Return to the Workplace: Determining Vaccination Policies
UPDATE: Since the publication of this blog post, OSHA has announced a new policy mandating vaccination or regular COVID testing for all businesses with 100 or more employees. The mandate is currently in litigation and is not being enforced, but businesses should monitor the litigation process and any consequences of its outcome. Although the OSHA order has not been implemented, businesses should consider including a vaccination policy as part of their return to work protocol, especially in the light of new variants that are emerging.
UPDATE 2: The Supreme Court has since ruled that OSHA does not have the authority to impose a vaccination mandate on businesses. However, your local jurisdiction may have their own policies on workplace vaccination, so be sure to monitor news from your public health agency closely. Furthermore, the Supreme Court ruling does not prevent businesses from creating and enforcing their own vaccination policies.
As businesses prepare to return to their workplaces (RTW), leaders must consider multiple variables to determine the timing of the return (WHEN) and the protective policies to be implemented once the office reopens (WHAT). An ongoing assessment of local capacity limits and other policies, local case numbers and vaccination rates, employee readiness to RTW, physical site preparation, and conditions in the local community (safety and restrictions for public transportation, etc.) will inform the timing of RTW (See An Introduction to Health Preparedness Partners’ Return to Workplace Framework for a more detailed description of each of these factors).
Key Considerations
Once leaders determine the timing of RTW, they will have to make the next most important decision: what will the business’s vaccination policy be and how will it be implemented? Vaccines are a proven solution to reduce the number of COVID-19 cases and hospitalizations, so organizations can safely have employees return to the workplace. Workplace protective actions like mask wearing and distancing should be directly linked to the company’s vaccination policy. Experts recommend that unvaccinated people wear masks in public settings.
Before they can decide on a policy, employers must take into account several factors. Perhaps most important is the local vaccination rate. If there are low vaccination rates in the communities where the business is located and employees reside, then the chance of an infected person in the office markedly increases and the business may want to establish a protective vaccination policy. To inform policy development, business leaders may also consider polling their employees (anonymously) to assess the current staff vaccination level and sentiments about vaccination.
The rapid spread of the omicron variant and subvariants throughout the United States makes vaccination even more important. The current increase in COVID-19 cases and hospitalizations is almost solely among unvaccinated people. By mandating or encouraging full vaccination before a RTW, business leaders can do their part to protect their workforce and reduce the spread of disease at the workplace and in the community.
Employers should also consider that some staff, even if vaccinated, will still be at higher risk for illness, especially those who have certain medical conditions and those who are immunocompromised, because they are less likely to develop antibodies that fight COVID after vaccination. That means that, even if they are vaccinated, they are still at some risk of infection. The CDC recently recommended that immunocompromised persons “continue to follow current prevention measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19 until advised otherwise by their healthcare provider.” These employees may not feel comfortable returning to work in close proximity to unvaccinated colleagues and may request to continue to work remotely, or have other accommodations. Some employees may not receive a vaccination because of medical or religious reasons. Recently updated EEOC guidance emphasizes the employer’s role in providing reasonable accommodations for those employees as well as protecting employees that are vaccinated but immunocompromised.
Finally, considerations of the corporate culture and employee input should be factored into decisions about a vaccination policy. Although vaccination against COVID-19 has been found to be safe and effective, there is still a sizeable proportion of people who are skeptical or refusing to be vaccinated. Some employees will have strong feelings about vaccines. Thorough discussions about the company’s vaccination policy should be conducted between business planners and the company’s counsel and leadership so the best policy fit can be achieved.
Vaccination Policies – Three Options
In light of the considerations outlined above, business leaders should determine their vaccine policy prior to re-entry to the workplace. Any preparation for a RTW should be tied closely to the company’s vaccine policy because site preparation and mitigation strategies should be directly informed by the chosen vaccination policy. Three workplace vaccination policies are outlined below:
1. Mandate Full Vaccination
The most stringent and protective policy is to require all employees to remain up-to-date on their vaccines (meaning they have a primary series and any recommended booster shots).
In July 2022, The Equal Employment Opportunity Commission (EEOC) released updated pandemic guidance, solidifying previous guidance stating that employers can mandate employees receive an FDA-authorized COVID-19 vaccine before physically entering the workplace. Although this federal guidance has been released, be sure to check state and local policies to ensure there are no prohibitions for implementing a mandatory workplace vaccination policy.
Leaders should keep in mind that not all staff can or will be vaccinated so, per EEOC and OSHA, reasonable accommodations must be provided on an individual basis to those who cannot be vaccinated because of medical or religious reasons. The EEOC guidance also emphasizes the employer’s role in providing accommodations for employees that are vaccinated but immunocompromised.
Asking all who come into the workplace to be up-to-date on their vaccines provides the -highest level of confidence that everyone at the worksite is vaccinated and that the risk of infection is very low. If employees feel sure that their colleagues are up-to-date, their anxieties about workplace safety may begin to ease. Meetings, consultations, food and drink consumption, and work-related social events can resume, if not in crowded spaces. This policy may also incentivize vaccination for some staff, increasing the overall safety of the workforce.
In implementing this policy, consider how to improve compliance by compensating employees for time off to get vaccinated and recover (if needed) or by providing other incentives (check state and local policies as some areas mandate that employers grant this paid time off).
