Given the urgency to reach 70 percent vaccination in America by President Joe Biden’s July 4 deadline and the rapid decline in the number of new people getting shots, it is time to shift our strategy and move to plan B: for Bosses.
Plan A—build it and they will come—worked great to reach those most concerned about getting infected and especially those over 65. Now, however, with the continued threat of variant strains and areas of low vaccination coverage in states like Mississippi, Arkansas, Alabama, and Arkansas, we have to move to a new plan centered on workplace vaccination requirements.
And the White House needs to get in on the action, rather than ducking ugly fights.
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The United States Equal Employment Opportunity Commission (EEOC) recently updated its guidance regarding COVID-19 vaccination, stating business owners can legally require vaccination for their employees. Further, the EEOC asserts mandating vaccine requirements does not violate any federal laws. Requiring vaccination benefits businesses by reducing employee sick days, giving greater confidence in the safety of business environments for customers or clients, and reducing the strain on local health systems.
Furthermore, requiring vaccination might be the only way to get those less willing or concerned about COVID-19 vaccinated. Historically, vaccination requirements work extremely well for children, college students, the military, health-care workers, laboratory personnel, and travelers to certain countries. With vaccination requirements, more than 90 percent of children are protected against devastating diseases like polio and measles. Through vaccination requirements, smallpox was eradicated from planet Earth.
Depending on the state and to avoid coercion, employers may have to issue exceptions for medical reasons, or personal beliefs. In addition, some employees may be exempt if working remotely, and consideration for existing inequalities in vaccine access among underserved populations is important, including allowing an extended period for compliance.
But the point is that businesses can—and should—be doing everything they can, even if it risks legal blowback, to force people to get their shots. Now.
And politicians can help them.
Some jurisdictions have recently passed health orders requiring employers to track personnel vaccination status. In California, Santa Clara County began requiring employers to track vaccination status for employees. Some companies have mandated vaccine requirements, such as legal services firms. Many universities and colleges are also requiring vaccination for all students, staff, and faculty.
The science is not out anymore. A slew of studies have shown that vaccinating employees dramatically reduces infection, disease, hospitalization, and death due to the novel coronavirus. A CDC study among health-care workers and essential workers found 90 percent protection against infection among those vaccinated. Another study from the University of Texas Southwestern Medical Center reported only four new infections out of 8,121 employees fully vaccinated.
No, they have not been fully approved yet. But the COVID-19 vaccines in the United States have been rigorously reviewed by the U.S. Food and Drug Administration during clinical trials and after authorization. They are safe, and the benefits greatly outweigh the risks. Safety is continuously monitored by the Centers for Disease Control and Prevention through the V-safe program, a smartphone-based reporting system. The U.S. Department of Health and Human services also uses VAERS, a reporting system to capture data on any reported adverse health events related to vaccination. Based on those systems and continued monitoring, employers can feel confident that vaccination does not put employees at risk.
Individual businesses and even local government is one thing; another is for the feds to step in.
One strategy might be through government backed incentives similar to Biden’s program of tax credits to offset costs for employers who provide paid time for their workers to get vaccinated. Further tax credits could be given to employers who implement vaccination requirements. Another option might be through a law or new U.S. Department of Labor policy that mandates employers put in place vaccination requirements similar to other Occupational Safety and Health Administration rules that ensure worker safety.
Then again, the Biden administration may not be the place to look for answers.
The recent announcement from Team Biden that federal agencies should not generally require vaccination is unbelievable. That is a huge error and a missed opportunity. Why the federal government, with a workforce of over two million employees and nearly double the number of contractors, would not seek to assure the protection of its own workforce and the public with whom they interact is confounding. That might be one of the biggest public health policy mistakes of the current administration in its response to COVID-19. Not only is it inconsistent with best practices in public health, but it sends a terrible message to other employers.
After all, an important part of the imperative to require workplace vaccination is ethical. Despite the fact that nearly two-thirds or more of American adults have gotten at least one shot, many people, particularly those who live in rural and less resourced areas, are being left behind. It is critical to reach those unvaccinated through the workplace. In the beginning of the pandemic, we neglected the health and safety of essential workers, failing to provide routine testing or require strategies to mitigate the spread of infection, like adequate workplace ventilation. Now is the time to make up for that mistake and make sure workers are vaccinated, not only to protect them and their families, but to accelerate the economic recovery.
The administration markets itself as a force for workers. That means making sure they get their shots, whether employers like it or not.
Jeffrey D. Klausner, MD, MPH, is a former CDC medical officer and Professor of Preventive Medicine and Medicine, University of Southern California Keck School of Medicine. Daniel Yepez, BS, is a Graduate Student in Epidemiology, University of Southern California Keck School of Medicine
