Rhode Island’s major hospital systems are continuing to encourage - but not mandate - vaccinations against COVID-19 for its employees.

But that could change in the wake of rising infections driven by the spread of the more contagious Delta variant and growing pressure from health professional associations recommending mandatory vaccinations for health care workers to prevent the virus’ spread to the most vulnerable populations.

The American Hospital Association and the Association of American Medical Colleges last  week recommended that teaching hospitals and medical schools require their employees to be vaccinated against COVID-19.

And after a federal court judge in Texas in June sided with a Houston hospital that required workers to get a COVID-19 vaccine, more hospitals and health systems around the country have begun imposing vaccination requirements.

In New England, major hospital systems including the Boston-based Mass General Brigham, Yale New Haven Health in Connecticut, and Southcoast Health, in southeastern Massachusetts and Rhode Island, have reportedly announced plans to require workers to get vaccinated. 

At Yale New Haven Health, about 81% of hospital employees have been vaccinated, The Connecticut Mirror  reported July 15. The Connecticut-based hospital system which operates Westerly Hospital  plans to require all workers to be vaccinated by Sept. 30. 

Rhode Island’s largest hospital system, Lifespan, said that about 70% of its  nearly 16,000 employees have been vaccinated through the hospital system. Other employees who may have been vaccinated outside the company’s employee health services are not included in the count, Kathleen Hart, a Lifespan spokeswoman, said in an email.

“In light of recent recommendations” by two national hospital associations,” Hart said, “Lifespan is reviewing its current policy and expects to issue further guidance on vaccinations in the next few weeks.”  

Care New England, the state’s second-largest health system, said that 76% of Care its employees are fully vaccinated, Raina Smith, a Care New England spokeswoman, said in an email Friday.

Care New England, which is seeking approval to merge with Lifespan, is requiring COVID-19 vaccines for new hires, volunteers and students, Smith said. As for the rest of its employees, she said, “we continue to watch the unfolding situation and consider our best response in conjunction with our key stakeholders.”

More than half of Rhode Island’s civilian labor force is employed in the health services industry, according to data compiled by the Kaiser Family Foundation. Hospitals employees were among the first in Rhode Island  to offer the vaccine in mid-December, starting with high-risk staff. 

Nationally, about one in five adults remains reluctant to get a vaccine, with about 6% saying they will do so “only if required” for work or other activities, according to a June Kaiser Health News poll. About 14% of adults said they would “definitely not” get vaccinated. The report said those numbers have remained unchanged since January.

More than 96% of  practicing physicians surveyed in June the U.S. are fully vaccinated against COVID-19, according to the American Medical Association, with no significant regional differences in vaccination rates. Of those physicians not yet vaccinated, the survey found, 45% said they planned to do so.

Any vaccine mandate for hospital employees would likely run into opposition from the union that represents about 2,500 employees in the Care New England system. Though the union is “enthusiastically pro-vaccine….as long as the vaccine has only been approved (by the FDA) for conditional use, and as long as healthcare workers aren't granted time off with pay should they develop symptoms in response to the vaccine, our members have a right to choose whether or not to be vaccinated,’’ Heather Kelley of District 1199 New England of the Service Employees International Union, said in an email. 

Many health care professionals have urged the Food and Drug Administration to grant final approval to the COVID-19 vaccines, saying it would encourage skeptical Americans to get vaccinated and prevent another surge of the pandemic. (The vaccines are currently being used under emergency authorization.) The New York Times reported last week that President Biden told a town hall audience in Ohio that he expected the FDA to give final approval either at the end of August or early September or October.

 But waiting until then to mandate vaccinations for health care employees may not be prudent, said Dr. Philip A. Chan, an infectious disease specialist at Brown University. “Where we are now with the Delta variant,’’ Chan said, “I think that we need to seriously consider it now.”

Because the Delta variant is much more infectious than previous strains of the virus, Chan said, the vaccination rate needed to reach herd immunity will likely be “above”  70%.

The state Department of Health reports that about 61% of all Rhode Islanders are fully vaccinated, including 71% of adults (18 and older). But the rate varies widely by community. In Woonsocket, only 44% of the residents are fully vaccinated, the lowest in the state. That’s compared with about 51% of residents in Providence and Pawtucket; 58% in Cranston and 63% in Warwick.

Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on Twitter LynnArditi