Ensure there is ample access to vaccinations in the communities where employees live. As part of re-entry, employers can also host COVID-19 vaccination clinics at the workplace to make it convenient for staff to get vaccinated. Business leaders will need to ensure that employees understand that they must be up-to-date to enter the workplace. It is also important to specify what vaccines are acceptable (suggest only including vaccines for which FDA has issued an emergency use authorization (EUA)). It is also important to share this policy in writing well ahead of the date for RTW so employees have time to achieve full vaccination.
Business leaders will also need to determine how employees will prove their vaccination status. EEOC guidelines state that “employers must keep vaccination information confidential pursuant to the ADA” and not store vaccination status in personnel files. Options for proof include presenting or uploading images of vaccination cards, screenshots from apps, or by signing an attestation document to affirm they are up-to-date, as well as the “honor system”. Consequences for noncompliance will also need to be formulated and shared with the workforce.
2. Strongly Encourage Vaccination
Employers can also actively encourage staff to get vaccinated without making it a requirement for re-entry by educating the workforce and offering a reasonable incentive for vaccination. Incentives can include providing paid time off to receive the vaccine and recover from side effects, if needed (which may be required by states or localities, so check), as well as offering gift cards, other paid time off, or cash bonuses. It is important that encouragement does not extend to enacting consequences and other policies that might feel overly restrictive or intrusive.
A recent poll conducted by the Kaiser Family Foundation found that about two-thirds of employed persons who responded to the poll reported their employer was encouraging vaccination and half said their employer is offering paid time off to get vaccinated. The poll also found that employees whose company encouraged vaccination or offered paid time off to receive a vaccination were much more likely to be vaccinated compared with those working for employers who did not offer these benefits.
As with the mandatory policy (above), employers can also host or arrange for COVID-19 vaccination clinics at the workplace to make it convenient for staff to get vaccinated. If leadership gets vaccinated and shares that with the workforce, that can serve as a role model to encourage others to get vaccinated.
While this policy does not provide the same level of confidence in workplace safety, it may be feasible if a large proportion of the workforce is vaccinated, there are relatively high rates of vaccination in the surrounding community, and community disease transmission levels remain consistently low.
As part of encouraging vaccination, it is important to educate the workforce about the vaccine. COVID-19 vaccines have been shown to be safe and effective, they are widely available, and currently, almost all hospitalizations and deaths are occurring in unvaccinated people. There is so much misinformation about the vaccine, and chances are, at least some employees have been exposed to and influenced by it.
Some employees may object to this policy because they don’t know if the workplace is safe due to uncertainty about their colleagues’ vaccination records. The latest CDC guidance advises routine mask wearing and physical distancing for unvaccinated employees in workplaces with a mixture of vaccinated and unvaccinated staff. Some may find it difficult to work with a mask on all day and others may not comply with mask wearing at all. In addition, unvaccinated staff in close proximity to others may pose a risk for vaccinated but immunocompromised employees. It is important to think through in advance, how these issues will be managed.
3. No Vaccination Policy
Some companies are choosing to have no statement or policy on vaccination status as a prerequisite for RTW. Although this policy may avoid a potentially controversial stance, it misses the opportunity for the employer to increase vaccination rates among employees either through mandates or incentives.
A lack of policy could also incur backlash from staff who perceive the workplace as unsafe. As with the “Encourage Vaccination” option described above, having both vaccinated and unvaccinated staff in the workplace at the same time would require routine mask wearing and distancing among unvaccinated staff (who may object or not comply), and having unvaccinated persons in the workplace can pose a risk to vaccinated but immunocompromised people.
Based on cases of mask-wearing refusals in some worksite and public places, this option may elicit workplace conflicts between vaccinated and unvaccinated staff, so careful planning for managing these issues is advised.
Considering the Impact and Costs
While many companies may be concerned about adopting a vaccine policy, the risk of sick employees and the costs of having no policy may be significant. To examine the potential impact of these vaccination policy options, Health Preparedness Partners (HPP), in partnership with the computational modeling company Epistemix, conducted a study of hypothetical companies that had 1,000 employees and were located in ten US cities with varying vaccination rates. For each of the companies, the simulation explored the productivity and health costs of the three vaccination policies after reopening in August, 2021. In every scenario, companies without a vaccination policy had higher costs and more staff absences from COVID-19 than companies with any vaccination policy.
Here are some of the major take-aways from the study:
Businesses that required employees to be fully vaccinated before they returned to the office experienced no staff illnesses, missed workdays or increased expenses related to COVID-19.
Businesses of 1,000 employees without an employee vaccination policy are likely to have an estimated 392 missed days of work over the upcoming fall and may spend $798,000 on COVID-19 health costs, on average.
Businesses can prevent nearly 200 missed workdays in the fall from employee absences and save around $326,000 by strongly encouraging employees to get vaccinated before returning to the workplace.
Businesses that strongly encouraged vaccination before entering the workplace can reduce workplace absences due to illness and lower COVID-19 health costs by 59%, compared with having no vaccination policy.
A Difficult Decision
It’s clear that business leaders have to come to a decision about their vaccine policy before a return to the workplace commences, but that doesn’t mean it will be easy. This blogpost only describes three options, whereas hybrid approaches or other permutations may be more suitable for some businesses. Leaders need to understand of the pros and cons of the different possible workplace vaccination policies and take into account local pandemic trends and level of vaccination, their company’s tolerance for risk and their company’s culture before making a choice. Finally, leaders need to clearly communicate the company’s vaccination policy to all employees, and if a mandatory policy is chosen, provide ample time for staff to get up-to-date before returning to the office. For an approach tailored to your company’s needs, contact us to schedule a consultation.