For months, Mayor Bill de Blasio has been reluctant to make coronavirus vaccinations mandatory for anyone, hoping that encouragement, convenience and persuasion would be enough.
But with two million adult New Yorkers still unvaccinated — including a high percentage of employees in the public hospital system — and the Delta variant threatening the city with a third wave of cases, City Hall is trying out a new tactic: requiring workers in city-run hospitals and health clinics to get vaccinated or else get tested on a weekly basis, the mayor’s spokesman said Tuesday.
The new policy, which will be announced by Mr. de Blasio on Wednesday and goes into effect at the beginning of August, goes nowhere near as far as San Francisco’s announcement last month that it would eventually require all municipal employees to get vaccinated. Still, it is Mr. de Blasio’s first move to require any city employee to show proof of vaccination or a recent negative coronavirus test as a condition of showing up to work, city officials said. It will apply to more than 10 percent of the well over 300,000 people who work for city government.
It remains unclear whether City Hall intends to expand this approach to other city employees — police officers, teachers, clerical workers — or will limit this to those who work in hospitals and clinics.
“It’s all about the safety of a health care setting,” Bill Neidhardt, the mayor’s press secretary, said of the policy.
Hospital workers were the first group to get access to Covid-19 vaccines, when the city’s vaccination campaign kicked off in December amid New York’s second wave. Seven months later, the vaccination rate among workers in New York City’s public hospital system is slightly below the citywide average for adults, to the dismay of public health experts and government officials.
City Hall’s policy — which is more of a mandatory testing policy than a mandatory vaccination policy — seems crafted to avoid litigation or a fight with labor unions. Some of the largest labor unions representing city health care workers have publicly stated their opposition to mandatory vaccination requirements.
The city’s new policy will apply to the entire 42,244-person work force of the public hospital system, Health and Hospitals. The system has 11 hospitals, which include Bellevue and Elmhurst, as well as nursing homes and clinics. The policy will also cover some employees of the city’s Health Department.
There are still two million adult New Yorkers who have yet to receive a dose of any coronavirus vaccine.
As the initial crush of adults eager to get vaccinated began to subside in late April, the city tried knocking on people’s doors and offering shots in settings ranging from subway stations to museums, among other tactics. And yet that has not done much to jump-start the flagging vaccination campaign. Each day, fewer than 10,000 New York City residents on average are opting to get their first shot.
Getting more adults vaccinated is a pressing concern as the Delta variant has already sent case counts spiking to nearly 600 a day in the last week, more than double the daily average in late June.
And while nearly 54 percent of city residents of all ages are fully vaccinated — some five percentage points more than the national average — there are some neighborhoods with far less protection. The vaccination rates across the Bronx and Brooklyn are below the national average. Black neighborhoods and Orthodox Jewish neighborhoods in particular tend to have lower vaccination rates, with as few as 35 percent of residents fully vaccinated in some ZIP codes.
Hospital workers tend to be vaccinated at slightly higher rates than the general population. Across New York City, 70 percent of hospital workers are fully vaccinated, according to state data, compared with an adult citywide vaccination rate of nearly 65 percent.
But within the city’s public hospital system, Health and Hospitals, the vaccination rate is markedly lower. Almost 60 percent of the system’s work force is vaccinated, a Health and Hospitals spokesman, Christopher Miller, said.
One reason for the low rate, city officials have said, is intertwined with the demographics of the public hospital system’s work force. About 44 percent of city hospital workers are Black.
What to Know About Covid-19 Booster Shots
The F.D.A. has authorized booster shots for millions of recipients of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
Black New Yorkers, who make up about a quarter of the city’s population, have gotten vaccinated at lower rates than other groups. In interviews, many Black New Yorkers have voiced doubts about the safety of the vaccines and expressed concern that a full understanding of the side effects had yet to emerge. Others also cited the long history of doctors treating Black patients differently from white patients and past medical experimentation on Black people.
The city’s largest private hospital system, NewYork-Presbyterian, announced last month that it would require employees to be vaccinated against Covid-19, becoming an outlier among the city’s large hospital systems.
But it has yet to enforce that policy, allowing employees until Aug. 1 to apply for exemptions and until Sept. 1 to get the first shot. More than 70 percent of employees are vaccinated, according to Alexandra Langan, a spokeswoman for NewYork-Presbyterian.
Other major hospital systems in New York City have yet to make coronavirus vaccinations mandatory.
NYU Langone Health, a large New York City hospital group, said that 81 percent of its staff was currently vaccinated against Covid-19. Vaccinations would become mandatory for employees without valid exemptions after the vaccines receive full approval from the Food and Drug Administration, an NYU Langone spokeswoman, Lisa Greiner, said. Currently, the vaccines are being administered in the U.S. under an emergency use authorization.
District Council 37, the union that represents city workers, has been part of conversations with Mr. de Blasio’s administration about vaccinating health workers, although the union did not learn about the mayor’s new policy until Tuesday, according to two people familiar with the matter.
“The union strongly encourages vaccinations among membership and we’ve done a lot to help our members get vaccinated,” a union spokeswoman, Freddi Goldstein, said. Still, she said, “the union does not believe it’s the place of the employer to mandate it.”
Ms. Goldstein added that the union was supportive of more testing. “Of course with all things, we’ll need to see how it’s being implemented,” she added.
One epidemiologist said the new city policy was better than nothing, but he wondered why testing was only occurring once a week, and why the policy was not expanded beyond health care settings to include other city employees.
“One test a week is better than no test, but more frequent testing is always better when you have a lot of community transmission and we may have that situation among unvaccinated people in the fall,” said Denis Nash, a professor of epidemiology at CUNY School of Public Health.
Emma G. Fitzsimmons contributed reporting.