Updated March 4, 2020.
As has been widely publicized, several coronavirus vaccines have been developed and are currently in distribution. The vaccine manufacturers include pharmaceutical companies Pfizer, Moderna, and Johnson & Johnson in the United States and AstraZeneca outside of the United States. The most recent vaccine to receive emergency use approval (EUA) by the United States Food and Drug Administration (FDA) was Johnson & Johnson, which received EUA on February 27, 2021. Unlike the previously approved vaccines, the Johnson & Johnson vaccine requires just one dose.
Pfizer and Moderna report a 95% effective rate in early clinical trials, whereas Johnson & Johnson and AstraZeneca report lower efficacy rates but are still considered highly effective vaccines. The biggest hurdle for distribution of the Pfizer and Moderna vaccines was the extremely cold storage required. The FDA has eased storage constraints a bit, making distribution of these vaccines easier, but it’s still a challenge. The advantage of the Johnson & Johnson vaccine is that it can be stored in standard refrigerator temperatures, thus making it much easier to store and ship.
With emergency use approval granted, the Centers for Disease Control (CDC) has continued working closely with state public health departments, healthcare associations and pharmaceutical companies on flexible COVID-19 vaccination programs that can accommodate various different vaccines. One key priority is to ensure that vaccines are available to all communities, and that they can be administered in various settings such as doctor’s offices, retail pharmacies, hospitals and federally-qualified health centers. Initial distribution of the Pfizer vaccine has been to hospitals to begin vaccinating healthcare workers.
Given that supply will be limited at first, the CDC will look to the Advisory Committee on Immunization Practices (AICP) for recommendations on which groups will be initially eligible for a vaccine. ACIP’s recommendations include healthcare workers, workers in essential and critical industries, people 65 years and older, and people at high risk due to existing health conditions. The Indiana State Department of Health (ISDH) updates its website when each new group becomes eligible. It is important to note that while the ACIP provided guidelines, states ultimately are in control of how distribution is handled within the state. To get an idea of your place in line, check out this vaccine tool.
My colleague Ryan Bojrab, Senior Director of Health Strategy, talked with Scott Jones of FOX59 News about whether employers can require vaccinations and how people leaders like you can approach the next few months.
Health Plan Coverage and Costs
The CARES (Coronavirus Aid, Relief, and Economic Security) Act requires employer-sponsored health plans to cover a COVID-19 vaccine at no cost to plan participants for the duration of the public health emergency. On October 28, the Departments of Health and Human Services, Labor, and Treasury jointly issued an interim final rule implementing this requirement. Under this rule, group health plans and health insurers must cover COVID-19 vaccines within 15 business days of approval by the CDC. Coverage must be provided with no cost sharing regardless of whether the vaccine was administered by an in-network or out-of-network provider. This rule also holds true for individual policies, Medicare and Medicaid. As a practical matter, this coverage will likely be added immediately upon a vaccine’s approval.
While the CARES Act coverage mandate does shift additional costs to employers, these costs aren’t anticipated to be significant. The recently released Medicare payment rate for a two-dose COVID-19 vaccine is $45.33. Although providers often charge employer health plans a rate higher than Medicare, it’s not likely that the price of the vaccine will increase substantially over the Medicare rate, as the majority of development costs have been funded through government grants.
And, although health plans will bear the cost of these vaccines, it’s likely to be a financial win due to the avoidance of the COVID-19 infection. The cost of contracting the virus could be significantly higher depending on the severity of the case.
Should You Require Employees to Be Vaccinated?
Now that vaccines are readily available, you may wonder if you should require employees to get one. The EEOC issued guidance on December 16, 2020 specifically addressing workplace issues and the COVID-19 vaccine.
The new EEOC guidance is consistent with guidance in past pandemics (such as H1N1 in 2009) and permits employers to enforce a vaccination requirement, as long as accommodations under Title VII and the Americans with Disabilities Act are made. This means that employees who have a qualified disability under ADA that prevents them from getting a vaccine must be exempt. Employees with sincerely held religious beliefs against vaccinations must also be exempt from the requirement.
Finally, state laws can come into play as well. Although several states currently require influenza vaccines for healthcare workers, other states – including Indiana – encourage vaccinations but do not require it.
What is clear from this guidance is that you will want to carefully consider whether to require your employees to get the vaccine. While it may be legal to do so, the question of whether it’s advisable is an important one to ask. This is an area where individually-held beliefs are often strong one way or the other. There are also individuals who will fear the vaccine, and you should take those fears into account when implementing a vaccine policy.
Adopting a COVID-19 Communication Strategy
Whether your organization does or doesn’t require the vaccine, a clear communication strategy about your policies will be important now that the vaccinations are available. As the circumstances of 2020 have made clear, this is a time where people feel vulnerable and often isolated. An empathetic communication approach that advises employees of plan coverage provisions, options for where to get the vaccine, and rationale for requiring or recommending the vaccine will be critical. Above all, the message to employees the health and safety of employees and their families is top priority must be loud and clear.
For more internal communications ideas, be sure to check out these other blogs:
- The Key to Understanding Individual Communication Preferences
- Five Reasons Your Open Enrollment Should Go Digital
- Employee Benefits Communication: A Key to Positive Business Outcomes
The First Person team is closely monitoring the status of vaccine approval and related guidance, and will continue to update this article as more information is released.
For a more intimate look at the regulations and strategies you can implement now, join your fellow HR leaders for an on-demand replay of How the 2021 Political Landscape Impacts You.
Have you created a clear and compliant communication and health strategy for the vaccine rollout? Your people may be in the dark. Get your on-demand webinar on all things vaccine strategy – what you need to know about the vaccine, what and how to communicate with your people, and how some organizations are approaching rollout.