The Maine Board of Emergency Medical Services passed an emergency rule Monday that effectively narrows the scope of a state mandate requiring all health care workers and emergency medical personnel to receive the COVID-19 vaccine before October.
The board took action after hearing several hours of testimony from dozens of EMS workers, many of whom say the mandate eliminates medical autonomy and will force some to leave their jobs at a time when staff shortages already are prevalent.
The rule would give licensed EMS workers an additional month to become fully vaccinated and would exempt EMS dispatchers and students who don’t work directly with patients from the mandate.
However, it’s unclear what the rule’s impact will be, given strong opposition to mandated vaccination by some EMS personnel. Moreover, one board member stated emphatically that the rule doesn’t affect the original mandate announced Aug. 12 by Gov. Janet Mills, the Maine Department of Health and Human Services and the Maine Center for Disease Control and Prevention.
“What we do today has no impact one way or another on the existence of the CDC rule,” said board member Joe Kellner, who offered amendments to the EMS rule that narrowed its scope and provided additional time to comply.
The governor’s office didn’t respond to an email request for comment on the board’s action.
Mills announced this month that all hospital and nursing home staff, as well as dentists, EMS personnel and other health care workers, will be required to receive their final vaccine dose by Sept. 17. Mills said the “aggressive but achievable” timeline means all should be fully vaccinated against the viral disease by Oct. 1.
The EMS board voted 9-7 in favor of the emergency rule, which will be in effect from Aug. 23 through Nov. 21, rather than Nov. 15 as originally proposed. Under the rule, EMS workers will have until Oct. 15, rather than Oct. 1, to show proof that they have received their final shot and will be fully vaccinated no later than Oct. 29.
In addition, the rule would give exempted EMS personnel the option to get tested before each shift, or up to three times per week, if test kits are available at no cost.
The board also approved a resolution asking the DHHS and CDC to include Maine EMS representatives in their formal review of the mandate, or to at least limit the scope of the mandate to EMS workers who engage in direct patient care. Under Maine EMS guidelines, that means personnel who work within 6 feet or less of patients for 15 minutes or more, Kellner said.
Kellner noted that EMS agencies must report the percentage of vaccinated staff to the state by Sept. 1, and he asked that those numbers be provided to the board for review at its September meeting.
While some board members opposed the emergency rule and the vaccine requirement, Dr. John Martel, an emergency room physician at Maine Medical Center, offered some front-line perspective before voting in favor of the rule.
“We’re at a point where our armed forces are going to be vaccinated, so I think we need to consider the gravity of the situation,” Martel said. “We’ve seen a very, very large rise in cases, to the point it’s causing near paralysis within the hospital system.”
Still, as the board prepared to vote, people watching the proceedings on Facebook posted comments questioning why the board wouldn’t reject the mandate completely.
“The rule may be temporary, but the vaccine is permanent,” wrote Karen Cassidy, whose Facebook profile says she’s an advanced emergency medical technician with Freeport Fire & Rescue.
The board is the state agency that oversees and licenses EMS professionals, including fire and ambulance services. It held an emergency public hearing Monday to hear from members about the mandate that Mills announced this month.
There were 5,557 licensed EMS workers in Maine in 2018, according to a report by Maine EMS.
Chris Thomson of Limington, head of the Portland firefighters union, spoke out against a vaccine mandate for EMTs at a hearing on Monday. Ben McCanna/Staff Photographer
More than 650 people joined the online Zoom meeting, which started at 9 a.m. Most who spoke expressed opposition to the mandate and their arguments overlapped. The biggest concern was potential loss of workers who are unwilling to abide by the mandate.
“There are people who are willing to walk away,” said Kyle Baker, an employee with Winthrop Ambulance Service. “That puts a tremendous strain on those who stay.”
Chris Thomson, president of the union that represents Portland firefighters, said the department has not had a work-related COVID case in 18 months. He said members pose no risk to the public.
“We have members who will walk,” Thomson said. “We’re seriously worried about meeting the mission.”
Steve Benotti, fire chief in Sanford, said he, too, expects to lose staff if this mandate holds.
