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Several hundred health care workers across Virginia state have either lost their jobs or been suspended because they are refusing to comply with mandates to get vaccinated against COVID-19.

Gov. Ralph Northam, a Democrat, in August joined other states including California, New York and North Carolina, in issuing a directive mandating the COVID-19 vaccine for most of Virginia’s state workers—a move that applied to more than 120,000 executive branch employees.

Two further vaccine mandate deadlines for major hospital systems in the state, including Sentara and UVA Health, have been set for Oct. 18 and Nov. 1 respectively.

“Anyone who is unvaccinated on Nov. 1 will face disciplinary action, including the possibility of termination,” a UVA Health news release said.

“This timeline gives employees eight weeks to become fully vaccinated now that the FDA has approved at least one of the vaccines,” Sentara said.

According to the Washington Post, rural areas of Virginia state, with larger numbers of unvaccinated individuals, are see ing a higher number of health care workers either being suspended, fired, or quitting their jobs over vaccine mandates.

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In Inova, 89 health care workers—less than half of 1 percent of its workforce—have either lost their jobs or been suspended because they are refusing to comply with the system’s requirement. Slightly more than 1 percent of Valley Health workers have been fired over the vaccine mandate, the Post reported.

Some health care systems in the state, citing fears of staff shortages, haven’t implemented COVID-19 vaccine mandates.

“In a rural hospital it doesn’t take a whole lot of people to walk away for it to have a serious effect on your hospital,” Alan Levine, the CEO of Ballad Health told the Post. “It’s a lot easier to recruit nurses to Northern Virginia than it is to Southwest Virginia.”

Levine said he estimates that 5 to 10 percent of Ballad Health’s workforce would be lost if it were to mandate vaccines against COVID-19, the disease caused by the CCP (Chinese Communist Party) virus.

Separately, J. Stephen Jones, the president and CEO of Inova, told the news outlet that its mandate is “based on very strong, extremely clear guidance on the safety and efficacy of the vaccine,” adding that the policy has helped with recruitment.

About a dozen states nationwide have enforced vaccination mandates for health care workers in hospitals, long-term care facilities, or both. While some allow exemptions on medical or religious grounds, those workers often must undergo regular COVID-19 testing.

The Biden administration also announced that some 17 million workers at health care facilities that receive federal Medicare or Medicaid will be required to be fully vaccinated against COVID-19. That rule is still being developed. 

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