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Texas Children’s Hospital

Have I mentioned that we need to get more kids vaccinated?

Seriously, y’all.

Since November, 693,345 Texas elementary-age children have received at least one dose of the vaccine, accounting for about 24% of the state’s 2.9 million children ages 5-11 — and a figure in line with the national rate. Nearly 390,000 of the 5-11 group are fully vaccinated, while more than half of Texans ages 12-15 are fully vaccinated.

Texas’ child vaccination rate is higher than in many other Southern states, where rates as low as 10% are being recorded. In the first two weeks after the shot was approved for emergency use in the younger age group, some 100,000 children showed up to Texas school clinics, pharmacies and pediatricians’ offices to get inoculated.

[…]

At Texas Children’s Hospital in Houston, positive cases among patients went from zero in early December to some 70 patients with COVID-19 a month later, mostly among unvaccinated children, said Dr. Jim Versalovic, pathologist-in-chief for the hospital. Their hospitalizations of children with COVID-19 broke all previous pandemic records, and at breakneck speed, he said. Just weeks after omicron was first detected in Texas, it was causing more than 90% of new cases showing up at his hospital — less than a month after the vaccine was approved for young kids.

“We have staggering numbers here during this omicron surge,” Versalovic said in a news conference in early January.

That same day, the state broke its own record of children hospitalized with COVID-19, reporting 350 — five more than the previous peak a few months before.

On Friday, the state health department released data on 3.8 million confirmed cases of COVID-19 in Texas in the first two years of the pandemic. Almost 19% of them — 722,393 — were diagnosed in residents under age 20. The demographics do not include cases reported in 2022.

During the first week of January, the Texas Department of State Health Services and the Texas Education Agency reported that about 26,500 students and 11,800 staff members had been infected with COVID, according to data released Friday.

While the numbers of student cases are nearing levels not seen since the start of school last fall, there are more cases of COVID-19 among staffers than at any other time in the pandemic. The numbers are likely to increase as more districts report their numbers to the state. The current numbers include only about half of all of the state’s 1,200 districts, and the number of districts reporting any numbers is inconsistent from week to week.

Meanwhile, on Wednesday, the state reported 471 children in Texas hospitals with COVID-19. Most of them are unvaccinated, hospital officials have said. But there is no state data detailing how many COVID-19 child patients are in Texas pediatric intensive care units.

Yes, I’ve said this before. The numbers have climbed a bit since then, but there’s so much farther to go. As was the case with previous iterations of the vaccine, there was a large initial burst of activity, as the folks who had been eagerly awaiting the day that it became available for that group rushed out to get it, then it leveled off. The difference is that this time that initial burst was much smaller. Gotta say, I have no idea why. Get your kids vaccinated. What are you waiting for?

We need to get more kids vaccinated

C’mon, y’all. Now is very much not the time to be hesitant.

Most Houston parents have not rushed out to inoculate their children against COVID-19, new data show, the latest indication that achieving widespread immunity among the young may be a faraway prospect, even as case counts explode across the region.

Overall, about 85 percent of 5- to 11-year-olds in the nine-county Houston area have not yet received a COVID vaccine, according to tallies compiled by Texas Children’s Hospital. The remaining 15 percent have had at least one dose, the lowest rate among any eligible age range.

The figures are far below what health officials hoped to see nearly two months ago when the shots became available. In promoting the shots, public officials — including First Lady Jill Biden, who visited Texas Children’s Hospital in November to plug the pediatric vaccine — have struggled to reach the broad swath of parents who remain reluctant to vaccinate their children.

Dr. James Versalovic, the hospital’s pathologist-in-chief, said he hopes the arrival of the highly contagious omicron variant gives hesitant parents a renewed sense of urgency.

The doses are tailored for children and have a “tremendous safety record,” he said.

[…]

It is unclear whether the low rate of childhood vaccinations means the region has reached a saturation point, or whether harried parents simply have not had time to vaccinate their little ones.

“There’s not one specific reason why some parents haven’t vaccinated their kids,” said Jermaine Monroe, co-chair of Texas Children’s COVID Task Force. “We are trying to meet people where they are to help parents overcome their concerns.”

