We Asked, You Answered: The HERO Registry Weighs in on Employer Vaccine Requirements

Will employer requirements for COVID-19 vaccines help the nation increase its rate of vaccination? The recent push by the Biden Administration to require SARS-CoV-2 vaccines for federal employees and all employers with more than 100 employees will prompt more employers to mandate COVID-19 vaccination in the coming weeks.

Many healthcare workers have already been required to get a COVID-19 vaccine. We asked our HERO Registry community in July 2021 what they thought about employer requirements for vaccination and whether it influenced their decision to get vaccinated. What can we learn from their experiences?

Hot Topic: Vaccine Mandates

The HERO Registry seeks to understand pandemic-related perspectives and problems of anyone in the U.S. who works in any type of first responder or healthcare setting, as well as the people who know them. One of the ways we do this is to ask you, our community of over 50,000 members, to answer brief surveys on topics of concern.

Among those who responded to the survey, only 13% of healthcare workers reported they were required by their employer to get vaccinated.  75% of those responding said they were not required by their employer and the remainder are currently not employed. Among those whose employer required a COVID-19 vaccine, most (68.5%) reported they would have been vaccinated even if their employer did not require a vaccine. Among those whose employer did not require COVID-19 vaccination, 78.8% reported they would have been vaccinated even if their employer did not require it.

However, of those who were required to be vaccinated by their employer, 13% said “Yes, I have been or will be vaccinated, but only because of this requirement” and 16% said “Yes, I have been or will be vaccinated sooner than I would have been without this requirement.”  Less than 1% said “No, I have not been or will not be vaccinated even though my employer requires it.”

Of those who have not yet been required by their employer, 3% said “I would be vaccinated only because of this requirement” and 9% said “I would be vaccinated sooner than I would have without this requirement.” Almost 3% said “I would not be vaccinated even though my employer required it.”

When asked “Are there any other thoughts you’d like to share about employer requirements for COVID-19 vaccinations?” Most of the responses fell into one of the following overarching themes:

  • Employers should require COVID-19 vaccines: Most respondents said that vaccines should be required by employers, especially those working with the public. “If you work around or in the medical field you should already know the importance of being vaccinated,” said one healthcare worker. Many expressed sadness, frustration, and fear that their employers had not already required vaccines. “As a nursing staff working directly with patients, I find the fact that my employer does not require vaccination appalling. I feel that maybe there should be legislation or at least a firmer push for front line businesses (especially in healthcare) to require it as a condition of employment,” said another respondent. “I think it is imperative that all healthcare employees be vaccinated. If you do not believe in the science related to the vaccines, then what are you doing working in modern healthcare?” asked another healthcare worker.
  • Employers should not require COVID-19 vaccines: While only a very small minority of healthcare workers said they would quit their job if required to be vaccinated, many did not think employer mandates were fair for a wide variety of reasons including bodily autonomy, skepticism about the vaccines, bad experiences with vaccines, or a fear of worker short ages if mandates went into effect. “We are so short staffed that my employer is scared to require it. It’s less safe for us to have fewer staff than for us to be at risk of covid. We will wait until others require it so that there is nowhere for our staff to go before requiring,” said one healthcare worker. Others felt that employers should not require vaccines until there was FDA approval and more evidence. Many said that they themselves were vaccinated but that they don’t think requirements are fair: “I believe everyone who can should be vaccinated, but holding people’s jobs as ransom to force them is not okay,” said one healthcare worker.
  • Motivation for getting vaccinated: Many healthcare workers shared their motivation for getting vaccinated and said that they would have done it with or without a requirement. “I work in food, so I see it as my duty to those that I’m serving food to, to be as safe from COVID-19 as I can be,” said one worker. Others said that incentives at their workplace nudged them towards vaccination. “My employer continues to quarantine employees but without pay, which is why I got the vaccine.”
  • Carrots & Sticks: Respondents described different incentives their employers were providing as well as punishments outside of a vaccine requirement. Many healthcare workers said that employers should be doing all they can to encourage vaccination through paid time off and convenient vaccination sites. “I feel if employers are going to mandate vaccinations, they need to either provide vaccines while at work or give folks paid time off to go get them. They also need to ensure paid time off if folks get side effects,” said one person. Others described employers who will not provide paid sick time for those who are not vaccinated. Some expressed concern over how their employers were identifying those who are unvaccinated through stickers on badges, mandatory testing and masking, and other measures. “I’m finding it interesting the number of employers that would like to “mark” employees with a badge buddy or sticker or another form of ID to show to all who see you that you are vaccinated,” said one person. “I understand their reasoning, but say you forget your additional ID, others automatically think you aren’t vaccinated because you don’t have the ID showing it. It’s one thing to require vaccination for any one item (flu, Covid, Tetanus etc.) but another entirely to display one’s personal status linked with their employment ID.”

Do employer mandates work?

Looking at the HERO data, it appears that very few healthcare workers are willing to give up employment over a mandate and that requirements may nudge a small but significant number of healthcare workers into getting vaccinated. For many healthcare workers, as in the general public, FDA approval will make them more comfortable with requirements. However, on the whole healthcare workers, like the nation, are divided over the requirements. Many are passionate that healthcare workers have a responsibility and duty to protect the public through vaccination. “I know that people are skeptical about getting the COVID vaccine and all. But, if you have the chance to be vaccinated for free, take it. You’re helping to save lives. Including your own,” said one healthcare worker.  Another expressed sadness that requirements are needed at all: “It makes me sad that this is what we’ve come to, that healthcare providers are refusing to take measures to protect themselves, their families, their coworkers, and their patients from illness. As healthcare providers, we shouldn’t need our employer to force us to do what is in the best interest of health and wellness. We should be vaccinated because it’s the right thing to do.”

Share your Experiences

If you are already a member of the HERO Registry, thank you! Anyone who works in a healthcare setting, their family members, and close community contacts are invited to join the HERO Registry, a community of people who share what it is like to work and live during the COVID-19 pandemic. As a Registry member you can help identify priorities for research and possible solutions for people impacted by the pandemic.

The HERO Registry is funded through a Patient-Centered Outcomes Research Institute Award (COVID-19-2020-001). The program is coordinated by the Duke Clinical Research Institute and leverages PCORnet®, the National Patient-Centered Clinical Research Network.

References:

Kaiser Family Foundation: Workers Are More Likely to Get a COVID-19 Vaccine When Their Employers Encourage It and Provide Paid Sick Leave, Though Most Workers Don’t Want Their Employers to Require It

Washington Post: Opinion: Yes, you can get some immunity from having covid-19. But no one should wait to get vaccinated.