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Order Requiring Verification of Vaccination Status and Requring Weekly COVID-19 Testing for Certain Unvaccinated Workers

ORDER OF THE MARIN COUNTY PUBLIC HEALTH OFFICER REQUIRING THE VERIFICATION OF VACCINATION STATUS AND REQUIRING WEEKLY COVID-19 TESTING FOR CERTAIN UNVACCINATED WORKERS

Date of Order: January 6, 2022

UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 101040, 101085, AND 120175, THE HEALTH OFFICER OF THE COUNTY OF MARIN (“HEALTH OFFICER”) ORDERS:

  1. Summary.  This Order supersedes the September 1, 2021 Order of the Health Officer (“Prior Order”) requiring Law Enforcement, Fire, Emergency Medical Services (“EMS”), Temporary Disaster Shelter, and Public Sector Employers to verify the Coronavirus Disease 2019 (“COVID-19”) vaccination status of all Personnel.  The Prior Order also required Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel who are not Fully Vaccinated to undergo weekly testing for the virus that causes COVID-19 and imposed reporting requirements in the event an employee tests positive for COVID-19. This Order requires all Personnel subject to the Prior Order to undergo weekly COVID-19 testing, with certain exceptions, or prove that they are fully vaccinated and have received a booster shot, if eligible.   
  2. Basis for Order.  On July 26, 2021, the California Department of Public Health (“CDPH”) issued an Order requiring employers of high-risk health care and congregate settings to verify the vaccine status of all workers and require unvaccinated or unverified workers to undergo routine COVID-19 surveillance testing.  This order did not include Law Enforcement, Fire, EMS and Temporary Disaster Shelter Personnel despite their critical role in public health and safety and the fact that Personnel in these sectors regularly interact with and enter high-risk health care and congregate settings.  Personnel within these sectors also interact regularly with medically vulnerable individuals in the community.  The July 26, 2021 CDPH Order is insufficient to protect our community from the spread of COVID-19 due to its omission of Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel.

On August 28, 2021, the Marin County Public Health Officer issued an order requiring Law Enforcement, Fire, Emergency Medical Services (“EMS”), Temporary Disaster Shelter, and Public Sector Employers to verify the COVID-19 vaccination status of all Personnel and requiring Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel who are not Fully Vaccinated to undergo weekly testing for the virus that causes COVID-19.  On September 1, 2021, the Marin County Public Health Officer issued the Prior Order which maintained the requirements of the August 28, 2021 order but added additional verification and reporting requirements.

Since the issuance of the Prior Order, the protection offered by all of the COVID-19 vaccines authorized for use in the United States has been found to wane after a period of time, and the CDC now recommends booster shots at six months after a person’s second dose of a two-dose mRNA vaccine (Pfizer or Moderna) and two months after the Johnson & Johnson single dose vaccine.  These developments necessitate a new requirement that vaccinated individuals exempt from weekly COVID-19 testing pursuant to the Prior Order receive boosters when indicated to remain exempt from the testing requirement. 

This Order is also being issued in light of the emergence in Marin County of the Omicron variant of SARS-CoV-2, the virus that causes COVID-19, and the imminent threat that it poses to the health of vulnerable residents and the capacity of the healthcare system.  Emerging evidence indicates that the Omicron variant is significantly more transmissible than prior variants of the virus and that individuals who have had only their initial vaccine series and are eligible for the booster are susceptible to the Omicron variant.  Initial evidence also shows that individuals who have received a booster shot increase their immunity to a level that confers more protection from all circulating SARS-CoV-2 variants, including the Omicron variant. 

Vaccination remains a safe and effective means of preventing COVID-19 and its associated harms.  Individuals who have not received a booster shot are more likely to become infected and spread infection to others and are more likely to become seriously ill and die.  Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel should receive booster shots when eligible to maintain the protective effects of the high community-wide vaccination rates in our County.  Ensuring that Personnel working in these higher risk settings are both vaccinated and boosted, when eligible, is critical given the emergence of the Omicron variant. Personnel working in these settings can expose highly vulnerable individuals who are at increased risk of severe illness and death and they must be protected from COVID-19 to the maximum extent possible to ensure adequate staffing in these critical settings.  In considering options to stem the anticipated rapid increase in COVID-19 transmission, ensuring that Personnel who work in these higher risk settings are all vaccinated and boosted when eligible is critically important. 

