Charlie O’Neill obtained a part of her husband’s liver in a 2013 residing donor transplant and has been taking medicine that suppress her immune system ever since to forestall her physique from attacking the organ.

“I regularly get infections,” she stated. “Simply being an immune-compromised individual, you’re confronted with simply each little chilly and flu.”

O’Neill lives in the small city of Pony in southwestern Montana’s Madison Valley. Regardless of residing in an uncrowded rural setting, O’Neill stated, the primary yr of the coronavirus pandemic was terrifying. She not often left house, ready for covid-19 vaccines to turn out to be obtainable.

Even now, after being vaccinated, O’Neill stated the virus is at all times on her thoughts when she drives into close by Bozeman for groceries and different fundamental wants. She wears a masks and avoids folks as a lot as she will be able to. Whereas vaccinations present strong safety in opposition to hospitalization and demise for the everyday particular person, they’re far much less efficient in those that are immunocompromised.

O’Neill developed abscesses on her liver, requiring day by day visits to the Bozeman hospital for antibiotic infusions. In a state the place the governor has inspired well being staff to hunt vaccination exemptions, she nervous about which of the many individuals concerned in her care had been as an alternative placing her in danger: the folks checking her in on the entrance desk, the touring nurses, the imaging technicians?

Gov. Greg Gianforte’s workplace estimates that “hundreds of well being care staff” have obtained spiritual exemptions and “stay in the workforce,” in line with a latest press launch.

“I so boldly ask folks typically simply in the event that they’re vaccinated, particularly if I’ve to take my masks off for MRIs or one thing like that,” O’Neill stated. She stated she’d request another person if a employee advised her she or he had been unvaccinated or declined to reply, however that hasn’t occurred.

Most medical staffers throughout the U.S. are actually required to be absolutely vaccinated in opposition to covid below a federal Facilities for Medicare & Medicaid Providers rule. Whereas, legally, requests for spiritual or medical exemptions have to be allowed at each establishment, in a lot of the nation they’re reviewed fastidiously and authorised judiciously. In New York Metropolis’s 12-hospital public system, for instance, 100% of employees members contained in the hospitals are vaccinated; the few who had been granted exemptions are assigned outdoors duties.

However in Montana, the pendulum has swung in a distinct path.

Gianforte, a Republican who opposed the federal mandate, inspired well being staff to hunt spiritual exemptions earlier than the Feb. 14 deadline to obtain one dose of vaccine. His administration offered guidance to hospitals that stated the validity of well being care staff’ spiritual beliefs shouldn’t be questioned in looking for exemptions. Gianforte additionally advised the state well being division to create an utility for religious exemptions, which is posted on the high of its web site to obtain.

When requested for an interview with Gianforte, spokesperson Brooke Stroyke referred to the governor’s open letter to health workers dated Feb. 10.

“The State of Montana will proceed to press its claims that the mandate is unconstitutional or in any other case illegal in the district and appellate courts,” the letter learn. “Within the meantime, nonetheless, I urge these of you who’re unvaccinated to think about using the spiritual and medical exemptions that your employers are required to supply, in addition to discuss to your colleagues or private well being supplier about getting vaccinated.”

The Equal Employment Opportunity Commission stated that employers ought to assume a request for a non secular exemption is predicated on sincerely held beliefs, however that if there’s an goal foundation for questioning the request, the employer is justified in making a restricted factual inquiry.

There’s no manner of understanding simply what number of well being care staff stay unvaccinated at any facility. Many hospitals throughout the state are unwilling to share the info.

Out of almost 65 hospital amenities statewide, 11 shared their exemption charges with Montana Public Radio, Yellowstone Public Radio, and KHN. These charges vary from below 1% at two essential entry hospitals operated by the U.S. Indian Well being Service to 37% at Prairie Neighborhood Hospital in Terry. 4 amenities reported {that a} quarter or extra of their staff had exemptions.

Prairie Neighborhood Hospital CEO Burt Keltner stated he didn’t query exemption requests as a result of dropping almost 40% of his employees would shut the hospital.

“A few of the people who had made the selection that they didn’t need to get the vaccine had been a few of our greatest workers,” he stated.

Montana Hospital Affiliation CEO Wealthy Rasmussen stated one cause most hospitals are leery of sharing what number of staff stay unvaccinated is a law passed last year prohibiting discrimination based on vaccination status. Hospitals worry that even offering percentages of unvaccinated staff might spell authorized bother for them, he stated.

Facilities for Illness Management and Prevention spokesperson Martha Sharan stated the company will quickly publish nationwide vaccination charges for medical staffers in CMS-certified acute care hospitals. She added that the dashboard might ultimately embrace nationwide knowledge from different medical amenities taking part in sure CMS packages.

CMS will submit facility-level vaccination charges from these amenities on its Care Compare web site in October, CMS spokesperson Beth Lynk stated.

An analysis of voluntarily reported data by the CDC discovered that nationwide 70% of employees members at medical amenities had been vaccinated as of mid-September however famous decrease vaccination charges had been probably in rural areas. That was earlier than the Biden administration introduced the CMS vaccine mandate, and charges have probably elevated since.

Paul Conway, chair of coverage and world affairs on the American Affiliation of Kidney Patients, stated the shortage of transparency round covid vaccination charges for medical staff places immunocompromised sufferers in a bind.

“Throughout covid, when you’re in a dialysis middle the place you’re in there for hours, you’re having blood exchanged, you’re round a number of totally different staff, you’re round a number of totally different sufferers, your susceptibility could be very excessive,” he defined.

A University of Michigan study discovered {that a} quarter of sufferers on dialysis died in the event that they contracted covid. That examine used knowledge from 2020, when vaccines weren’t obtainable till December.

Conway stated the kidney sufferers’ affiliation desires CMS to make vaccination charges for hospitals and dialysis facilities public to assist sufferers make knowledgeable selections. However in the interim, he stated, they’re on their very own. That leaves them in the uncomfortable place of interrogating caregivers about their vaccination standing at a time when that could be a charged situation in a lot of the nation.

“Patients at all times do have the best and the liberty to ask the query and, equally, docs and nurses even have the liberty to reply the query or not,” stated Joel Wu of the College of Minnesota’s Heart for Bioethics. “I believe answering the query honestly is vital as a result of I believe it builds belief.”

Roger Gravgaard, a 62-year-old kidney transplant recipient from Billings who serves as a affected person advocate for kidney illness organizations, stated unvaccinated staffers want to grasp there are actual penalties for sufferers like him. He’s grateful all his suppliers have been forthcoming about being vaccinated with out his even having to ask, he stated.

“I really feel higher understanding that they’re vaccinated and I might hope that they’ve the identical feeling understanding that I’ve been vaccinated, as a result of it’s a two-way avenue,” he stated.