Essential workers, often low paid and paid by the hour, are vaccinated at lower rates than other groups. Many people attribute this reduction in vaccine use to “vaccine reluctance” due to false beliefs or even justified skepticism. But there is a systematic Catch-22 that has been created: at least 40% of people who get the vaccine have flu-like symptoms within a day or two of their injection, and anyone with these symptoms is not allowed to. come to work.
This risk is compounded by the fact that if the person has already been infected with COVID-19, their likelihood of developing flu-like symptoms is even higher.
Many of these workers cannot afford extra time off. Many have already had to take time off work to recover from COVID-19 or care for family members.
Many have chronic health conditions that are already predictably consuming their 10-day sick-day allowance. And many have seen a reduction in paid hours due to the pandemic. Is it realistic to ask them to do something where they have a high probability of having to take additional unpaid leave when they are already in a precarious financial situation?
We support a consistent national policy to ensure low-wage workers receive two extra days of paid leave for vaccine-related adverse events: this would be funded with federal dollars so that employers are only responsible for costs related to paid workers. higher, and would be offered. for those who get a full vaccination.
Of our health workers at Yale University and Yale New Haven Hospital, 75% have been vaccinated. However, among low-hourly wage earners, 1 in 2 people have not yet been vaccinated. We surveyed our employees and found that one of the factors that would make people more comfortable getting the vaccine was a provision of additional paid sick days. This finding was also replicated in subsequent surveys of essential workers.
Taking the gamble of potentially getting – or not getting – COVID-19 and continuing to take masking and distancing precautions is a rational decision. If a person doesn’t get COVID-19, they don’t need to take time off work and can maintain financial security. Conversely, a known high probability of needing to take a day or two off work after being vaccinated may seem unwise.
With the vaccines soon to be available to all American adults, we have the opportunity to resolve this difficult choice. While hourly paid employees earning less than 300% of the federal poverty line were all granted two extra days of paid adverse event leave (based on a full vaccination), an impossible tug of war between financial security and health would be eliminated. This policy should be funded by the federal government for all employees below 300% of the federal poverty line so that companies with a high percentage of low-wage workers are not unfairly burdened.
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Of course, employees may abuse this privilege. People may stay home just for arm pain or if they are not at all sick after vaccination. However, the cost of two days of paid leave is minor compared to the cost of 10-14 days required for quarantine if an employee contracts or is exposed to COVID-19. Not to mention the costs if an employee is hospitalized, suffers from a long-term disability from COVID-19, or dies.
By the nature of their jobs, these essential workers come into contact with many other people in our community in places like grocery stores, hospitals, food services and laundromats. Vaccination of this population is essential to mitigate the spread of the disease. As such, investing in supporting essential workers to get vaccinated is likely to translate into great returns on the health of the population.
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A healthy and supported workforce is a productive workforce. Providing our most vulnerable people with the support they need to keep themselves, their families and our communities healthy. The CARES Act offers extended sick leave, but this effort requires additional interpretation from the executive branch and a clear communication strategy so that employers and employees are fully aware of what is available to them when making their decisions. .
This is a pandemic that occurs once every hundred years. Funding an additional two days of “immunization leave” per year for those who cannot afford it seems like a small price to pay to support the health and well-being of our nation. If these workers are truly essential to sustaining our communities and our economies, then let’s provide the essential support needed to keep them and our communities healthy.
Brita Roy, MD, MPH, MHS (@ Broy3445) is director of population health and assistant professor of medicine and epidemiology at Yale University; Howard P. Forman, MD, MBA (@thehowie) is Professor of Public Health, Management and Economics at Yale University.