I’m sure the holiday season is a contributing factor, though you’d think it would also be an incentive, and there would be more opportunities with people off work. I hope this picks up in January, we really need to do everything we can to resist omicron. In my particular bubble, it seemed like most of the folks I know with kids in that age range got them vaxxed as soon as they could, but those I know who haven’t done that yet aren’t posting about it on social media, so I don’t have a full picture. Just, please, let’s get this going.

More proof that vaccine mandates work

In the end, most people just get the damn shots. The rest is sound and fury.

Protests, lawsuits and national media coverage surrounded Houston Methodist Hospital in June when it became the country’s first major health system to require a COVID-19 vaccine as a condition of employment.

Now, as other Houston healthcare providers begin to enforce similar mandates, the drama has faded into the background. Hospitals are not facing the same pushback, officials say, and only a small portion of employees are holding out on the vaccine.

“There is a lot of noise around (mandates), and the anti-vaxx movement has been vociferous, but this is more of an outcry from the community rather than when it comes down to the brass tacks in facilities,” said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association.

Texas Children’s Hospital and Baylor College of Medicine were the first to reach their vaccine mandate deadlines following Methodist.

Baylor required its roughly 9,000 faculty and staff members to be fully vaccinated by Sept. 15. Those who did not attest to receiving their vaccine were subject to “progressive discipline,” which includes a series of warnings that ends in firing, according to a statement. The vast majority of employees complied, while about 3 percent were granted an exemption, according to numbers provided by the school.

One employee resigned. Another five will be fired after facing warnings.

[…]

Texas Children’s Hospital also passed its first-dose deadline on Sept. 21. Its doctors are employed by Baylor and already covered by the school’s mandate. In a statement, the hospital said “a very small number of employees did not receive the vaccine and therefore chose to leave the organization.”

Texas Children’s spokesperson Natasha Barrett said the hospital could not disclose a specific number of people who left or whether any exemptions were granted.

See here, here, and here for some background. A lawsuit by the (very small number of) fired Methodist employees was dismissed, though it is being appealed. There’s growing evidence from around the country that this is what happens pretty much everywhere that there’s a vaccine mandate – lots of loud whining and complaining and threats to quit, followed by near-universal compliance. This is why I’m happy for the San Antonio ISD vaccine mandate fight to move slowly through the courts, because regardless of outcome it’s going to cause people to get the damn vaccine. And don’t anyone tell Greg Abbott, but Southwest Airlines is doing a mandate now, too. The more, the very much better.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

More on the Memorial Hermann and Baylor vaccination mandates

Memorial Hermann: Get your shots or get out.

Memorial Hermann on Monday said it will require all employees to be vaccinated by Oct. 9, becoming the third Houston healthcare institution to do so.

The hospital system follows Baylor College of Medicine, which announced its employee vaccine requirement last week, nearly two months after Houston Methodist reached its vaccination deadline.

Managers and other leaders across the organizations must be compliant by Sept. 11. The deadline is Oct. 9 for all other employees, including the system’s affiliated providers and volunteers.

About 83 percent of Memorial Hermann’s workforce is fully vaccinated, including 87 percent of bedside staff, 95 percent of managers and above and all executive leaders, according to the hospital system. Memorial Hermann employs more than 29,000 people.

Exemptions will be made for those who are unable to be vaccinated due to medical or religious reasons. Employees who are not exempt and refuse the vaccine “will be deemed to have voluntarily resigned their position,” said Dr. David L. Callender, Memorial Hermann President and CEO.

He said spiking hospitalizations and COVID cases prompted the move.

“We’ve been waiting a little bit just to make sure the circumstances fully warrant moving forward, and we think they do now, “ Callender said Monday. “We’re seeing the impact of the very aggressive delta variant, a significant spike in new cases and hospitalizations, and about 50 percent of Houston’s population remains unvaccinated, which means the community continues to be at risk.”

See here for the background. I don’t think that justification needs any further explaining. By the way, the Memorial Hermann CEO wrote an op-ed in March, just as we were starting to hear about some scary variants out there, begging Greg Abbott to leave mask mandates in place. We know how that went.

Here’s Baylor, from about a week ago, with a somewhat less punitive approach.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. However, he believes termination will be a “rare event.”

“We thought it was important to make a statement,” McDeavitt said. “As an organization, we are committed to vaccination, and we have been involved in all stages of the pandemic, from the development of vaccines, testing, clinical trials of medications and critical care of patients. (Requiring vaccines) was a necessary step for us to close that loop.”