“I believe in vaccination but am against the mandate,” he said. “I have not seen data that shows EMS is a problem with the spread of the virus.”
Benotti echoed several others in suggesting an alternative to the mandate – allowing unvaccinated individuals to submit to regular testing. Others questioned whether emergency dispatchers, who don’t interact with the public, should be included.
Many who spoke Monday said they were vaccinated and that they support widespread vaccinations, but not a mandate.
“It takes away the right of autonomy. That’s what we preach to patients, and yet we cannot practice it ourselves,” said Jenny Sheriff with Delta Ambulance.
Since Mills announced that all health care workers in Maine would need to be vaccinated against COVID-19 or risk losing employment by Oct. 1, there has been significant pushback. Some of it has been driven by anti-vaccine activists and some elected officials, but emergency service professionals have emerged as a particularly loud voice.
The state board was supposed to meet last week, but officials had to postpone because they didn’t adequately prepare for a large turnout.
Michael Sauschuck, Maine’s public safety commissioner, spoke before the public hearing and acknowledged that “a lot of people are passionate about it.” He also said that he understands that the mandate was announced quickly and without much input from stakeholders and he apologized to members for that.
To meet the Oct. 1 deadline, unvaccinated workers would have needed to get their first dose of Moderna vaccine on or before Aug. 20, their first dose of Pfizer vaccine by Aug. 27, or the one-dose Johnson & Johnson vaccine by Sept. 17.
Some wondered why they aren’t being given more time to implement the mandate, while others talked about the importance of being able to choose.
Dr. Nirav Shah, director of the Maine CDC, briefly addressed the board before the public hearing. He praised EMS officials as “the finest partners we have as we battle COVID” and “a core piece of the health care community.”
“That is one of the reasons we felt it was worthwhile to include them in this,” Shah said.
Although critics outnumbered supporters dramatically, some did speak in favor of the mandate.
“I believe in the effectiveness of the COVID-19 vaccine,” said Phil Selberg, deputy fire chief in South Portland. “This is about being part of a bigger team.”
Following the public hearing, EMS board member Brad Chicoine, a firefighter in Saco, cautioned other members about taking the public comments made Monday as “gospel.” He said he’s heard from just as many people who support the vaccine requirement.
“There is a bigger picture involved,” he said, adding that he’s not sure the mandate will lead to the mass worker exodus some fear.
Monday’s debate comes amid a dramatic rise in cases over the last few weeks. Hospitalizations from COVID-19 escalated to 123 on Monday, up from 98 on Friday and the highest since May 15. Of those hospitalized, 61 are in critical care, which is the highest total since January 23 – eight full months ago.
Shortly after the meeting began, the FDA announced it had given full authorization for the Pfizer vaccine, blunting somewhat the argument made by some that the vaccine only had emergency use authorization and therefore shouldn’t be mandated. The Pentagon said shortly after the FDA’s announcement that it will require service members to receive the COVID-19 vaccine and other employer mandates are likely to follow.
Another concern raised Monday by EMS professionals in Maine had to do with the transmissibility of the delta variant, which has driven the recent surge both in Maine and across the country. Research has suggested that vaccinated people who contract the virus have the same viral load as unvaccinated people, which means they can spread it just as easily.
“If vaccinated and unvaccinated (people) are still carriers, what’s the benefit?” asked Paul Silva with Standish EMS. Silva also said he has experienced side effects from getting the vaccine.
Chris Clark, who works for AMS Ambulance, said he was vaccinated but had the same question.
“Why the mandate when we can still get COVID?” he said, adding that vaccinated people who contract the virus often don’t have symptoms. “Wouldn’t we be more likely to transmit to patients if we don’t know we have COVID?”
Although Maine’s vaccination rate has reached 62 percent, there are still more than 500,000 individuals – including all under 12 who are not eligible – who are unvaccinated.
The most recent data tracked by the Maine CDC shows that since the state began administering vaccine, 863 of 37,993 new cases have been breakthrough cases. That’s 2 percent. Additionally, of the 852 people who have been hospitalized since vaccines were authorized, just 35 have been vaccinated, or 4 percent.
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