On August 23rd, the FDA granted full approval to the Pfizer-BioNTech COVID-19 vaccine. The military and many states soon went to work, mandating that soldiers, healthcare workers, state employees and others must get vaccinated against COVID in light of the ongoing - and, in many places, worsening - pandemic. 

But what about addiction treatment centers? Should your facility mandate vaccines? And for whom? What is the legal standing of such a mandate? What are the risks and liabilities associated with vaccine mandates for addiction treatment centers? 

Today, we will look at the whole picture of vaccines and addiction treatment and examine what we know about requiring - or not requiring - vaccines at treatment facilities throughout the United States. 

The Rationale Behind Vaccine Mandates for Addiction Treatment Centers

Several important players in the addiction treatment community have come out in favor of vaccine mandates for addiction treatment employees. 

Perhaps one of the most prominent addiction treatment centers in the United States, the Hazelden Betty Ford Center, began requiring vaccines for all employees back in May, before the FDA approval was even complete. For Hazelden, the issue is both a health care imperative and a mission affirmation of their commitment to equity. We know that people with substance use disorder (SUD) are at higher risk for COVID and serious complications than the general population. We also know that BIPOC patients make up a disproportionate number of COVID infections and deaths. 90% of staff at Hazelden have complied with the program. 

The NAATP has also spoken strongly about vaccinations for the addiction treatment community. On their website, they state: “As essential healthcare staff working with individuals at high risk of contracting COVID, addiction treatment providers have an ethical imperative to get vaccinated unless there is a medical reason not to do so.”

Your Addiction Treatment Center’s Ability to Require Vaccines Depends on State Law 

It is highly unlikely that the federal government will mandate vaccines for all national citizens or even all national healthcare workers. At this point, it is a matter of intense legal debate if the federal government is even in a position to do so lawfully.

That leaves the question of vaccine mandates - or bans on vaccine mandates - up to individual states and, in some cases, individual business owners. 

States With Vaccine Mandates for Healthcare Workers (Including Addiction Treatment) Already in Place 

At this writing, 22 states have mandated vaccines for healthcare workers (which typically includes addiction treatment center employees): 

• Washington 

• Oregon 

• California

• Nevada

• Colorado

• New Mexico

• Minnesota

• Illinois

• Kentucky

• Virginia

• North Carolina

• Maryland

• Pennsylvania

• New York

• Massachusetts

• Maine

• New Jersey

• Connecticut

States That Have Banned Vaccine Mandates for Addiction Treatment Center Employees

Other states have explicitly banned healthcare worker mandates. This means that these states will never issue a mandate requiring healthcare workers to get vaccinated. Note that these bans don’t necessarily mean that private employers can’t require vaccines at their individual healthcare facilities. These states are: 

• Montana 

• Texas

• Arkansas

• Tennessee

• Georgia

States That Have Exempted Healthcare Workers from Vaccine Mandate Bans 

Still other states have banned vaccine mandates but exempted healthcare workers from those bans. In these states, state-issued vaccine mandates could become a reality for healthcare workers in the future, but they’re not in effect now. This state of affairs applies to the following states: 

• Utah 

• Arizona 

• Oklahoma 

States Which Bar Private Addiction Treatment Facilities From Requiring Vaccines for Employees

Finally, there are some states that have pre-emptively said that no private employer may require vaccines as a condition of employment. Only one of these states (Montana) has also banned state-level vaccine mandates for healthcare workers. Those states are: 

• Montana 

• North Dakota 

• Florida 

Bringing it Together: Deciding Whether or Not Your Addiction Treatment Center Should Require Vaccination 

If your state has already mandated vaccination for healthcare workers, then your addiction treatment center doesn’t have a choice to make; the state has already said that your employees must be vaccinated. 

If your state has banned healthcare worker mandates, then you know that the question of requiring vaccines for employees at your facility won’t be decided by the state; instead, that’s likely your choice. That is, to say, unless your state has also banned vaccine mandates for private employees. 

If your addiction treatment center is a private entity in Montana, North Dakota or Florida, then you are barred from implementing vaccine requirements as a condition of employment for private employees. 

Now that you know more about your addiction treatment facilitiy’s position within your state, you have a choice to make. Requiring vaccination - with exceptions for health conditions and religious choice - can feel intimidating. These are uncharted waters for many addiction treatment centers. In a future blog post, we will focus on how to implement vaccination requirements at your addiction treatment center, should you wish to do so. 

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