Baylor’s vaccine policy had been in the works for some time, McDeavitt said, but the spike in cases was a catalyst for releasing the policy this week. “The spreading of the delta variant had a role in the timing of the release of this,” he said.

The policy, which was sent to employees Wednesday, details requirements for annual influenza and COVID-19 shots, except for people who have religious beliefs or a medical condition that would preclude them from becoming immunized.

So far, employee feedback has been positive, he said.

“I haven’t gotten any negative pushback to date,” McDeavitt said.

Baylor looked to Houston Methodist’s example when developing its policy, McDeavitt said. Methodist was the first health system nationwide to require vaccinations for employees in early June. More than 150 hospital employees resigned or were fired over the new policy — fewer than 1 percent of Methodist’s 25,000 employees.

“We will roll this out differently than Houston Methodist did. If someone flat-out refuses to become vaccinated, we don’t intend to jump to termination,” McDeavitt said.

For employees who are vaccine-hesitant, there will be a human resources process to further encourage them to take the shots. McDeavitt hopes no one is terminated over the new vaccination policy.

We’ll see how that works for them. I don’t care either way, as long as it gets the desired result. There’s no indication in that story of how many BCM employees are already vaccinated. MH’s 83% is not bad, but obviously it can – and will – be better. I wish they had done this sooner, but at least they are doing it. Texas Children’s, where are you on this?

More hospital systems to require vaccines

About time.

Memorial Hermann officials are finalizing details on its mandatory vaccine policy for employees.

During a radio interview Wednesday, Dr. David L. Callender, president and CEO, said the system will soon announce the timeline for its employees to become fully vaccinated.

The new measure comes as a fourth wave of the virus spreads across the state, due in large part to the ultra-transmissible delta variant. On Friday, the Department of State Health Services reported 13,871 new confirmed COVID cases, the largest single-day count since last winter’s surge and more than 12 times the number of cases confirmed on July 1.

“We think it’s very important for health care workers across the country to be vaccinated as vaccination is really the only way to stop this pandemic,” Callender said on the Houston Public Media radio show. “We’re working on (the policy), and will be making an announcement early next week.”

As of Friday morning, no details were made available on a vaccination deadline for employees or what type of discipline they may face if they do not comply with the new policy.

[…]

Memorial Hermann follows Baylor College of Medicine, which this week became the second Houston-area health care facility to require vaccines for employees, nearly two months after Houston Methodist reached its vaccination deadline.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. McDeavitt expects most of the system’s employees will comply, and he believes firings connected to the policy will be rare.

I mean, Houston Methodist was doing this back in April, before any of us had ever heard of the Delta variant. They prevailed in a lawsuit, which is now under appeal, so the legal precedent is there for Memorial and Baylor. I honestly don’t know what has taken them so long, but better late than never. Now I’m wondering about other hospital systems – when I went to the Memorial Hermann Twitter page to get their logo for the embedded image, they suggested Texas Children’s Hospital, and now I’m wondering what their policy is. A Google search did not answer that question for me, which suggests the answer is No. Get it together, Texas Children’s!

Here comes the Delta variant

Be vaxxed or be vulnerable.

Texas Medical Center hospitals are seeing an uptick in patients infected with the COVID-19 Delta variant, and infections are prevalent among young children and adults who have not been immunized.

At Texas Children’s Hospital, fewer than 10 kids have been diagnosed with the Delta variant, which epidemiologists say is more transmissible than the original strain of SARS-CoV-2. Doctors have diagnosed 48 cases of the Delta variant at Houston Methodist since the end of April.

“The big concern with Delta is that it could spread like wildfire,” said Dr. James Versalovic, interim pediatrician-in-chief at Texas Children’s Hospital. Experts expect the numbers to increase in the coming days because the virus is “highly contagious” and can infect even those who have been partially vaccinated. The Delta variant is able to spread more rapidly by binding to host cells in the body. Currently, the variant accounts for one in five cases in the U.S.

Early studies of the Delta variant indicate the current COVID-19 vaccines can protect patients from severe infections. In a pre-print paper published by Public Health England, researchers found the two-dose Pfizer-BioNTech and AstraZeneca vaccines were 96 percent and 92 percent effective, respectively, against hospitalization for COVID-19. Moderna’s vaccine is also effective against Delta, the company said on Tuesday.

