Home Nurses Caring for Fragile Children Must Now Be Vaccinated


Parents of children with severe health conditions won a victory Thursday when President Joseph Biden required that in-home nurses be vaccinated against Covid-19.

A plan Biden revealed to boost vaccine requirements across the U.S. includes home health workers among 17 million medical staff who must be inoculated, according to a White House summary

The order came less than a day after Bloomberg News reported that parents of children with conditions like cerebral palsy or severe epilepsy have had to choose between risking the virus or caring for children alone. They have forgone sleep and endangered their own mental health. 

The president’s plan will require vaccinations for workers at hospitals and in other settings, including home-health companies, that participate in Medicare and Medicaid. The federal agency that oversees both programs will work out the details of implementation.

Most in-home pediatric health care is paid for by Medicaid, a shared federal-state program. The plan also sets vaccine requirements for large employers and strengthens a mandate for federal workers and contractors.

Little Lobbyists, a national advocacy group for children with complex medical needs, has been pushing the Biden administration to institute a vaccine requirement for home health workers, Executive Director Elena Hung said. 

“Requiring that home care workers be vaccinated is just one of the many steps we need to take to protect our disabled children, and it is a huge relief to our families that President Biden included that in his action plan today,” Hung said in an email. 

Dangerous Conditions

Children who rely on devices like ventilators and feeding pumps to survive are particularly vulnerable to Covid-19, and many are too young to be vaccinated. 

Early in the pandemic, 83% of children admitted to pediatric intensive-care units with Covid-19 had pre-existing conditions, most relying on technology to survive even before they caught the virus. About 3 million children nationwide have complex medical needs, according to the Children’s Hospital Association. 

The National Association for Home Care and Hospice estimates a vaccination rate as low as 40% among the industry’s 2 million nurses, who work in a variety of specialties.  

Before Biden’s order, only Maine and Massachusetts specifically extended vaccine requirements to in-home health workers. Parents were concerned workers opposed to vaccines would leave hospitals that required them and find work in home health. 

Some in the industry are concerned that the long-standing scarcity of at-home nurses could be exacerbated by vaccine mandates. 

Nicole Jorwic, senior executive officer of state advocacy at the Arc, an advocacy group for people with intellectual and developmental disabilities, said that there should be common standards for care, whether it’s delivered in a hospital room or a bed room. 

“What we’re talking about is equity,” Jorwic said. 

©2021 Bloomberg L.P.

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