TIME'S UP Healthcare
Leaders’ Guide to Providing Employees with Equitable Access to Vaccines
** UPDATED July 2021 **
The coronavirus pandemic has caused the largest public health crisis in a century, with over 33 million cases in the United States alone, resulting in the tragic deaths of more than 591,000 Americans and counting. Since February 2020, COVID-19 has also upended our economy and society with the loss of 7.6 million jobs, 55% of which were jobs that women held. Women of color have been hit the hardest: Out of the 2.1 million women with job losses in 2020, 564,000 were Black women and 317,000 were Latinx women.
Essential workers, who are the most at risk of contracting COVID-19, are disproportionately women of color, with Black women earning 62 cents for every dollar paid to white, non-Hispanic men, Native American women 57 cents, and Latinx women 55 cents. Essential workers who are mothers are more likely to be women of color as well, which means additional child care expenses while school and care centers were closed. Low-paid work coupled with caregiving costs in a global economic recession means that workers are struggling to make ends meet — even as they sustain greater illness and death.
Though over 50% of the U.S. population aged 12 and over are fully vaccinated, vaccination rates are stagnating. More importantly, there are persisting vaccination disparities among communities of color, with Black and Latinx people receiving fewer vaccinations relative to both their percentage of COVID cases within their communities and across the population in most states. The pandemic has made it all the more critical that vaccine distribution and recovery efforts are just, safe, and especially equitable. Realizing this vision requires the leadership of government, the healthcare industry, and employers.
Below is the updated guidance prepared by the TIME’S UP Impact Lab, outlining what employers should consider to ensure all Americans, especially those facing the greatest social and economic inequities, have access to vaccines and related care.
MAKE VACCINES NOT JUST ALLOWED, BUT ENCOURAGED AND EQUITABLE
To ensure that workers, especially those who serve on the front lines, are protected from COVID-19, employers need to make vaccinations not only allowed but encouraged, and access to them equitable. In encouraging vaccination uptake, employers should make clear that their workers will not face retaliation for taking time off to get vaccinated or getting vaccinated during work hours. Employers should formalize these protections as a part of their company policy and inform their workers of their rights.
Prioritizing equity is paramount to vaccinating vulnerable workers — this means that businesses need to ramp up resources that increase accessibility for their workers. This includes hands-on vaccine discussions and scheduling, including language and mobility support. Further, employers can distribute information that address potential vaccine barriers such as cost, privacy, and immigration status.
Making vaccinations equitable also means making them accessible to workers who have caregiving responsibilities. Employers must recognize that women workers have specific vaccinated-related concerns that are interwoven with caregiving needs for themselves and others. As vaccine distribution becomes more age-inclusive for children, employers should put resources in place that support workers in scheduling multiple vaccine appointments for themselves and their families, as well as care for their loved ones should they experience vaccine side effects.
PROVIDE WORK FLEXIBILITY FOR VACCINE APPOINTMENTS AND POTENTIAL SIDE-EFFECT RECOVERY
Providing work flexibility, such as paid time off (PTO), shift accommodations, and work-from-home options, are critical steps in enabling all workers to receive vaccines. Some of the main issues with vaccination uptake include scheduling conflicts and cancelled appointments, which lead to many valuable vaccines being wasted, as they expire quickly when left unused. Moreover, anticipating specific days off post-vaccination is not always easy given that the onset of side effects can last between one to three days and may be more severe after the second dosage. That’s why it’s important to create better work allowances, which will give workers the time they need to receive their vaccines and recover from potential side effects between dosages.
On April 21, 2021, the Biden-Harris administration announced a paid leave tax credit to support employers in getting their workers vaccinated. The tax credit will offset the cost for businesses with fewer than 500 employees to provide fully-paid time off for vaccination appointments and recovery time; the government will cover these costs for up to 10 workdays, or 80 work hours per employee. Eligible businesses can complete a Form 941, Employer’s Quarterly Federal Tax Return in anticipation of claiming paid leave tax credits to keep the federal employment taxes that they otherwise would have deposited, as well as access additional resources via the IRS website. The administration’s American Rescue Plan also includes additional support for extended sick leave, including time for employees to obtain the vaccine, and indicates government plans to compensate employers for such programs. The credit and supplemental funds should be used above and beyond what is already in place, to create additional hours that specifically account for up to two vaccines and associated side effects.
Employers can use this guidance and the president’s plan as a starting point, but should develop and tailor their own policies to match their workforce’s specific needs. Overall, the extra time should be viewed as a worthwhile investment; the return on investment is preventing many more hours lost to illness. Further, it is a critical resource for essential workers and low-wage workers who have given their service over the past year.
