Nurses Must Take the Lead on Mandatory COVID Vaccines for Health Care Workers

Nurses must consistently follow the evidence and make sound ethical and logical decisions that are in the best interest of our profession and the public we serve. This includes getting vaccinated against COVID-19.

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The nursing shortage is caused by multiple factors, including retirement drain, job stress, lack of nurse educators, understaffing and work environments. COVID-19 has intensified and exacerbated these issues. (Wikimedia Commons)

As new cases of COVID-19 continue to climb across the country, a polarizing spirited debate regarding mandatory COVID-19 vaccinations for health care workers, specifically for nurses, rages on social media. It is important to note that the unvaccinated are not a monolith, and thus unvaccinated does not always mean anti-vax. Nurses, with their intersectional identities and circumstances, are included in this. However, many nurses appear to be divided into two camps: those who support mandatory COVID-19 vaccinations and those who are against these mandates.

A concerning developing trend is that nurses and health care workers (HCWs) with anti-vax sentiments also tend to disseminate COVID-19 vaccine misinformation. This is even more egregious when nurses who share their unsubstantiated opinions regarding COVID-19 and the COVID-19 vaccines have large social media followings and are highly esteemed by some within the nursing profession. This allows them to potentially negatively influence their nursing peers and the public against getting vaccinated and widens the reach of COVID-19 misinformation far beyond their immediate community. Such widespread COVID-19 misinformation can have dire and tragic consequences, even including death. To counter this, a group of nurses created a Twitter account to advance knowledge and competency in immunizations and to position nurses as immunization advocates for peers and the public.

It’s also unsettling to see nurses on social media suggesting mandatory COVID-19 vaccinations will result in a significant exodus of nurses leaving the profession, thus creating an even greater nursing shortage during a pandemic. To suggest mandating COVID-19 vaccinations will be the major catalyst for the growing nursing shortage is disingenuous.

Evidence suggests the nursing shortage is chronic and is caused by multiple factors, including retirement drain, job stress, lack of nurse educators, understaffing and work environments that create nurse burnout. COVID-19 has intensified and exacerbated those chronic issues in the field.

Contrary to concerns about vaccine mandates instigating an exodus, thus far, health care organizations that have mandated COVID-19 vaccination for all health care workers have only experienced a minimal exodus of nurses who refused to be vaccinated.

What is also missing from this perspective is the enormous emotional, mental and psychological toll it is taking on frontline nurses who’ve been caring for COVID-19 patients and immersed in death for the last 18 months. Research has shown that frontline nurses are at three times the risk of COVID-19 hospitalization and their family members are at two times the risk of hospitalization for COVID-19 versus the general population. Nurses have accounted for approximately 30 percent of COVID-19 cases despite being only 15 percent of health care workers.


Frontline nurses are at three times the risk of COVID-19 hospitalization and their family members are at two times the risk of hospitalization for COVID-19 versus the general population.


Mandating vaccinations for nurses and other health care workers is not novel to COVID-19. Many HCWs are routinely required to have multiple screening tests and vaccinations to start their program of study and particularly before being placed in clinical settings. These same screening tests and vaccinations are required, some annually to maintain employment in health care.

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Health care workers are required to have multiple vaccinations to start their studies and particularly before being placed in clinical settings. (Creative Commons)

A core tenet of nursing is practicing in a way that validates the autonomy of individuals in their health and care. However, as nurses, we are held to a standard where we must evaluate how our personal decisions impacts those around us, as we practice our profession. For nearly two decades in a row, the public has ranked nurses as the most ethical and honest profession. Nurses must begin and continue to wield this trust in a way that is meaningful to the communities in which we practice.

This has historically been a challenge for the profession at large. It is unconscionable that nurses should openly reject proven vaccines against COVID-19 while allowing willfully unvaccinated nurses to continue to place people in their communities at risk.

Currently, emergency departments (ED) and intensive care units (ICUs) across the U.S. are filling with unvaccinated patients, resulting in resources being stretched to the brink. In Texas, the third wave of COVID-19 has prompted the governor to ask for out-of-state medical personnel and to request hospitals voluntarily postpone all elective medical procedures. Nurses are again sounding the alarm regarding unsafe staffing ratios and lack of other vital resources as we enter another COVID-19 surge because some, including nurses, refuse to get vaccinated.

These issues also manifest in other parts of hospitals, beyond the ICUs and EDs, impacting health care workers in every department, even those that don’t house and directly care for COVID-positive individuals. Further, the impacts of COVID spills beyond the walls of hospitals and into the community, where organizations and workers are also expending themselves to meet rising needs and ongoing challenges.

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Courts have upheld an employer’s right to dictate conditions of employment, including mandating vaccines. (Courtesy of CVS Health)

Still, there appears momentum is shifting as health systems across the country have begun to issue COVID-19 vaccine mandates for all staff, students and volunteers. Although some nurses have protested these mandates, courts have upheld an employer’s right to dictate conditions of employment. As this trend continues, it seems nurses who refuse the COVID-19 vaccination will have limited employment opportunities. Additionally, as a result of the significant economic toll the COVID-19 pandemic has taken on the economy, companies including Disney, Walmart, Google, Netflix, Microsoft and the NFL are following suit and mandating COVID-19 vaccine for their employees. 

Nursing is both an art and complex science. Nurses are expected to possess the most accurate and up-to-date evidence-based knowledge along with clinical skills to provide the best person-centered care possible. Our patients also depend on us to be compassionate and effective communicators. To accomplish this we must consistently follow the evidence and make sound ethical and logical decisions that are in the best interest of our profession and the public we serve and this includes getting vaccinated against COVID-19.

Multiple major professional health care organizations have acknowledged support of mandatory vaccination policies for health care workers and institutions. As positive COVID-19 cases are beginning to creep up in long-term care settings, seemingly due to unvaccinated health care workers bringing the virus into facilities, the nation’s nursing home operators are poised to mandate COVID-19 vaccinations for long-term care staff. In August of 2021, it was announced by President Biden that COVID-19 vaccination would be required of staff in long-term care facilities receiving Medicare and Medicaid.  This is the right thing to do for our patients, our communities and our peers. 

Mandatory COVID-19 vaccinations for nurses and health care workers will mitigate the spread and mutation of the COVID-19 virus, thus saving lives. Together we can ease the burden of the COVID-19 virus on our patients and communities—but only if we nurses follow the science and evidence and get vaccinated against COVID-19.

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About

Patrick McMurray BSN, RN is a nurse educator and experienced cardiovascular critical care and intermediate care nurse. He is also a strong advocate for supporting all pathways to nursing education including programs graduating licensed practical nurses (LPNs) and associate degree nurses (ADNs). McMurray is currently completing his master’s degree in Nursing (MSN). He will begin studies next fall to pursue his PhD in nursing.