Additionally, given the importance of booster shots to ensure the continued benefit of high community-wide vaccination rates, this Order requires Law Enforcement, Fire, EMS, Temporary Disaster Shelter, and Public Sector Employers to verify the vaccination status of employees, including whether employees have obtained booster shots, if eligible.   This Order also continues to impose reporting requirements on all Employers within the Count

           

  1. Definitions. For purposes of this Order, the following terms have the meanings given below.
    1. CDC. “CDC” means the U.S. Centers for Disease Control and Prevention.
    2. COVID-19 Test. “COVID-19 Test” means a nucleic acid or antigen test to detect infection of a person with SARS-CoV-2, the virus that causes COVID-19.
    3. COVID-19 Vaccine. “COVID-19 Vaccine” means a vaccine to prevent COVID-19 that is (1) administered under an emergency use authorization from the FDA; (2) approved by the FDA; or (3) listed for emergency use by the World Health Organization.
    4. FDA. “FDA” means the U.S. Food and Drug Administration.
    5. Fully Vaccinated. “Fully Vaccinated” means a person’s status two weeks following the person’s receipt of a single-dose COVID-19 Vaccine or the second dose of a two-dose COVID-19 Vaccine.
    6. Fully Updated.  “Fully Updated” means that an individual is not only “Fully Vaccinated” but has also obtained a booster dose of a COVID-19 vaccination for which they are eligible as authorized by the FDA.  For example, as of the effective date of this Order, individuals who received their second dose of the Pfizer or Moderna COVID-19 vaccine more than six months ago are eligible for and must obtain a booster shot to be Fully Updated, while individuals who received one dose of the Johnson & Johnson COVID-19 vaccine more than two months ago are eligible for and must obtain a booster shot of any of the available vaccines to be Fully Updated. 
    7. Law Enforcement.  “Law Enforcement” means all law enforcement officers and administrative/clerical support staff working in (1) the Marin County Sheriff’s Office; (2) any police department of a city or town within Marin County; (3) the Central Marin Police Authority; and (4) the College of Marin Police Department.
    8. Fire. “Fire” means all firefighters and administrative/clerical support staff, including part-time, stipend, and volunteer.
    9. Emergency Medical Services or EMS. “Emergency Medical Services” or “EMS” means all prehospital emergency medical personnel and administrative/clerical support staff, including but not limited to: authorized registered nurse or mobile intensive care nurse, emergency medical technician, advanced emergency medical technician, paramedic, or a physician and surgeon who provides prehospital emergency medical care or rescue services. 
    10. Temporary Disaster Shelters. “Temporary Disaster Shelters” means small-, medium-, and large-scale, organized, and temporary accommodations for persons displaced by disasters.  Facilities may be residential (e.g., dormitories, campsites) or non-residential (e.g., sports stadiums, school, churches).
    11. Public Sector. “Public Sector” means all personnel working for local government entities within Marin County, including the County of Marin and towns and cities within Marin County. 
    12. Employer. “Employer” means an employer of Law Enforcement, Fire, or Emergency Medical Services, or an operator of a Temporary Disaster Shelter in Marin County. 
    13. Personnel. “Personnel” means employees and volunteers of an Employer.
    14. WHO. “WHO” means the World Health Organization.
    15. Business. “Business” means any for-profit, non-profit, or educational entity, whether a corporate entity, organization, partnership or sole proprietorship, and regardless of the nature of the service, the function it performs, or its corporate or entity structure, having a place of business within Marin County.  
  2. Verification of COVID-19 Vaccination Status.  All Law Enforcement, Fire, EMS, Temporary Disaster Shelter, and Public Sector Employers must verify the COVID-19 vaccination status of all Personnel. Any Personnel asserting that they are Fully Vaccinated or Fully Updated must present their Employer with one of the following: 
    1. The original U.S. Department of Health and Human Services CDC vaccination card issued to the individual following administration of the COVID-19 Vaccine (“CDC Card”);
    2. The original WHO International Certificate of Vaccination or Prophylaxis issued to the individual following administration of the COVID-19 in a foreign country (“WHO Yellow Card”);
    3. A paper photograph or photocopy of the CDC Card or WHO Yellow Card;
    4. An electronic image of the CDC Card or WHO Yellow Card;
    5. A digital copy of the individual’s COVID-19 Vaccine record, obtained through the following portal: https://myvaccinerecord.cdph.ca.gov/; or
    6. Documentation from a licensed healthcare provider that the individual is Fully Vaccinated.

