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Vaccine mandate for health care workers halted in Missouri for now, judge rules

The federal vaccine mandate for health care workers cannot be enforced in Missouri — or in the nine other states that joined the lawsuit — for now, a federal judge said Monday. 

Judge Matthew Schelp of the Eastern District of Missouri issued a preliminary injunction blocking the Biden administration from enforcing its COVID-19 vaccine mandate for health care workers under the Centers for Medicare and Medicaid Services (CMS) umbrella. 

Schelp, a University of Missouri alumnus who was appointed to his position by former President Donald Trump in 2019, said the CMS mandate needs congressional approval and would be “overwhelming” in terms of cost. 

“[T]he political significance of a mandatory coronavirus vaccine is hard to understate, especially when forced by the heavy hand of the federal government,” Schelp said in the order. “Indeed, it would be difficult to identify many other issues that currently have more political significance at this time.” 

“Truly, the impact of this mandate reaches far beyond COVID. CMS seeks to overtake an area of traditional state authority by imposing an unprecedented demand to federally dictate the private medical decisions of millions of Americans,” he continued in the order. “Such action challenges traditional notions of federalism.” 

Alaska, Arkansas, Iowa, Kansas, Nebraska, New Hampshire, North Dakota, South Dakota, and Wyoming fall under the injunction along with Missouri. 

Attorney General Eric Schmitt said the order was “significant” for health care facilities, particularly in rural areas, that were concerned the mandate would lead to even greater staffing shortages.

The Biden administration unveiled two heavily expected COVID-19 vaccination requirements earlier this month. One required employers with at least 100 workers to ensure they are fully vaccinated against COVID-19 or submit to weekly tests by Jan. 4. 

The CMS rule required all health care workers, clinical and non-clinical, under Medicare and Medicaid programs to be fully vaccinated against COVID-19 by Jan. 4. Exemptions would be permitted for people with a medical or religious excuse, a senior administration official had said. 

Both rules would cover about two-thirds of the workforce in the country, according to the White House. 

Missouri Attorney General Eric Schmitt, who is running for U.S. Senate, led the lawsuit earlier this month

“This is a huge victory for health care workers in Missouri and across the country, including rural hospitals who were facing near-certain collapse due to this mandate,” Schmitt said in a statement. “While today’s ruling is a victory, there’s more work to be done, and I will keep fighting to push back on this unprecedented federal overreach.” 

Speaking to reporters from St. Louis Monday afternoon, Schmitt said the order was “significant” for health care facilities, particularly in rural areas, that had concerns the vaccine mandate could lead to even greater staffing shortages and potential closures.

Aside from a lack of congressional approval, Schelp’s order said CMS did not properly consider alternatives to a mandate. It also said while CMS might have “evidence” showing a vaccine mandate for long-term care facility workers, it failed to demonstrate the need for other health facilities under its umbrella or adjust for risk factors or patient contact. 

“This injunction is rooted in misinformation and the political aspirations of some elected officials rather than in responsible public health policy,” said SEIU Healthcare Missouri State Director Lenny Jones. “Vaccine mandates are an opportunity for employers and workers to come together to provide education, listen to workers’ concerns, and address safety issues in facilities.”

Schmitt has already sued to block the federal vaccination requirements for large companies and federal contractors and employees.

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Also on Monday, President Joe Biden addressed the nation in an attempt to calm fears over the new omicron COVID-19 variant. He encouraged vaccinations, including the booster shot, as well as wearing face coverings in public, indoor places. 

Biden said the new variant is not a cause for panic but concern. 

“In the event, hopefully unlikely, that updated vaccinations or boosters are needed to respond to this new variant, we will accelerate their development and deployment with every available tool,” the president said. 

About 54 percent of Missourians who are at least 5 years old have completed the vaccination process against COVID-19. In the past seven days, there have been nearly 7,200 confirmed cases of COVID-19 in Missouri and 12 deaths, according to the latest data from the state health department. 

Missouri ranks last in the nation in terms of long-term care facility employees who are fully vaccinated. About 58.8 percent of all employees are vaccinated, according to CMS data. 

recent study from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) found long-term care facilities are facing the worst labor crisis and job losses of any other health care sector. Nationally, employment levels dropped by 14 percent since the start of the COVID-19 pandemic.

Representatives from Missouri’s business and health care communities warned lawmakers during a September House hearing of potential ramifications from a sweeping vaccine mandate.

“The entire health care industry right now, the health care system right now, is burned out,” Nikki Strong, executive director of the Missouri Health Care Association, said at the time. “To put additional strain and pressure on our workers who — for whatever reason, whatever belief they have, whether it’s taking the vaccine, taking a test daily, or whatever that mandate may be — is going to continue to decimate our workforce.”