Tens of thousands of health-care workers in New York are likely to have refused a coronavirus vaccine before a state requirement went into effect on Monday, serving as a preview of resistance that the Biden administration’s vaccine requirements will face on a bigger scale in coming weeks.

Resistance to the coronavirus vaccines means large numbers of health-care workers could face dismissals or unpaid leaves of absence in the state, exacerbating an already existing labor shortage in the critical world of medical care during the pandemic.

The Biden administration, meanwhile, is writing its own vaccine requirements, which would apply to a much larger group of workers, effectively anyone working at a firm with more than 100 employees. The clash in New York could presage much bigger confrontations around the country in coming weeks as the Biden administration tries to roll out its new policies and resistance to government measures to mitigate the pandemic animates the country’s right wing.

Officials in New York had braced for the confrontation as the deadline, set as part of the mandate instituted by former governor Andrew Cuomo, a Democrat, last month, neared. Gov. Kathy Hochul late Monday signed an executive order that officials hope could offer some short-term reprieve with staffing shortages. In the six-page order, she temporarily changed the state’s rules to more easily allow health-care workers from other states and countries to begin practicing in New York, among other things.

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Anticipating that many of the unvaccinated health-care workers will soon leave their jobs, private businesses in the medical industry have begun paring back some of their services so that an already overstretched workforce can focus on providing essential care. It was unclear whether workers who did not want to get vaccinated would acquiesce in the face of government restrictions or hold out. It appears there are significant groups of people in both camps.


Public health officials say the vaccines are safe and necessary for getting the pandemic under control. And despite the public’s overall support for the shots, and stronger measures to combat the pandemic, a vocal minority resistant to immunization and coronavirus restrictions has become a potent political force.

Even in New York, a blue bastion that is in the top 10 states for vaccination rates nationwide, the mandates have caused major headaches. According to data from the state, about 84% of its 450,000 health-care workers were fully vaccinated as of last Wednesday, leaving some 70,000 unvaccinated.

But state officials said that many workers went and got vaccinated as the deadline neared. The governor’s office pointed to preliminary data showing that 92% of nursing home and hospital staff had received at least one vaccine dose as of Monday evening.

Thomas Quatroche, president of the Erie County Medical Center Corp., which includes a hospital, a long-term-care facility and outpatient facilities in Buffalo, said the center put 152 workers – about 5% of its staff – on unpaid leave Monday morning because they were not vaccinated by the state’s deadline.

That puts additional strain on the facility, which is already struggling with a labor shortage – some 400 open positions – about double the typical amount, he said, after many staffers, particularly nurses, have retired or moved on after a physically and emotionally grueling year.

The labor issues are affecting the service the hospital provides.

Staffing woes at nursing homes, which are particularly acute, make it harder to discharge some patients, meaning that emergency rooms are backed up and have longer wait times. A week ago, for example, Quatroche’s hospital was at near capacity – and about 1 in 5 people ended up leaving the ER without being seen.


The hospital has had to adjust its service to conserve staff in response – canceling elective procedures and reducing outpatient visits, for example. It opted to put the staff members on unpaid leave on Monday, instead of dismissals, with the hope they would be pushed to comply with the mandate, Quatroche said.

“It is their choice to not get vaccinated, but the other choice is that they won’t be able to work in health care,” he said, adding that the hospital has previously had mandates for other vaccines – for the flu, tetanus and other illnesses – that he said had never been an issue. “I don’t think anybody predicted these numbers would be so high.”

The mandate in New York, which required all health-care workers at hospitals and nursing homes in the state to have had at least one dose of a coronavirus vaccine by Monday night, has kicked off lawsuits and protests, including one Monday planned for a hospital in Rochester.

Other states and jurisdictions like Rhode Island, Maine and the District of Columbia, have similar measures, but New York’s is one of the earliest and most stringent. Workers must get vaccinated to remain employed, with exemptions allowed only for medical reasons.

A federal judge in the state issued a temporary restraining order, however, that has blocked the prohibition on religious exemptions and is expected to rule further on the matter on Oct. 12.

