitals and health systems requiring the jab for their staff before state and federal orders to do so.

The rule (RIN 0938-AU75) went through an expedited process due to the public health emergency. It will take effect as soon as it is published in the Federal Register. The Centers for Medicare & Medicaid Services may solicit feedback after the rule is published and post an updated final rule.

The Biden administration announced the mandate Sept. 9 as part of a broader action plan to combat the pandemic, with a more widespread vaccine mandate for large employers setting off similar rulemaking in the U.S. Labor Department’s Occupational Safety and Health Administration.

“There is no question that staff, across any health care setting, who remain unvaccinated pose both direct and indirect threats to patient safety and population health,” Department of Health and Human Services Secretary Xavier Becerra said after the requirement was announced.

Medical groups, including the American Hospital Association, said they supported the requirement when it was announced but urged the CMS to consider appropriate medical and religious exemptions.

The mandates don’t have full buy-in from staff, even in an industry at higher risk of contracting the coronavirus. Nursing home employees have been notably hesitant to get the shot, and their employers have been reluctant to require it out of fear workers might quit or not comply, worsening nationwide staffing shortages. Protests against the mandates have popped up across the country, generally from people who believe they are an imposition on their bodily autonomy.

Rulemaking typically starts with a proposed rule and a 30- to 60-day pause to solicit comments, followed by a sometimes lengthy review process. The Office of Management and Budget received the interim final rule for review Oct. 8.

To contact the reporter on this story: Allie Reed in Washington at

To contact the editors responsible for this story: Brent Bierman at; Karl Hardy at