In September, the Biden administration announced that COVID-19 vaccination would become mandatory for federal employees and millions of healthcare workers and federal contractors. Since then, more than 3,500 organizations have followed suit, making vaccination required at 25 percent of businesses.
Plenty of news coverage has focused on the controversial and negative side of vaccine mandates, where workers are fired after refusing to get vaccinated. This Washington Post headline, “N.C. Hospital System Fires About 175 Workers in One of the Largest-Ever Mass Terminations Due to a Vaccine Mandate” is a good example. If you only saw the headlines, you might think vaccine mandates are failing. After all, isn’t the point to get more people vaccinated, not put people out of a job?
However, the overall numbers tell a very different story – that vaccine mandates have been extremely successful. A White House report found vaccine mandates often increased vaccination rates by 20 percentage points or more across an organization. For example, in New York State, only about 75 percent of hospital and nursing home workers were vaccinated against COVID-19 in August. By the first week of October, as the mandatory vaccine deadline passed, vaccination rates reached 92 percent. That represents an increase of over 100,000 vaccinated workers. Yet the headline was “New York’s Largest Healthcare Provider Fires 1,400 Employees Who Refused to Get Vaccinated.” The reality is that no public education campaign or incentive program has come close to increasing vaccination rates by that margin in a month.
That’s not to suggest there won’t be fallout, both for the workers who lost their jobs and the people who rely on hospitals and nursing home facilities for care. Many providers have warned customers may see longer wait times than they’re used to, especially for elective procedures. However, we have to weigh these impacts against the larger public health benefit of getting all these workers vaccinated.
We’re already seeing the benefits of no longer having clusters of unvaccinated people in workplaces with a high risk of transmission. For example, after a company that runs long-term care facilities across the U.S. implemented a mandatory vaccination policy for its staff this summer, cases of COVID-19 among residents fell by almost 50 percent.
As organizations try to measure the successes or failures of vaccine mandates, it’s also important to keep in mind that most workers can’t do their jobs if they get COVID-19. OSHA’s emergency temporary standard for the healthcare industry requires workers who test positive and their close contacts to be removed from the workplace. Many companies in non-healthcare settings have similar policies in place for infected and exposed workers.
“Without a vaccine mandate for team members, we faced the strong possibility of having a third of our staff unable to work due to contracting, or exposure to, COVID-19,” said Carl Armato, the CEO of Novant Health, which employs over 35,000 healthcare workers. “This possibility only increases heading into a fall season with the more contagious and deadly Delta variant.”
Lessons Learned from Vaccine Mandates
Many companies have found that the number of workers who are actually willing to lose their job is much smaller than the number of workers who say they will refuse the vaccine initially. The North Carolina hospital system that ultimately fired 175 workers first suspended about 375 people; 200 of those workers got vaccinated within a week and were reinstated. On average, it appears that vaccine mandates at large organizations are resulting in one percent or less of workers losing their jobs, with another two to three percent of workers receiving medical or religious exemptions.
Employers considering vaccine mandates can benefit from educating workers and surveying them about the reason for their hesitancy. The results can help inform an approach that has the right mix of “carrot” (e.g., educating employees, dispelling misinformation, incentives) and “stick” (e.g., suspension, termination) to get the desired result. For more information about surveying workers, see the LHSFNA’s Promoting COVID-19 Vaccination at Your Workplace guidance document on our COVID-19 Resources page.
Given the current political landscape, vaccine mandates aren’t likely to get less controversial anytime soon. Workers who oppose them often say their personal freedoms are being infringed upon. Organizations who implement vaccine mandates should be clear that the point is to protect everyone in the workplace, not only the workers who don’t want to get vaccinated. In a workplace environment – where employers have a legal duty to protect workers from known hazards – one person doesn’t have the right to put the health of others at risk.
No one likes to be told what to do. In this case, where one person’s decision could affect the lives of their coworkers, their coworkers’ families and their community, the benefits outweigh the costs.