While reasons given for seeking exemptions vary, the vaccines’ remote link to fetuses aborted decades ago is often cited — lab-grown cell lines descended from those fetuses were used in testing and manufacturing processes. The vaccines do not contain fetal cells, however, and workers generally are seeking the exemptions without the backing of major denominations and prominent religious leaders.

But as the healthcare mandate takes effect, hospital leaders acknowledge that they see the exemptions as a way to retain staff at a time when resources are already stretched thin.

“Our position has been we would we want we want everyone vaccinated,” said Brock Slabach, chief operations officer for the National Rural Health Association. “But we also think that access to care is incredibly important.”

Similar stories abound across the country.

At the 25-bed Community Hospital in McCook, Nebraska, in the southwestern part of the state, about 20% of the 320 employees have not been vaccinated. About 35 applied for exemptions, and others are still deciding what to do. The hospital has rejected some requests that relied on specious religious reasoning.

“If it’s a complete, like, essay on the science behind why this shouldn’t be allowed, or a complete essay on why a certain political party or political figure is an idiot, which we’ve seen, we don’t go with that because that’s not religious at all,” hospital president and CEO Troy Buntz said. “We do push back on those, but I don’t know if other people are even reading the exemptions as much as they probably should be.”

In Mississippi, some hospitals have nearly all their employees vaccinated while others are closer to the 50% to 70% range, according to Richard Roberson, the state hospital association’s general counsel. Since the mandate was announced, he has received dozens of calls inquiring about how the exemptions work.

“I don’t know how many there will be, but we’re in the heart of the Bible belt. And so that is something that is very near and dear to everyone’s heart,” Roberson said.

And at the 14-bed Holton Community Hospital in rural northeastern Kansas, 28 out of 193 employees have gotten religious exemptions and one got a medical exemption. The mandate helped nudge the staff vaccination rate from around 75% to nearly 87%, but some younger nurses remain hesitant because of disproven concerns that the vaccine could hurt their fertility, CEO Carrie Saia said.