Local, state, and federal pandemic response leaders are pinning their hopes for widespread immunity to COVID-19 on growing numbers of vaccination mandates, but some frontline workers, including California police officers, firefighters, health care workers, and prison guards, are resisting.

Peter Chin-Hong, MD, a UCSF professor of medicine and infectious disease specialist, told Los Angeles Times reporter Hayley Smith that the biggest boost to vaccination rates “will come from mandates. . . . It will lead to more companies in the private sector and the public sector [requiring vaccines as a condition of employment].”

Counties and cities throughout California and the rest of the US have put mandates in place for people charged with protecting public health and safety. Los Angeles, San Diego, San Francisco, Oakland, and San Jose are among the major cities that have instituted vaccine requirements for city workers, including those in fire and police departments. Last week, a judge ordered that prison guards must be vaccinated. People who decline the vaccination risk disciplinary action and may eventually lose their jobs.

The California Department of Public Health issued an order in August requiring vaccinations for health care workers in a variety of settings across the state. California is one of four states, along with New York, Rhode Island, and Connecticut, that set deadlines of last week for health care worker vaccinations.

Frontline workers in public safety and health care hold a special position that “requires them to interact with our most vulnerable residents, many of whom are unvaccinated,” the San Jose Mercury News and East Bay Times pointed out in a recent editorial in both publications. Data from 2018 show that 61.5 million Americans had at least one in-person contact with a police officer (PDF) in 2018.

COVID-19 Outbreaks Erupt at LAPD and LAFD

An investigation by the Los Angeles Times published last week suggests that police officers and firefighters are at high risk of contracting the virus. More than half of all outbreaks in public safety agencies in Los Angeles County have happened within police and fire departments.

“Los Angeles County health officials have identified hundreds of coronavirus outbreaks at police and fire agencies since the start of the pandemic,” the Los Angeles Times reported.

In an analysis of city data, reporter Kevin Rector found 37 outbreaks of COVID-19 in Los Angeles police agencies, leading to 1,061 cases of the illness. The Los Angeles Fire Department had 75 outbreaks that resulted in 553 COVID infections.

In response to the mandate, employees from both LAPD and LAFD filed lawsuits challenging the requirement, while thousands more have indicated they intend to claim a religious or medical exemption, Rector reported.

According to the firefighters’ lawsuit, they are “pawns in a political chess match, ordered by 13 politicians on the Los Angeles City Council to inject themselves with an experimental vaccine — over their objections — or lose their jobs.” (Research has shown COVID-19 vaccines are safe and effective at preventing serious illness, hospitalization, and death.)

San Diego, San Francisco Cops Threaten to Quit or Seek Exemption

In San Diego, about 90% of police officers surveyed by their union said they oppose COVID-19 vaccination mandates, and 65% said they would consider quitting over the mandate.

“The San Diego Police Officer Association will not agree to mandatory vaccinations,” the union told the mayor’s office, saying they were drawing a “line in the sand.”

In San Francisco’s 2,835-member police force, 366 employees are unvaccinated, the San Francisco Chronicle reported. “Of the unvaccinated, 193 want religious exemptions and eight have requested medical exemptions.”

The department responded that “if unvaccinated officers continue to interact with those in the community, they could put themselves or others at risk.” County rules require those who work in high-risk occupations, including police officers, to be vaccinated by October 13. All other city workers must be vaccinated by November 1 or face disciplinary action.

California Prison Guards Ordered to Get Shots

On September 27, a federal judge ordered mandatory vaccinations for prison guards after outbreaks surged over the summer, fueled by the Delta variant. “From August to mid-September, the ruling noted, a ‘staggering’ 48 outbreaks have been traced back to prison staff,” Byrhonda Lyons reported in CalMatters. More than 5,000 prison staff members attended one-on-one counseling sessions to address concerns related to vaccination and 262 agreed to be vaccinated, while 4,300 others signed a statement of refusal.

“We still believe the voluntary approach is the best way forward,” Glen Stailey, president of the California Correctional Peace Officers Association, told Lyons. “We are looking into our legal options to address this order.”

Mandates for Health Care Workers

California is one of about a dozen states that require vaccinations for health care workers. Those affected by the initial order had until September 30 to get fully vaccinated. Laura J. Nelson and Connor Sheets of the Los Angeles Times reported that while “thousands of workers remain unvaccinated, either in defiance of the state’s order or through approved exemptions for medical or religious reasons . . . the number of holdouts seems to represent a small fraction of the Golden State’s approximately 2.4 million health care workers.”

Last week, the state also mandated vaccinations for adult and senior care facility workers, In-Home Supportive Services providers, certified home care aides, hospice workers who work in people’s homes, and people working in the state’s regional centers that serve people with developmental and intellectual disabilities, Victoria Colliver reported in Politico Pro.

In September, President Joe Biden announced plans to require full vaccinations for about 17 million health care workers at facilities that accept Medicare or Medicaid. The rule to implement this is still being developed, Hollingsworth and Webber reported.

White House press secretary Jen Psaki noted that hospitals in Houston and Maine lost relatively few employees after requiring employee vaccinations. “We’re seeing in a lot of places that this is working, it’s effective. It’s creating more certainty and protection in their workforces,” Psaki said.

The success of the mandates so far, wrote New York Times reporter Shawn Huber, is “bolstering the case for employer mandates.”

To send questions or comments, tweet at me with #EssentialCoverage or email me.

Heather Tirado Gilligan

Heather Tirado Gilligan is a journalist who has written for publications including Slate, The Nation, CNN, and the Washington Post. Previously, she was executive editor of the California Health Report, a news nonprofit covering disparities in health and access to health care. Heather received a master’s degree in journalism from UC Berkeley and a PhD in English from Rutgers University, where she studied race in American culture.

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