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5/3/21 COVID-19 Brief: What to Do About Unvaccinated Workers – A 5-Part Approach

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The post-pandemic economic recovery that has begun is going to require that employers not only safely return their employees to full-time and full-speed work, but that their employees work together as never before to solve problems, improve output, and innovate to capture new growth opportunities. Among the greatest threats to success in this scenario is vaccine hesitancy.

A Message on COVID-19 from WorkSTEPS Medical Director Dr. Ben Hoffman

What to Do About Unvaccinated Workers – A 5-Part Approach

A Difficult Dilemma

The post-pandemic economic recovery that has begun is going to require that employers not only safely return their employees to full-time and full-speed work, but that their employees work together as never before to solve problems, improve output, and innovate to capture new growth opportunities.

Among the greatest threats to success in this scenario is vaccine hesitancy. Particularly with the rising threat of more contagious and lethal variants, workers who choose not to get vaccinated pose a risk to their own health, and the health of their coworkers and customers, including those who cannot be vaccinated due to health or other reasons, and – to a small degree – those who have been fully vaccinated.

Beyond the biological risk, vaccine hesitancy is forcing employers to choose between supporting the rights of those who have been vaccinated to safely return to a state of normalcy, and the rights of those who have not been vaccinated to participate in that new normal state. The rights of these groups are in conflict. Something has got to give.

A Recommended Approach

1. Set a timeframe, tied to vaccination and case-rate milestones: It is important to give employees as sense of when things will return to something that looks and feels like normal, and to tie that to objective milestones. For example, you might say that: By July 1, we expect that 75% of employees in [location or community] will have been vaccinated. If the case rate in our community indicates a low risk of Covid-19 infection, we will be able to make major strides in our journey back to normal operations, dramatically relaxing and even eliminating many of our Covid-19 prevention protocols.” You don’t need to be more specific than that just yet. Let employees begin to imagine and anticipate what returning to normal will be like.

2. Reinforce the need for ongoing preventive measures, aligned to CDC recommendations: Masks, distancing, sanitation, and ventilation remain the norm for indoor spaces. Be sure to update policies to reflect changes, including this week's guidance which offers new possibilities for outdoor meetings and gatherings among employees regardless of vaccine status.

3. Encourage and support vaccination, giving people information, encouragement, space, and time to make their own decisions: Everyone in your workforce is now eligible to receive the Covid-19 vaccine, and in most states, vaccine supply is sufficient to meet demand. It will be helpful to think about your employees in four groups. The first group has been waiting for eligibility, or simply hasn’t been willing or able to navigate the processes that have been in place. All they need is reminders and basic information about where they can get vaccinated.

You may have a second group of employees who are facing real or perceived barriers to getting vaccinated. For example, some employees fear they will lose wages if they take time to get vaccinated, or if vaccine side-effects cause them to miss work. Providing paid time off for workers to get vaccinated, or for lost time due to post-vaccination side-effects are policies that can help. The Biden administration is even providing a tax credit to reimburse employers who cover vaccination-related lost time costs.

The third group of employees is the most challenging – those who are reluctant to get vaccinated because they’ve been misinformed/misled through information sources and influences tied to their political affiliation, or because of institutional distrust within their ethnic or racial community. What won’t work with these employees is anything that further marginalizes or pushes them into a corner. Use your most trusted voices, provide credible information, amplify testimonials, communicate a compelling vision of a return to normal, and perhaps even offer an incentive for employees to speak with a health care professional if they have questions or doubts. Put all these things in place, then give people space and time to decide for themselves.

The fourth group of employees is the hard core anti-vaccine group. There is nothing you can do about this group, except to not give them attention. However, if you have leaders who are using their position to promote their misguided beliefs, they need to be held accountable.  

4. Educate those who’ve been vaccinated about the benefits and freedoms they now have. A recent study published by the American Psychological Association found that 49% of those who have already been vaccinated are uneasy about returning to in-person interaction once the pandemic ends. After more than a year of fear and isolation, many people will be very cautious about returning to work and engaging with potentially-unvaccinated colleagues or customers face to face (even masked).

Vaccines are highly effective at preventing infection, and among those who do become sick after full vaccination, risks of serious illness, hospitalization and death are small. Because of this, people who have been vaccinated can safely enjoy freedoms they’ve abandoned through the pandemic. Employees need to understand such messages to reduce undue anxiety about returning to in-person interaction.

5. Develop and communicate specific policies and expectations that will enable the company to return to normal while controlling the risk posed by unvaccinated employees. This step fills in the details behind Part 1. The goal should be to set clear expectations about what will be required of people who are not vaccinated. Will they need to be masked at all times when indoors? Will all people need to be masked for in-person meetings regardless of vaccine status, or will only unvaccinated employees be required to mask up (or attend virtually)?

None of the policy questions will be easy, but they will need to be answered with clarity and consistency. My bias is to position infection risk as a safety matter. As such, the policies represent the company’s obligation to protect workers from illness and injury. Just as a company may require the use of PPE in certain circumstances, it will require the wearing of masks by those who pose a transmission risk.

Give It Time

I used July 1 as the target date in my example under Part 1 above for a reason. I believe the challenge of unvaccinated employees will get easier over the next three months.

I was getting my hair cut the other day, and of course, talking about Covid-19. She told me about one of her customers – an ornery older man who she had to cajole into wearing a mask and who had vowed not to get the vaccine. He got his first shot last week. Why? Because he wants to go to concerts and do some traveling this summer, and it just wasn’t worth fighting anymore.

I think that anecdote sums up a number of important dynamics that are going to play out in the next few months: the desire to get out and do things again; the sense that unvaccinated people may be formally or informally excluded from certain activities or environments; the fatigue of fighting against an increasingly-large majority; and the accumulating evidence that vaccines are safe, and they’re working.

So, give it time. Barring any unforeseen news about vaccine efficacy or risks, more people will decide to get vaccinated, and the job of navigating the competing rights of vaccinated and unvaccinated employees will get easier.

We Can Help

The issue of unvaccinated workers is just one of the return-to-work issues companies will face in the coming months. In our next newsletter, I’ll outline the broader challenges and an integrated approach we recommend companies take so they can meet demand and grow their business during a robust recovery cycle. Contact us if you’re interested in learning more about how we can help your company.

Ben Hoffman, MD, MPH
Chief Medical Officer, WorkSTEPS

For more from Dr. Hoffman, connect with him on LinkedIn.

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Newsletter written by WorkSTEPS CMO Dr. Ben Hoffman and WorkSTEPS’ expert medical team.

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