In the absence of knowledge to the contrary, an Employer may accept the documentation presented as valid.

For clarity, Employers must ascertain the vaccination status (fully updated, fully vaccinated, partially vaccinated, or unvaccinated) of all Personnel.  Personnel who do not provide the documentation specified in section 4.a-f., must be considered unvaccinated. 

  1. COVID-19 Test Requirements.  Except as set forth in Section 6 of this Order, Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Employers shall require its Personnel to do the following:
    1. Receive a COVID-19 Test at least once a week; and 
    2. Unless test results are sent directly to the Employer by the test provider, Personnel must promptly provide the results of each COVID-19 test to the Employer for Record-Keeping.

An Employer may confirm a positive antigen test with a confirmatory nucleic acid amplification test (e.g., polymerase chain reaction (“PCR”) test); an Employer shall not use another antigen test to confirm a positive antigen test.  Employers must exclude from work any Personnel who receives a positive antigen test until the Employer receives results from a confirmatory nucleic acid amplification test.

While not required under this order, Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel Employers are encouraged to consider more frequent surveillance testing (e.g., twice weekly) for Personnel who have regular contact with high-risk patients and/or health care settings as defined by the July 26 CDPH Order (e.g., hospitals, nursing facilities).

  1. Fully Updated Personnel.  An Employer may exempt the following Personnel from the COVID-19 Test requirements set forth in Section 5 of this Order:
    1. Fully Updated Personnel; and
    2. Fully Vaccinated Personnel who are not eligible for a booster (as defined in Section 3.f).  Fully Vaccinated Personnel must show proof to their Employer that they have received a booster of a COVID-19 vaccination within fifteen (15) days of becoming eligible, or they must be subject to the COVID-19 Test Requirements in Section 5.  
  2. Record Keeping Requirements. An Employer must keep and maintain a record of the following information for the purpose of inspection by an authorized representative of the Health Officer:
  1. For Personnel who provide the Employer with documentation of Fully Vaccinated status in accordance with Section 4 of this Order: (1) Full name and date of birth; (2) COVID19 Vaccine manufacturer; and (3) date of COVID-2 Vaccine administration (first dose, and if applicable, second dose).
  2. For other Law Enforcement, Fire, EMS, and Temporary Disaster Shelter Personnel: (1) COVID-19 Test results, if applicable.
  1. Mandatory Reporting Regarding Personnel Contracting COVID-19. Businesses and Employers must require all employees to immediately alert the Business or Employer if they test positive for COVID-19 and were present in the workplace within the 48 hours prior to the onset of symptoms or within 48 hours of the date on which they were tested. If a Business or Employer identifies three or more COVID-19 cases at a single worksite within fourteen days, the Business or Employer must report the cases to the Public Health Department at 415-473-7191 within forty-eight hours pursuant to Labor Code section 6409.6. Businesses and Employers must also comply with all case investigation and contact tracing measures by the County, including providing any information requested.

  1. Effective Date. This Order shall become effective at 12:01am on January 28, 2022. This Order shall continue to be in effect until it is rescinded, superseded, or amended in writing by the Health Officer.

  1. Copies. Copies of this Order shall promptly be: (1) made available at the Bulletin Board adjacent to the entrance to the Chambers of the Board of Supervisors, Room 330, Administration Building, and in the display case in the center arch of the Hall of Justice, Marin County Civic Center, San Rafael, California; (2) posted on the County of Marin website (www.marincounty.org) as well as the County of Marin Department of Health and Human Services website (www.marinhhs.org); and (3) provided to any member of the public requesting a copy of this Order.
  2. Severability. If any provision of this Order or its application to any person or circumstance is held to be invalid, the remainder of the Order, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect.  To this end, the provisions of this Order are severable.

 

IT IS SO ORDERED:

Matt Willis MD, MPH                                                                       

Health Officer of the County of Marin

Dated: January 6, 2022