ARM TWISTING

The case for mandating a Covid-19 vaccine at work—and the case for merely encouraging it

Should your job depend on it?
Should your job depend on it?
Image: Reuters/UW Health handout/John Maniaci
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Vaccinations have begun at last. Now come the questions, with one big issue hanging over companies: Should they make Covid-19 vaccines mandatory? And, if they choose not to, how can they ensure employees will roll up their sleeves and voluntarily take the jab?

In some industries, there is little to debate. Frontline healthcare workers, for instance, have long faced vaccine requirements for a variety of illnesses. For people who work in offices, warehouses, meat-packing plants, fast-food outlets, and other sites, what employers should do now is not as obvious. When you consider a poll from the Pew Research Center in which 39% of Americans said they do not intend to get the vaccine, or at least not initially, a mandatory vaccine could invite serious blowback.

While the current Covid-19 vaccine is only authorized for emergency use, in the US it’s expected that the same legal guidelines will apply to it (and others to follow in the Covid battle) that apply to the flu shot and other fully approved immunizations. That is, yes, employers have the option to make the needle necessary and fire anyone who refuses it, but employees can request exemptions for medical reasons or on religious grounds.

What’s more likely, in many settings, is that employers will encourage but not require vaccination. That’s already happening at companies like Facebook, where CEO Mark Zuckerberg told his 50,000 employees that he looks forward to getting the vaccine but won’t require that anyone else does before returning to the office.

Most companies have yet to be as clear, says Justin Holland, CEO and co-founder of HealthJoy, an employee benefits platform. Many business leaders have been hesitant to even comment on future plans for their office space, or whether a company with remote workers will stay partly or wholly remote, he adds, but they’re running out of time. “There’s going to have to be a decision made in this next quarter, because they’re going to have to define what workplace safety looks like in their office,” Holland says, and with vaccines becoming more widely available in the coming months, “a lot of employees are going to demand clarity.”

The case for mandating vaccines everywhere

Arguments for and against making vaccines mandatory at any job site are already circulating in the public conversation.

Writing in the New York Times, business journalist Andrew Ross Sorkin called upon corporate leaders to leverage their weight and make vaccinations a requirement to keep one’s job. He believes a mandate could create a competitive advantage for companies, since they could reassure customers that their food servers, chefs, flight attendants, salespeople, and so on have been inoculated (though he acknowledges that early attempts at such statements have led to a swift backlash).

He also sees a mandate as a workplace benefit. “If employees knew that everyone around them is vaccinated, they would feel more comfortable working there,” Sorkin writes.

Amber Clayton of the Society for Human Resource Management agrees. However, she cautions that a vaccine requirement could just as easily become a liability in the labor market: Employees could leave, or companies might have to fire people off for refusing a vaccine when they don’t have a legitimate reason to be exempted. Companies may even find it difficult to attract talent if a vaccine mandate is in place, she says.

And if vaccine rules lead to power struggles and mistrust, then the public health and economic promise of the vaccine roll-out could be compromised.

If employers do choose to mandate vaccines, they might also consider committing to the hybrid model, Holland proposes. “You can make it clear that ‘Hey, if you’re going to work in the office, or even come to the office, you have to get a vaccine,’” he says. Holland believes people will face the same rule if they want to access other spaces, like airplanes, and that offices should be no different. But if a company has made it possible to work from home or the office, people wouldn’t feel pushed to choose between keeping their job and getting the vaccine.

The case for encouraging a vaccine, but not mandating it

Employers also might keep it simple and strongly encourage the vaccine, but stop short of requiring it. Bunny Ellerin, director of the healthcare and pharmaceutical management program at Columbia Business School, sees the most upside in this option for office-based firms where social distancing is possible. It would mean that companies are treating employees like adults, allowing them to make the decision to be vaccinated or not, she says.

Making it mandatory would be “a slippery slope,” she argues. Your company can tell you not to smoke at work, for example, but it can’t block you from stepping outside for a puff. “The vaccine strikes me as somewhat similar to that. You’re injecting something into your body,” she says. But she argues that anyone who comes into contact with a lot of people, in a store or factory, for example, should face a vaccine requirement—which is arguably a slippery slope in and of itself.