Breakthrough infections can occur with the two-dose vaccines, but these infections are usually far less serious than the ones affecting people who have not been inoculated.

“The common theme in Delta variant patients we see is almost none of them have been vaccinated, and that’s especially true for the people who are hospitalized,” said Dr. Wesley Long, an infectious disease expert at Houston Methodist Hospital.

[…]

The emergence of the Delta variant prompted the World Health Organization to issue a new recommendation that all people, regardless of vaccination status, resume wearing masks indoors. Because the new variant is particularly contagious in undervaccinated areas, experts worry it could overwhelm Texas.

“It does raise some concern, because people are no longer practicing social distancing and they’re less consistent about wearing masks,” said Dr. Robert Atmar, professor of infectious diseases at Baylor College of Medicine. “Those individuals who aren’t vaccinated are at risk of getting sick or of needing hospitalization, and the rest of us who are vaccinated could still potentially (become infected).”

There’s basically zero chance that we get another mask mandate in Texas, and there’s no opportunity for the city or Harris County to issue one, either. I have started not wearing masks in indoor spaces, in recognition of my and my family’s vaccinated status, but I may reconsider that. Certainly, anyone with kids under the age of 12 should continue being cautious. Beyond that, it’s the same song, different verse: We need more people to be vaccinated. That is what will greatly slow down the spread of this variant and others like it, and will ensure we don’t have any more spikes in the hospitalization rate. It’s as simple as that.

Kids still get COVID, too

And they need to get vaccinated if at all possible.

Since the Food and Drug Administration approved emergency use of the Pfizer vaccine for 12 to15 year olds on May 10, more than 300,000 Texas adolescents and teenagers have received at least one dose. Girls in this age range are receiving the vaccine at a higher rate (153,000) than boys (149,000), according to Texas Health and Human Services. Nationwide, more than 626,000 12 to 15 year olds have received two doses, according to the CDC.

Though young people can now receive shots, the number of children and adolescents being hospitalized is increasing. The Centers for Disease Control and Prevention released data from the first half of 2021 that shows nearly one-third of adolescents who are hospitalized with COVID-19 require intensive care. Five percent of those patients need to be put on ventilators with supplemental oxygen, as well.

The CDC reports that nearly 400 children and adolescents are currently in hospitals across the country with COVID or complications from the virus. More than 16,000 under the age of 18 have been hospitalized from COVID since the start of the pandemic, and more than 300 of them have died from it, said Dr. Jim Versalovic, interim pediatrician-in-chief at Texas Children’s Hospital.

“This is a huge setback for a child or adolescent with time spent out of school or activities,” Versalovic said. “There’s a long recovery time even if the infection is mild initially.”

He attributes the increase to fewer masks and stagnating vaccination rates.

More than half of all Texans are vaccinated with at least one dose, but that doesn’t mean Houston is free of several coronavirus variants that are more transmissible and deadlier than the original virus.

In the last month, fewer people are masking up in public outdoors and indoors after the CDC said it was safe for vaccinated people to go masklessThree-day holiday weekends and the onslaught of summer weather has turned Houston into the partying swamp city it was before the pandemic, too.

[…]

Versalovic said about 10 percent of children diagnosed with the virus at his hospital require hospitalization. This rate is nearly three times greater than the seasonal flu, which the CDC reported killed nearly 600 children between 2017 and 2018.

Child survivors sometimes have a whole new set of problems when the initial infection clears. Several weeks after other symptoms have gone away, children who had mild COVID develop other symptoms that typically require hospitalization. This is called Multisystem Inflammatory Syndrome in Children, or MIS-C.

MIS-C symptoms include fever, stomach pain, diarrhea, vomiting, neck pain, random rashes and bloodshot eyes. Extreme fatigue is also a symptom, but it’s usually blamed on other problems.

Texas Children’s has vaccinated more than 18,500 12 to 15 year olds since early May. Any person age 12 and older is eligible for a free Pfizer vaccine from the hospital, regardless of whether they are currently a patient. Vaccines are available at six Texas Children’s sites across Houston Monday through Saturday.

The hospital is partnering with Houston-area school districts now to immunize their students, so middle and high schools can open safely for the fall semester, he added.

