Calling the Shots: Should Employers Mandate COVID Vaccines?
May 20, 2021
With about one-third of Americans still not convinced they need to be vaccinated for COVID-19, many employers are debating whether to require their workers to get vaccinated. We dig into the research to help employers weigh the pros and cons.
Listen to the full episode below, read the transcript, or scroll down for more information.
The Question: To Mandate or Not to Mandate?
According to the April 2021 Kaiser Family Foundation COVID-19 Vaccine Monitor, 34% of Americans are still not convinced they need to get vaccinated for COVID-19. That level of resistance and hesitancy, experts say, may keep us from reaching herd immunity and leave us susceptible to new, more dangerous variants.
This has led some employers — including Houston Methodist health system, Delta and Yale University — to require their employees to get vaccinated. (Delta’s mandate only applies to new hires.) Surveys show other companies are considering mandates as well, but few have implemented them so far.
Adult vaccine mandates are incredibly rare in the United States. Some counties required restaurant employees to get vaccinated for Hepatitis A during recent outbreaks, but mandates have historically been limited to health care settings and children. Research from those examples suggests mandates would increase vaccination rates and contribute to broader herd immunity (more on that below), but there are many additional questions facing employers considering a COVID-19 vaccine mandate.
Scroll over or tap on the cards below for more details.
The Research: Triangulating the Evidence
Because COVID-19 is a new disease and non-health care employees have almost never been required to be vaccinated for their jobs, there is no direct evidence that can tell us what will happen if employers implement mandates.
This is common — academics and policymakers are often interested in understanding proposed policies that have never been implemented and therefore never studied directly. When that happens, they look to studies of similar policies to come up with a best guess of how the new policy will work.
In this case, University of Minnesota health economist and Tradeoffs Contributing Research Editor Sayeh Nikpay looked to three findings from the research on vaccine mandates in health care settings and schools to provide employers with more information to make their decisions.
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Research Cited in the Episode:
Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis (Theodore Lytras, Frixos Kopsachilis, Elisavet Mouratidou, Dimitris Papamichail and Stefanos Bonovas; Human Vaccines & Immunotherapeutics; 5/5/2016)
Measuring Social and Externality Benefits of Influenza Vaccination (Corey White, Journal of Human Resources, forthcoming)
How Important is the Structure of School Vaccine Requirement Opt-Out Provisions? Evidence from Washington, DC’s HPV Vaccine Requirement (Brandyn Churchill, Journal of Health Economics, forthcoming)
Additional Reporting and Analysis of Vaccine Mandates:
How Employer Actions Could Facilitate Equity in COVID-19 Vaccinations (Samantha Artiga and Liz Hamel, KFF, 5/17/2021)
Health Advocate or Big Brother? Companies Weigh Requiring Vaccines. (Gillian Friedman and Lauren Hirsch, New York Times, 5/7/2021)
How health systems are deciding whether to mandate COVID-19 vaccinations (Kelly Gooch, Becker’s Hopsital Review, 5/2/2021)
Should the COVID-19 vaccine be mandated? Debate takes center stage, as hospitals, colleges and businesses start requiring the shot. (Andrew Dunn, Insider, 5/1/2021)
Want That Job Offer? A Covid-19 Vaccine Is Now Required. (Chip Cutter, Wall Street Journal, 4/26/2021)
Key Questions About COVID-19 Vaccine Mandates (MaryBeth Musumeci and Jennifer Kates, KFF, 4/7/2021)
‘Authorization’ status is a red herring when it comes to mandating Covid-19 vaccination (Dorit Reiss, I. Glenn Cohen and Carmel Shachar; STAT First Opinion; 4/5/2021)
Sayeh Nikpay, PhD, MPH; Tradeoffs Contributing Research Editor; Associate Professor of Health Policy and Management, University of Minnesota
Corey White, PhD; Assistant Professor of Economics; Cal Poly, San Luis Obispo
Brandyn Churchill, PhD Candidate, Vanderbilt University
The Tradeoffs theme song was composed by Ty Citerman, with additional music this episode by Blue Dot Sessions.
This episode was produced and mixed by Ryan Levi.
Special thanks to Hannah Geressu.
Additional thanks to:
Dorit Reiss, Alison Buttenheim, Mark Rothstein, Arthur Caplan, Jasmine Travers, Emily Lawler, the Centers for Disease Control and Prevention, the National Conference of State Legislatures, the National Academy for State Health Policy, and our stellar staff!