A week after President Joe Biden announced sweeping COVID-19 vaccination mandates for the nation's 17 million health care workers, hospitals say they are waiting for definitive guidelines before deciding how to respond.

"We are trying to figure all this out," said Jimmy Wilferth, marketing and foundation vice president at Saint Francis Healthcare System. "It's complicated."

At SoutheastHEALTH, marketing vice president Shauna Hoffman said it would be premature to act on the president's announcement before the government issues more specifics about the vaccination requirements.

"We haven't received anything to help us determine next steps," she said. "Really, we can't do anything until we know specific details and we don't want to do anything preliminarily relative to (our) staff."

Saint Francis Healthcare System and Southeast- HEALTH are among the largest employers in Southeast Missouri, with thousands of employees at their flagship hospitals in Cape Girardeau and at dozens of satellite facilities throughout the region. As of late July, Southeast reported "approximately 50%" of its employees were at least partially vaccinated, while Saint Francis said "the majority" of its staff had received at least one dose.

Patience 'wearing thin'

After month of "encouraging" Americans to be vaccinated, on Sept. 9, President Biden said his patience was "wearing thin" and ordered sweeping vaccination requirements that will not only impact health care workers but also federal contractors and workers at businesses with at least 100 employees. Although details of the president's order have not been released, non-complying hospitals and businesses could reportedly be subject to financial penalties.

While many Americans have welcomed the president's mandate, others say it is an example of government overreach and infringes on personal freedom to decide whether to be vaccinated.

"One thing I can tell you," Wilferth said, "is that Saint Francis Healthcare System will follow the law, once it has been confirmed. This could take a while to play out, though."

In addition to Saint Francis and Southeast, the Southeast Missourian also reached out to Missouri Delta Medical Center in Sikeston and Perry County Memorial Hospital in Perryville for their responses to Biden's vaccination directive. A spokesperson at Missouri Delta Medical Center said the hospital preferred not to comment on the president's announcement at this time while Perry County Memorial Hospital did not reply to several requests for comment.

Statewide perspective

"There are hospitals around the state and the country that are mandating (vaccinations) already," said Mary Becker, senior vice president with the Missouri Hospital Association (MHA). Among them, she said, are several health care systems in Southwest Missouri and the St. Louis area, including the BJC, SSM and Mercy Health systems.

"There are other hospitals in smaller communities that have said 'We're not going to do it,' and now their tune will have to change," Becker said. "It's all over the board right now."

Most hospitals, and MHA itself, are awaiting for the government to issue more details about the president's directive.

"Nobody really knowns what the requirements will be," Becker said. "Once we know more, it will be a little easier."

As an organization, MHA has not taken a position on whether staff at the state's 140 hospitals should be required to be vaccinated.

"Until we see what the mandate says, we really don't have a position," Becker said. "But we are absolutely supportive of vaccinations. It's going to be the way this pandemic ends (so) we highly encourage vaccinations."

Hospitals throughout the state are reporting high occupancy rates as a result of the virus with many COVID-19 patients occupying intensive care beds. As of earlier this week, Becker said ICU units in Missouri were averaging 82% occupancy with some exceeding 100%.

"It's usually never that high," she said. "And looking toward cold and flu season, if we have flu and other respiratory illnesses compounded with COVID, we could really be in a mess this winter, so it's really important to get people vaccinated. Wear the masks and take all the precautions to protect yourself and other people."

While it also encourages people to be vaccinated, the Missouri Chamber of Commerce and Industry says Biden's vaccine requirement is "the wrong approach for business."

In a statement issued shortly after the president's vaccination order, Missouri Chamber president Daniel Mehan said the federal government "should instead cooperate with the employer community to encourage vaccination and support employers that exercise their legal right to require vaccination."

Mehan said vaccinations are the "key to our economic recovery," adding, "We need more Missourians to get vaccinated so that we can begin to put this pandemic behind us."

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