PROVIDE INCENTIVES AND REMUNERATION FOR VACCINE-RELATED EXPENSES
Though the vaccines themselves are free, workers will likely face related costs that could act as a financial barrier. These costs could include transportation to and from doctor visits and vaccination sites, lost wages like tips, child care expenses, and more. Employers can support their workforce through pre-tax COVID-19 vaccine stipends to compensate for lost wages or caregiving costs, and reimburse workers for mileage and gas to and from vaccine appointments. Additionally, employers can also encourage workers to take advantage of free vaccination trips via rideshare apps such as Uber and Lyft, which are a part of the administration’s plan to get the majority of the nation vaccinated by July 4. However, employers should recognize that many employees may not use or have access to rideshare apps, and consider alternate or more flexible supports. For example, employers can also encourage workers to use flexible spending accounts (FSAs) to cover transportation costs incurred while obtaining a vaccine. Or, employers could identify and circulate information about vaccine sites and mobile vans throughout the community that will offer employees the least travel burden possible.
Furthermore, employers, especially those at well-resourced companies, should consider providing incentives to improve vaccine uptake. This could include cash benefits such as gift cards, meal vouchers, or lotteried, larger items. Both small and large businesses can also leverage incentives provided by major companies including free childcare from organizations like KinderCare and free groceries from major food retailers like Kroger. Employers can also consider PTO bonuses for both hourly and salaried employees independent of any time taken to recover from vaccination side effects. Employers should do whatever they can to keep workers safe while offsetting inequitable financial burdens. Ultimately, such actions sustain the viability of all workers and the economy as a whole.
DISTRIBUTE CREDIBLE, EVIDENCE-BASED VACCINE INFORMATION
Given the ever-changing information about COVID-19 and the general lack of clarity around vaccine logistics, companies should create a central repository of resources with readily accessible, up-to-date, multilingual, culturally competent, and multimedia information from organizations like the CDC. Employers and workers can also work together to identify and invite trustworthy medical experts and public health officials to address any vaccine-related questions and concerns through online presentations and Q&A sessions, facilitated web conferences, written newsletters, staff social channels, and other means of communication. Alternatively, employers can encourage their workforce to attend sessions hosted by local or state public health offices, health care systems, or universities. Employers should also disseminate information about obtaining the vaccine, including local vaccine locations, appointment registration, and what to expect post-vaccine.
One model for worker engagement is through the implementation of worker health and safety councils. Nominated and elected by the workers, workplace monitors can partner with employers to design vaccine information sessions and can be empowered to ensure widespread dissemination of information about vaccine logistics and aftercare. All information, whether educational or logistical, should be provided in many forms for different audiences — verbally, visually, online, and in writing — with workers’ language fluency and best practices about health and adult literacy in mind. To further increase equity and accessibility around vaccines, employers should also consider creating paid, peer vaccine support roles such as internal community health workers who can provide day-to-day assistance for workers.
CONSIDER ON-SITE OR SATELLITE VACCINATIONS
Depending on the chosen vaccine’s storage and handling needs, temporary or satellite sessions could either be on the company’s premises or at a nearby location — such as a school, movie theater, or restaurant outside of its normal operating hours. Such events should be optimally accessible to employees and established in conjunction with local, state, and federal guidance, as well as government and nonprofit leaders to protect both those receiving and administering vaccines. Now that vaccines are more readily accessible, place-based employers can still serve as on-site vaccine administration centers for the many employees still working from home, and help deliver vaccines safely and efficiently to all employees.
Employers can prioritize equity and accessibility through on-site and satellite vaccination as well. Businesses should consider hosting smaller events that proactively seek out those less likely to be vaccinated, such as workers of color. These events could offer expanded hours or overnight sites to accommodate workers who may be in lower-paid jobs such as night shift and multiple shift workers. Moreover, employers could create equitable vaccination sites not only near their work locations, but directly in their workers’ communities. Local churches, community spaces, and federally qualified health centers can serve as a trusted, safe space for workers to get vaccinated without having to travel potentially long distances to their vaccination sites at work.
Employers should also consider vaccinating workers’ families. Given the caregiving crisis that is driving women out of the workforce in record numbers, caregivers — the majority of whom are women — must consider their own health and safety, as well as their families’ well-being. The CDC provides additional guidance for planning ad-hoc vaccination clinics. Satellite clinics improve equitable vaccine uptake, lower dose wastage, and boost morale by showing that employers are prioritizing the health of their workers and their loved ones.
DON’T MAKE COVID SAFETY CONTINGENT ON VACCINATION ALONE
Some workers will remain unvaccinated or underprotected by vaccines — whether due to personal choice, allergies to vaccine components, or medical conditions that preclude an adequate immune response to the vaccines. Further, no vaccine is 100% effective, and vaccinated workers may still develop COVID-19, particularly if they have high exposure to others with active disease. Women and people of color tend to occupy roles with high exposure risk. Risk must be offset not only by vaccination, but by adequate supply of personal protective equipment (PPE) and work environments that comply with heightened OSHA safety standards related to COVID-19, including control measures that minimize workplace exposures to the virus.
The path to creating a healthy, functioning society requires mass vaccination — and that includes the workforce. It will get people back to work safely, build trust among workers that employers are prioritizing their health, and decrease virus transmission in surrounding communities. Companies should aim to be at the forefront of setting industry standards around vaccine education and accessibility. Employers wishing to maintain a high-performing workplace can lead the charge in ensuring that all workers, especially the ones most at risk, can receive the essential care that they need.