COVID infections double at VA facilities as agency mandates vaccines

The Department of Veterans Affairs announced Monday that it will require its health care professionals to be vaccinated within the next two months as coronavirus infections have more than doubled in the past month at its medical facilities.

The VA reported nearly 3,900 infections among veterans and staff Monday, up from about 1,500 in mid-June, a USA TODAY review found. Hospitalizations last week totaled 345, up from 225 at the end of May.

The numbers are nowhere near the peak of nearly 18,000 cases reported at the VA in January, but they're growing. In the past week alone, the VA reported 911 more active infections and 73 more deaths.

VA Secretary Denis McDonough said in a statement Monday that mandating vaccines is “the best way to keep veterans safe, especially as the delta variant spreads across the country.”

The VA is the first major federal agency require vaccinations. It's the second-largest agency behind the Pentagon.

VA medical centers in Florida reported the steepest increases in cases, with dozens more infections in Bay Pines, Gainesville, Tampa and Orlando, USA TODAY found. Deaths were scattered, with 18 facilities reporting at least two deaths, including those in Las Vegas, Houston and Fayetteville, North Carolina.

The VA runs more than 1,200 medical facilities across the country. Officials say veterans who aren’t vaccinated now account for 70% of its COVID-19 cases and 73% of hospitalizations.

VA data show roughly 300,000 employees – nearly 80% – have been vaccinated. But that includes staff not involved in patient care, and the percentage has varied widely by facility. Earlier this month, VA officials confirmed that 85% of staff at the facility in New Orleans had been inoculated, compared with 59% in St. Cloud, Minnesota.

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“Whenever a veteran or VA employee sets foot in a VA facility, they deserve to know that we have done everything in our power to protect them from COVID-19," McDonough said. With this mandate, we can once again make – and keep – that fundamental promise.”

'Trying to bust down all the doors'

Jane Kim, physician and chief consultant for preventive medicine at the VA, told USA TODAY in an interview last week the agency is redoubling vaccination efforts.

“Now more than ever, we're really trying to bust down all the doors to get the message out for people who haven't yet been vaccinated to please consider getting a vaccine,” Kim said.

Just over half of the roughly 6 million veterans who depend on the VA for health care have been inoculated, according to VA data. VA officials say they believe some patients have been vaccinated elsewhere, but they don’t know how many. Nearly 60% of adults in the United States are fully vaccinated.

VA officials said roughly 10% of veterans, or 600,000, indicated they are “not interested” in getting the shots.

The VA said in its statement announcing the employee vaccine mandate that four employees died from COVID-19 in recent weeks. All were unvaccinated.

"At least three of those employees died because of the increasingly prevalent Delta variant," the agency said. "There has also been an outbreak among unvaccinated employees and trainees at a VA Law Enforcement Training Center, the third such outbreak during the pandemic."

The vaccine mandate applies to health care personnel, including doctors, registered nurses and physician assistants.

Kim said the VA has been giving employees paid time off if they provide proof of vaccination.

Amid the increase in cases, “vaccination remains our key strategy to help keep our veterans safe and well as well as our staff,” Kim said.

‘Political mumbo-jumbo’?

When the pandemic hit last year, Melissa Vives and her husband settled into a routine of working from home, being cautious and staying safe. When vaccines first became available, the U.S. Army veterans weren’t eager to take what they saw as a risk.

“There was just this real concern of, what exactly are we getting ourselves into? Is this being pushed too fast? My God. Is this like a political mumbo-jumbo?” Melissa Vives said in an interview last week. "I think that everything was just so questionable.”

Many veterans like them were skeptical of the vaccine, the VA found in March. The VA found 3 in 10 surveyed had not been vaccinated; most of them didn’t plan to or were undecided.

The numbers were better than a poll by Blue Star Families in December, when nearly half of veteran families surveyed said they didn’t plan to get vaccinated. One veteran’s spouse told pollsters she objected to her family being “guinea pigs.”

But the Viveses decided they could help stop the spread of the virus by getting vaccinated. They called the VA, rolled up their sleeves and got vaccinated at a pop-up clinic in Aurora, Colorado. By the end of April, both had gotten their shots.

“This is uncharted territory for all of us,” Vives said. “But man, if there's a vaccine that is at least just a little bit of one step in the right direction, I'm going to jump on it and do it to help.”

