UVA Health plans to require its nearly 2,000 unvaccinated employees to receive a COVID-19 vaccine by Nov. 1, or face possible termination.

The health system announced its new vaccine mandate last week, just days after the Food and Drug Administration granted full approval for the Pfizer vaccine and local COVID transmission levels rose from “substantial” to “high.” 

Hundreds of other hospitals around the country have enacted similar mandates.

“The COVID vaccines were operating under an Emergency Use Authorization and there has been some confusing guidance over whether you could have a mandate with an EUA,” said Margaret Foster Riley, a joint professor in the University of Virginia’s School of Law and the School of Medicine’s Public Health Sciences department. “Now, since it’s approved, it’s that much clearer, with Pfizer. So, that’s why you’re seeing healthcare institutions making these mandates at this time.”

Federal and state law have long permitted hospitals and other healthcare organizations to mandate their employees be vaccinated against other diseases, like the flu, Riley said. 

The reasoning is twofold. Hospital workers are more likely than the general population to come into contact with sick individuals. They are also more likely to be near people who are most vulnerable to the disease.

“The new policy will protect UVA Health’s patients, guests and team members,” the university said in a statement. “UVA Health already has required all new hires to be vaccinated.”

Having preexisting vaccine mandates made it easier for healthcare organizations to require COVID vaccines than other types of employers, Riley said.

For example, while UVA Health is mandating vaccines outright, the university itself is giving non-medical faculty and staff the option of becoming vaccinated or submitting to a weekly COVID test. 

Still, if COVID cases continue to surge, Riley anticipates more employers requiring vaccines — and for the courts to uphold those requirements.

The average number of new daily cases in the Blue Ridge Health District this week is more than twice what it was at this time last year, according to data from the health department. Daily case numbers this week are comparable to those seen last December.

This surge is happening despite nearly 60% of the health district being fully vaccinated. Health officials say that is largely due to the much more contagious Delta variant spreading through the unvaccinated population.

Less than 1% of COVID cases reported in Virginia last week were among fully vaccinated individuals, according to health department data.

Assuming they live locally, vaccinating UVA Health’s 2,000 unvaccinated employees could increase the health district’s vaccination rate by about 1%. 

“It’s hard to know what the impact will be in the community,” Kathryn Goodman, a spokeswoman for the Blue Ridge Health District, said in an email. “This policy charge may not impact local attitudes toward vaccinations — likely no more than any other employer requiring their staff to be vaccinated — but we hope that this will motivate others to get vaccinated that haven’t already!”