Some of the largest U.S. hospital systems have dropped Covid-19 vaccine mandates for staff after a federal judge temporarily halted a Biden administration mandate that healthcare workers get the shots.

Hospital operators including

HCA Healthcare Inc.

HCA 0.42%


Tenet Healthcare Corp.

THC 0.70%

as well as nonprofits AdventHealth and the Cleveland Clinic are dropping the mandates. Labor costs in the industry have soared, and hospitals struggled to retain enough nurses, technicians and even janitors to handle higher hospitalizations in recent months as the Delta variant raged. Vaccine mandates have been a factor constraining the supply of healthcare workers, according to hospital executives, public-health authorities and nursing groups.

Many hospitals already struggled to find workers, including nurses, before the pandemic. The shortages were compounded by burnout among many medical workers and the lure of high pay rates offered to nurses who travel to hot spots on short-term contracts.

The American Hospital Association estimates that 42% of U.S. hospitals have Covid-19 vaccine mandates in place.


David Paul Morris/Bloomberg News

More recently, thousands of nurses have left the industry or lost their jobs rather than get vaccinated. As of September, 30% of workers at more than 2,000 hospitals across the country surveyed by the Centers for Disease Control and Prevention were unvaccinated.

“It’s been a mass exodus, and a lot of people in the healthcare industry are willing to go and shop around,” said Wade Symons, an employee-benefits lawyer and head of consulting firm Mercer’s U.S. regulatory practice. “If you get certain healthcare facilities that don’t require it, those could be a magnet for those people who don’t want the vaccine. They’ll probably have an easier time attracting labor.”

A federal judge in Louisiana ruled in November that the Centers for Medicare and Medicaid Services didn’t have the authority to mandate vaccines for healthcare workers, blocking a Biden administration rule that affected some 10 million workers. The mandate had required all workers at facilities that participate in Medicare and Medicaid to get second shots by Jan. 4. The American Hospital Association estimates that 42% of U.S. hospitals, some 2,640 facilities, have Covid-19 vaccine mandates in place.

The Cleveland Clinic is suspending vaccine requirements but adding safety measures.


Dustin Franz/Bloomberg News

“I don’t think the mandates were helpful and I think the court in Louisiana did everyone a service,” said

Alan Levine,

chief executive officer of Ballad Health, which runs 21 hospitals in Tennessee and Virginia.

Mr. Levine said his company has about 14,000 employees, some 2,000 of whom are unvaccinated or didn’t request an exemption to the requirement. “That many people having to be terminated would have been devastating to our system,” Mr. Levine said.

HCA, among the country’s largest healthcare providers by number of hospitals, said in November that all employees needed to get vaccinated by the Jan. 4 federal deadline. HCA said it suspended its vaccine requirement after courts halted the federal mandate.

“We continue to strongly encourage our colleagues to be vaccinated as a critical step to protect individuals from the virus,” HCA spokesman Harlow Sumerford said. He said a majority of HCA’s roughly 275,000 employees are fully vaccinated.

AdventHealth and Tenet also said they wouldn’t require employees to be vaccinated after the court decision. Workers in states that mandate vaccination must comply with local laws, HCA and Tenet said.

The Cleveland Clinic, which has 19 hospitals in Ohio and Florida and about 65,000 U.S. employees, and Utah hospital giant Intermountain Healthcare also said they would suspend vaccine requirements following the courts’ actions. The Cleveland Clinic said it would add safety measures, such as periodic testing for unvaccinated employees who care for patients. Intermountain said 98% of its workforce had complied with the federal mandate.

Research into vaccine mandates has shown them to be largely effective. Psychologists at the University of Pennsylvania published research in the journal Nature in October showing that vaccine mandates were more likely to prompt workers to get a shot than to discourage them from doing so.

Speakers at the WSJ CEO Council Summit weigh to what extent the government should be able to require Covid-19 vaccinations.

A study published Wednesday in the New England Journal of Medicine found that Covid-19 cases and deaths were higher among residents of nursing homes with the lowest rates of staff vaccination. Researchers found that during the summer of 2021, 4,775 Covid-19 cases and 703 nursing-home-resident deaths from the illness could have been prevented if nursing-home staff had higher vaccination rates.

Not all hospital systems have scratched the mandate. Kaiser Permanente, which runs 39 hospitals and hundreds of medical offices in California and other states and employs nearly 210,000 people, said it gave employees until Dec. 1 to get vaccinated. So far, 98% of staff are vaccinated, but on Wednesday the hospital system terminated 352 employees, and another 1,500 face termination in early January unless they become fully vaccinated or receive an exemption, Kaiser said.

Northwell Health, New York state’s largest healthcare provider with 77,000 employees, said its mandate remains in place. In October, Northwell told The Wall Street Journal that 1,400 employees had been terminated for refusing to get vaccinated.

“We will not hire anyone who has not been vaccinated,” a spokesman said.

Write to Robbie Whelan at and Melanie Evans at

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