Published by Patrick Bell

The long-awaited COVID-19 vaccine has brought various questions from employers about the safety, efficacy, distribution, timeline, and even if they can require their employees to get vaccinated. Below is a breakdown of what the vaccine could mean for your population, the vaccine availability, and policies you need to know if mandating the vaccine.

The Vaccine Is Just One Tool In Our Toolkit

The vaccine is not the end all be all to controlling the pandemic. While it will help expedite herd immunity and reduce the severity of COVID-19, it is just one additional tool in our toolkit. To date, no data is showing that the vaccine reduces transmission; thus making masks, social distancing, good hand washing, and symptom tracking all still necessary, regardless of your organization’s vaccination rate.

The Vaccine 101

As of today, two vaccines are being distributed in the US. Both are mRNA based with FDA Emergency Use Authorization. They are also both considered effective and safe:

• The Pfizer vaccine has a 95% efficacy for prevention. 
• The Moderna vaccine has a 94.1% efficacy for prevention. 

It is important to note that the vaccine should be administered in a medical facility, at least for right now, for two key reasons: logistical hurdles and safety. The Pfizer vaccine must be stored at -94° F and the Moderna vaccinate at -4° F, meaning special refrigeration equipment is needed to keep the vaccines effective. Although rare, there is potential for significant adverse side effects of the vaccine. Controlling the risks and ensuring the safety of people receiving the vaccine is a wise step at this phase of the rollout.

Further complicating things, just as the vaccine rollout was getting underway, a new variant was recently identified in several countries. The new variant has the potential to impact the effectiveness of the vaccines currently being administered. While the manufacturers think there are still protections, it is too early to tell.

One final note; there are over 50 other vaccines currently in development. The AstraZeneca vaccine was recently approved for use in the UK and is about 90% effective. Studies are ongoing, and we anticipate more progress to be made in the number and types of vaccines available in the coming months.

Rollout & Distribution

The Advisory Committee on Immunization Strategies (ACIP) run by the CDC has launched a tiered rollout driven at the state and local levels. They have provided guidance and recommendations, but local governments are managing the logistics and prioritization of the rollout. While we don’t anticipate it being this way forever, especially as the Biden administration takes control, this is an area HealthCheck360 continues to watch.

You can access your state’s policy in the “State & Territory COVID-19 Vaccine Information” section here.

Availability

Currently, the vaccine is in phase 1A of rollout and available to health care employees and long-term care facility residents. While progressing, there are still a lot of people in this group who have not been offered or received the vaccine yet.

After phase 1A, frontline essential employees in tier 1B will be up next. In many cases, this includes:

• Emergency personnel like firefighters, police officers, corrections officers
• Food and agricultural workers like meatpacking and processing facilities, food manufacturers, and grocery store workers
• Public service workers like postal service employees and public transit
• Education staff like teachers, daycare workers, and support staff
• Manufacturing workers making essential products and services

Below is a summary of the recommended populations for each tier:

Phase 1A

• Health care workers
• Long-term care residents

Phase1B

• People 75+
• Frontline essential employees (non-healthcare)

Phase 1C

• People aged 65-74 years old
• People with high-risk medical conditions aged 16-54

Phase 2

• General Population

Source: nga.org

Currently, the vaccine is not available for purchase through private channels; however, we expect this to change as the knowledge around the risks and side effects increases and new vaccines with fewer logistical hurdles are available.

Requiring the Vaccine

While requiring vaccines in certain workplaces is not new (think the flu shot for health care workers), there is a lot of controversy around the COVID-19 vaccine given the rate at which it was developed, and many unknown questions surrounding the risks and long-term effects.

The EEOC has stated that employers can require the COVID-19 vaccine. If you’re planning on requiring your employees to get the vaccine once it becomes available to the general public, keep in mind that you need to offer reasonable accommodation for employees with disabilities and religious objections. This could mean, getting a different vaccine that doesn’t affect their medical condition, teleworking, or even reassigning the employee to another role. When communicating the vaccine requirement, the process for requesting accommodations should also be documented and clearly visible.

Employers can also ask employees for proof that they’ve received the COVID-19 vaccine, as it will not be considered a “medical examination” under the ADA. Keep in mind that questions you ask around the vaccine could get a little too close to disability-related questions that violate the ADA, so use caution with any pre-screening or vaccine-related questions.

A perhaps better approach that many employers are exploring is encouraging vaccination among employees through education, promoting community and personal well-being, and incorporating it into the company well-being program and strategy. In some environments, the need to require the vaccine may not be an issue because there is enough standalone employee interest without needing a mandate from the employer.

Recommendations for Employers

Given all of the unknowns around the vaccine’s availability for the general public at this stage, what should employers be focusing on right now? Here are a few ideas:

• Look at the risk and role profile of your company. Are you able to work from home? Are some segments of your business able to work from home? Distancing measures are still some of the best ways to limit the spread, especially with the new variant and increasing cases. If you are a non-healthcare essential workplace, especially where people are in close contact with each other, stay up to date on your local and state guidance about availability for phase 1B in your area so you can begin offering vaccines as soon as reasonably possible.
• Gauge employee interest in the vaccine. Gathering some insights now into how many employees are interested in getting the vaccine, even at these early stages, will arm you with valuable information around the likelihood that you would need to require the vaccine. Polls and surveys are fast ways to get a pulse on the feelings of your employees.
• Have a multifaceted plan. Keep in mind, what you do today does not have to be what you do tomorrow. You can recommend and encourage employees to receive the vaccine and then require it for any of the holdouts. In addition, the pandemic and vaccine landscape is changing by the day. Staying flexible will be required of us all as navigate the ever-changing environment.
• Keep your mitigation practices in place. Even after employees are receiving the vaccine, plan to keep your symptom tracking, cleaning schedules, mask requirements, and social distancing policies in place. The vaccine data shows that it reduces the disease severity, but it is not yet known if it reduces transmission.