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Time is running out for unvaccinated Mayo Clinic employees to get a COVID shot.

The world-renowned health care organization is requiring all of its staff to be fully vaccinated against COVID-19 or to obtain an approved exemption. If a worker can't show they have received at least one dose of a COVID vaccine by Monday, Jan. 3, then they risk losing their job.

"We want to retain all of our staff," said Dr. James Watson, a Mayo Clinic neurologist, at a Dec. 8 Minnesota Senate committee hearing. "That being said, our highest obligation is to do everything in our power to keep our patients safe."

Related: Mayo Clinic tightens mask guidelines, visitor restrictions over omicron variant

Watson, addressing questions from committee chair Sen. Jim Abeler (R-Anoka), testified that Mayo's patients — many of whom have complex medical needs — "deserve and expect that we will provide the safest heath care environment that we can." That includes requiring Mayo staff to be vaccinated against COVID-19, he said.

A week after the committee hearing, Rep. Peggy Bennett (R-Albert Lea) and 37 other Republican state lawmakers signed a letter addressed to Mayo Clinic urging the health care system to replace its vaccine mandate with a "more reasonable" policy.

"Though 100 percent employee vaccination may be ideal according to Mayo guidelines, we do not believe it is ethical, nor is it realistic," the letter reads, citing the ongoing health care worker shortage in Minnesota and across the U.S.

The letter goes on to say the 38 lawmakers won't support state funding to help provide relief "if those hospitals then turn around and fire those employees" over "unrealistic vaccine mandate policies." (The letter prompted Star Tribune's Editorial Board to write an editorial calling the demands "reckless.")

Related: Omicron at least 50% of new COVID cases in Minnesota, MDH says

There's little evidence vaccine mandates are having a significant impact on health care staffing. Both Becker Hospital Review and Fierce Healthcare have lists detailing resignations or dismissals from various health care systems. A few have reported losing as much as 5% of their workforce, but most say the loss has been 1% or less.

In addition, experts were warning of a forthcoming health care worker crisis before COVID-19 hit.

Allina Health, which had an Oct. 1 deadline for its COVID vaccine mandate, had fired 53 people for non-compliance — about 0.2% of the health care system's workforce,  Director of Government Relations Kristen McHenry testified on Dec. 8.

Watson said Mayo Clinic is prepared "to absorb the impacts of these vaccine requirements on staffing," while expressing hope continued outreach and education efforts would minimize the losses.

The lawmakers' letter also accuses Mayo Clinic of being unfair and inconsistent in granting medical and religious exemptions to the mandate. Similar arguments came up on Dec. 8, and Watson defended the process at the time, saying the review teams are looking for a "sincerely held religious belief." 

Rejected exemptions have included things copy-pasted from the internet, he said, or featured arguments focused on non-religious or political beliefs, which don't qualify.

The majority of those Mayo employees who have requested an exemption have gotten it, he added, though declined to give a specific figure.

Mayo Clinic employs about 35,000 people just in Rochester, Minnesota, according to the city, a significant portion of its 65,000 total workers across all locations.

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