In states like California, New Jersey, Pennsylvania and Maryland, health-care workers have the option to get tested if they choose not to be vaccinated – a provision that is planned to be included in the coming federal rule that will require private companies of 100 employees to institute vaccine or testing requirements for staff.


Nurses said vaccine resistance among a small but stubborn sector of the workforce was causing tension at hospitals.

Gerry Harrington, a 47-year-old father and nurse in New Brunswick, N.J., who is vaccinated, works at a hospital where employees have the choice between immunization or weekly testing. Vaccinated staff are given a red sticker to put on their ID tags. But discomfort bubbles up in shared common spaces, like the break room, which he avoids if he sees unvaccinated co-workers eating or drinking there.

Harrington said he thought concerns about a labor shortage from the vaccine mandates were overblown, saying it was an issue the industry has been dealing with throughout the pandemic.

“People are burned out from covid,” he said. “They’re just . . . overworked. It’s very stressful, seeing so many people die in a room. So some people are left for easier jobs – working in surgical centers or outpatient offices like that.”

He relayed an anecdote about a co-worker who said she would leave the hospital or the field if a vaccine was required but eventually came around to it and got vaccinated as the rule was implemented.

“People need their money,” he said. “It’s not such an easy thing to be like, ‘I quit.’ “


Jeffrey Hammond, a spokesman for the New York State Department of Health, said that vaccination rates among medical workers in the state went up seven percentage points in the month and a half after the mandate was announced. For nursing home employees, who are also included in the mandate, the vaccinated percentage jumped even higher – from 70% on Aug. 15 to 89% now.

During an appearance Monday at a senior center, Hochul called the labor strife “preventable.”

“People have known for quite some time that this was the requirement and I’ve made it loud and clear over my four weeks in office that I was not going to change my position because I’m charged with protecting the health of all New Yorkers,” Hochul told reporters on Monday. “What’s going to happen tomorrow is that these hospitals and nursing homes who’ve had warning that this is going to happen will be working with us later today and tonight to figure out where people are needed and how we can deploy them in essential areas.”

Some nurses who have been resisting the mandate in New York said they had no plans to buckle.

An unvaccinated 29-year-old nurse in central New York, who spoke on the condition of anonymity to protect her privacy, said she would move out of the state if she is required to get vaccinated.

“I will not be getting this vaccine,” she said.

The nurse, who works in intensive care, said she has been given a religious exemption by the hospital where she works, the fate of which hinges on the coming court ruling.


She said she believes in God but is not part of a church or congregation, and she described her opposition to the coronavirus vaccines in personal and political terms. She also said she believed the natural immunity she has from a November 2020 bout of the coronavirus – which she thinks she contracted at work – offers her sufficient protection.

If the court upholds the state’s prohibition on religious exemptions, she does not plan to get vaccinated. Instead, she’ll move to another state, like Texas or Florida, where she would be allowed to work without it, she said.

“It is my right as an American citizen to choose what goes into my body,” she said. “It’s a complete overstep of government power. I think it should be a person’s right to choose what is instilled in their body. And that if we the people don’t stand up now, we’re going to end up losing all freedom. And who knows what’s going to be next.”

It is not just a battle between nurses, political rabble rousers and the courts. Patients – the public – are caught in the middle, too.

Andrew Perretti, 63, a father and retired operations official at the U.S. Postal Service, is battling Stage 4 cancer that has spread from his intestines to his liver – a diagnosis he received in June.

During an appointment at a hospital in the Bronx the next month to put in the port he needed to begin a grueling regimen of 16 chemotherapy sessions, he overhead a group of nurses talking to the nurse who was helping him – and giving her a hard time for not being vaccinated.


She wasn’t wearing a mask when she was attending to him, either, he said. It concerned him, he said, relaying the stories of two neighbors who died after contracting the coronavirus during routine procedures at the hospital.

So Perretti went to an administrator and asked that he be treated only by vaccinated nurses.

To him, the nurse’s choice, as personal as it may have been, was an affront to his health.

“She’s not concerned about my well-being,” he said. “It could be a combo of being selfish and a spoiled brat – I have seven of them – and/or politically motivated. It’s dividing the country.”