Legal liability is a factor, too—although there’s a tradeoff here. Without a vaccine requirement, an employer should be shielded if vaccination causes adverse side effects for an employee. But the lack of a mandate also might open the company to liability if an employee contracts Covid-19 and sues the employer for creating the conditions for exposure.

“In general, you could argue it either way, you really can,” she admits, “but I’m arguing that I don’t think [making vaccines mandatory] is the right strategy.”

Ellerin also underlines that employers should take as many steps as possible to make it easy for people who want to get vaccinated to do so. Until vaccines that are not temperature-sensitive arrive, companies can give people three or four hours off to go and get vaccinated, for example. Once vaccines that are easier to handle arrive, companies can set up on-site clinics or arrange for blocks of time to be reserved at clinics nearby for employees to get the shot. Make the vaccine part of companies’ larger wellness strategies, she says. “You’ve got the massage chair, a dietitian, you’ve got Weight Watchers, you’ve got a dentist,” and soon you could have the vaccine to block SARS-CoV-2.

HealthJoy’s Holland agrees and suggests that companies talk to their benefits providers about creating vaccination incentives, the way some firms give gift cards or points for Fitbit steps.

CEOs and other executives should also set the stage by making it known when they’ve been vaccinated, both Ellerin and Holland suggest. Executives might share photos of themselves getting the jab, says Ellerin, to “show people that they’re not afraid and they want to be good citizens and they want their employees to do the same.”

Through email messages, posters, flyers, and all-hand meetings, business leaders can use information from trusted sources to bust myths about vaccine efficacy or side effects, leading the battle against false claims and conspiracy theories, Holland suggests.

Half of Americans get their health insurance through an employer, and 61% of people surveyed in a recent study said they would take the vaccine that their employer recommended, he adds. That reality puts “the onus on business leaders to help make sure that they’re spreading the right information about the vaccine,” he proposes. And because vaccines have been politicized, he says, it’d be prudent for companies to make a plan now to get ahead of misinformation.

Yet a third option may be to find a middle ground between a strict rule and mere nudges. Daniel Schreiber, CEO of Lemonade insurance, has stated in a company blog post that he’s aiming for a vaccination rate at 100% for the firm, but he will rely on the honor system to make that happen and will not enforce vaccination. Schriber writes:

Governments are—correctly, we think—loath to force people to be vaccinated. But companies can do what governments cannot. We—employers—are at liberty to ask employees to comply with safety-at-work rules, and the Covid-19 vaccination should be one of these (with accommodations for rare medical conditions, and even rarer religious strictures).

Is it a problem that Ford is purchasing ultra-cold freezers?

Some employers have already signaled their willingness to normalize vaccination among employees. Ford Motor Co., for example, reportedly purchased 12 ultra-cold freezers, of the sort required to store Pfizer’s vaccine. Other major automakers are expected to follow suit, though unionized workplaces presumably would need union approval to set rules about immunization.

But Ford’s shopping spree raises another question: Should people be concerned that deep-pocketed employers will have more access to better serve employees, even when supplies are in short supply?

Ellerin doesn’t think so, pointing out that companies do all sorts of things to help their firms work better. “If we start penalizing companies that can do it versus those that can’t, you can follow that down the road to a lot of other things besides freezers,” she says. Besides, she doesn’t think that companies will jump the queue to have their employees prioritized over other members of the general public. They’ll follow CDC guidelines—either because they want to be good citizens, or because the negative publicity would be significant.

Until vaccines are widely available at pharmacies and doctor’s offices, Americans ought to expect all kinds of “small battles” around workplace vaccinations and equal access to vaccines, Holland predicts. But that doesn’t mean companies should step back from their immunization plans. “If business leaders are going to vaccinate entire populations of their employees, and they’re going to make it happen quickly and proactively, I have a hard time thinking that there’s an ethical problem or an ethical situation there,” he says. “It really comes down to, how do we saturate the population as fast possible to get to the point of herd immunity.”