“We are going to be very busy during the summer months as we seek to immunize as many children as possible,” Versalovic said. “It’s important to protect adolescents to stop the spread of COVID as they get ready for summer activities, camps, sports and the school year in August.”

Not much to say here that we haven’t said already, many times. Get your kids vaccinated. As long as there are unvaccinated and/or immunocompromised members of your household, you should continue with pre-vaccination safety protocols as much as possible, which I know is vastly more difficult now that masks are being removed all over the place. It is true that the health risks to kids from COVID are lower than they are with adults, but they are not zero and they can be serious. For all the progress we’ve made, we’re not out of danger yet.

Houston Methodist tells its employees to get vaxxed or else

I’m okay with this.

Four out of five Houston Methodist employees are vaccinated against COVID-19. The sliver who are not will be suspended or fired if they refuse the shot, according to company policy.

The hospital required managers to be vaccinated by April 15 and all other employees — about 26,000 workers in total — by June 7, said Stefanie Asin, a Houston Methodist spokesperson.

With 84 percent of the staff vaccinated, the hospital is close to herd immunity, CEO Marc Boom wrote in a letter to employees this month.

“As health care workers we’ve taken a sacred oath to do everything possible to keep our patients safe and healthy — this includes getting vaccinated,” Boom wrote.

A little more than 4,100 employees have not received at least a first dose of the COVID-19 vaccine. The hospital does not know yet how many employees potentially will be suspended or terminated because of the mandatory vaccination policy.

Since 2009, a hospital policy has mandated its workers receive the flu vaccine each year, unless they have a medical or religious objection qualifying them for exemption.

[…]

Several nursing homes in Houston are requiring COVID-19 vaccinations of their workers, while other hospitals in the Texas Medical Center have not yet followed suit.

“UTMB is not mandating vaccination,” said Christopher Smith Gonzalez, senior communication specialist for the hospital. “But, in view of the high contagiousness of the some of the SARS-CoV-2 variants, UTMB has implemented enhanced respiratory precautions for all unvaccinated individuals caring for or evaluating patients for COVID.”

While 80 percent of Texas Children’s Hospital employees are vaccinated against COVID-19, the hospital does not require inoculation. St. Luke’s Health has vaccinated “thousands of our staff,” vaccinations are not mandatory, according to the health system.

But some are considering it to cut back on health hazards for employees and patients.

“As a provider of health care services, Baylor College of Medicine currently requires vaccination for employees for a variety of infectious diseases,” said Dr. James McDeavitt, senior vice president of Baylor College of Medicine. “For example, flu vaccination for employees has been mandatory for several years. With appropriately defined exemptions (medical contraindications, religious beliefs), we support mandatory vaccination for COVID-19. We do not yet have this requirement in place, but it is under active consideration.”

Memorial Hermann will make COVID-19 vaccines mandatory after it relaxes some of its COVID-19 protocols, such as mask-wearing and social distancing. However, it has not set a deadline for employees to receive the vaccine, said Drew Munhausen, a Memorial Hermann spokesperson.

This all makes sense to me. They’re health care workers, which not only makes them at high risk for catching COVID, it means they’re in very close contact with a lot of extremely vulnerable people as well. The story notes a recent incident in a Kentucky nursing home, where an unvaxxed worker was the cause of an outbreak. While most of the residents, who had been vaccinated, had only mild symptoms, one of them died. None of that should have happened. State law requires that health care facilities have a policy about vaccinations, but doesn’t require that they mandate them; federal law allows employers to require vaccinations, but also doesn’t mandate it. I for sure would want to know that the doctor or nurse or physician’s assistant who is giving me medical assistance, as well as all of the support staff, have been vaccinated for COVID. I understand that some of the employees may be hesitant about the vaccine, and I have some sympathy for them, but only so much.

There is also this:

Houston Methodist was one of several companies to offer incentives for its workers to get a COVID-19 vaccine. The hospital is granting $500 bonuses to anyone who worked during the pandemic and received the vaccine.

“Already we’re seeing positive results as the number of employee infections has dropped inversely with the number of employees receiving the vaccine,” Boom wrote.

Paying people to get vaxxed has its merits. One of the hesitant Methodist employees from the story says that some of her fellow hesitators are thinking about getting the shots to keep their jobs. Clearly, incentives work. Maybe that’s a lesson for us for the broader issue.