She and her husband are volunteers with Team Rubicon, a veterans organization that was part of the Biden administration's wide-ranging campaign to encourage vaccinations in April. The group was among a dozen veterans’ organizations featured as “trusted voices,” including the American Legion and Vietnam Veterans of America.

Disabled American Veterans pitched in on a public service announcement and is spreading the message on social media. AMVETS has hosted vaccine centers at posts and a VA mobile vaccination clinic at its annual memorial motorcycle ride.

Team Rubicon joined other groups in the Veterans Coalition for Vaccination, hosted a May forum on Facebook, and created a series of public service ads. One tells vets that the vaccination effort is a “call to arms – yours.” The organization helped distribute more than 1.6 million vaccines across 95 cities.

Art delaCruz, CEO of Team Rubicon and a Navy veteran, said veterans could be key to reaching herd immunity in the U.S.

“We believe if we could get veterans on board, and they became the example and the messenger of vaccine confidence and acceptance, we could move the needle on the overall population,” he said.

Veterans come from a trusted institution – the military – and, he said, they understand the collective responsibility of being part of a unit where one person’s actions can protect or undermine everyone’s well-being.

“The discussion, the resistance, is at a singular level – ‘Don't tread on me. Don't tell me what to do,’” delaCruz said.

But for veterans, “this is something we know how to do – this is something we understand," he said. "Because as brothers and sisters in arms, we were in the ship, and we said, this isn't about me, this is about us.”

Infectious disease specialist Dr. Aileen Marty likens getting the vaccine to stopping at a stop sign or a red light. “Is it really a personal choice?” asked Marty, a medical professor at Florida International University and clinical consultant at the university’s high-complexity COVID-19 lab. “It's not just about the traffic ticket, it's about the fact that you can kill somebody.”

An unvaccinated person is “a risk to you and your family,” Marty said. “Because he is a contributor to that bolus of people where the virus can thrive and develop into a new, worse variant that can overwhelm the protection you, as a vaccinated person, have.”

Hundreds of thousands of veterans ‘take a pass’

The percentage of veteran patients vaccinated at VA facilities has ticked steadily upward: 21% in March, 36% in April, and 42% in May. By July, the pace slowed considerably. In the past three weeks, it inched from 49.5% to 51.5%.

Kim, the chief consultant leading the vaccination effort at the VA, said headquarters asked every medical center in May and June to go through their patient lists, contact every veteran with an unknown vaccination status, and ask them to get inoculated if they hadn’t already.

“And if they are deciding to take a pass and didn't want to be vaccinated, to just let us know that,” she said.

“If that's their choice, we've recorded it in our system and said, ‘We respect that,’" she said. "I mean, that's what I would say: ‘I respect that, we're here for you if you change your mind.’”

Aside from the roughly 10% of patients who said they weren’t interested, VA officials said they are still contacting veterans and gathering information and documentation of vaccinations performed outside the VA. Kim said efforts have intensified in light of the variants' spread, and the VA is sending letters to veterans nationwide imploring them to get the shot if they haven’t and telling them where they can get it.

“There’s still a pocket of people we have not yet reached,” she said. For those who are open to it, Kim said her message is that the vaccine is safe, effective, and abundant.

“If you're waiting to get a vaccine, why don't you go ahead and get it, because we have vaccine all over the place in VA, and at your local pharmacy, your local doctor's office – it doesn't matter where, just make the decision, go ahead and get the vaccine,” she said. “It will help all of us, it will help you, it will help your family.”

At the Vives’ house in Colorado, there is a new sense of urgency as the delta variant rages through the neighborhood. A family of six that lives next door all contracted the virus, Melissa Vives said. Only one had been vaccinated. They all got sick – the vaccinated one mildly, the others seriously.

One ended up in the hospital for two months. He got home about three weeks ago, she said, and he’s still on oxygen.

“He said, ‘Man, I don't trust the doctors. I didn't really trust the vaccine. But as soon as I have the chance to get the vaccine, I'm getting it,’” Vives said.

Her husband wishes there were an incentive to get folks over their vaccine distrust before suffering through the disease or watching their loved ones suffer and perhaps die.

“Afterwards, you hear them say, I wish I’d have gotten the vaccination,” Eddie Vives said. “We want everybody to be OK, to deal with this together, and just fight this virus.”

Contributing: Associated Press

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COVID infections double at VA facilities as agency mandates vaccines

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