Here’s one way to get a lot more people to take a vaccine: require it as a condition of employment.

Private companies can adopt that policy, which could have a big impact on the uptake of the new COVID-19 vaccines under rapid development. But such a move would be controversial.

The risk of a potential backlash can be seen in the vocal reaction against mask mandates coming from some corners. Given the current politics, imagine the potential opposition to requiring a coronavirus vaccine in order to come to the workplace.

“Employers are not trying to make a political statement, but they may be accused of it,” said L.J. Tan, chief strategy officer at the Immunization Action Coalition in St. Paul, Minn. “There’s a lot of autonomy and independence in the U.S., and that creates constant tension with the altruistic goal of trying to protect yourself and those around you.”

In the health-care industry, it’s fairly common for employers to require vaccines. The underlying premise is that health providers must take steps to protect their most vulnerable patients.

Last year, almost 45% of health-care workers said their employers required a flu shot, according to the Centers for Disease Control and Prevention. That aggressive approach paid off with 98% flu coverage among employees at those firms — twice as high as the flu immunization rate for the general public.

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Outside of health care, employers are much more likely to recommend a vaccine, rather than require it. A mandate can lead to worker objections over medical conditions, sincerely held religious beliefs and disabilities — and their claims are protected.

“In light of these exemptions and the risk of discrimination, the (Equal Employment Opportunity Commission) has advised that it is best practice to simply encourage employees to take the influenza vaccine rather than to mandate it,” two lawyers wrote in July in The National Law Review.

“A (COVID) mandate would be an issue for many employees,” said LaToya Alexander, a lawyer for Polsinelli in Dallas and co-author of the article. “Based on my clients, most don’t want to require a vaccine. We’re hearing a lot of, ‘What should we do? What can we do?’ ”

Employers often go to lengths to increase the uptake of annual flu shots in order to promote a healthier workforce. Many sponsor health fairs and bring in nurses to administer the vaccines for free. Some offer prizes and other incentives, and the COVID vaccine campaign is likely to have similar elements.

“It’ll be like the flu shot — plus, plus, plus,” said Harry D. Jones, a longtime employment lawyer for Littler Mendelson in Dallas. “There will be a lot more pressure to get it done because the cost to morale would be so great if companies have to exit the workplace again.”

Many people already complain about the fatigue from social distancing and wearing masks. By next summer, if the coronavirus is still spreading rapidly, it’s going to be difficult for employers to accept that some workers just don’t want to get a vaccine, Jones said.

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“Employers will say, ‘We don’t want to make this mandatory,’ ” Jones said. “The CEOs and heads of HR (human resources) don’t want another drama or contentious fight. But they want to stop the quarantines and disruptions.

“If we have a vaccine that’s safe and working, they’re going to become frustrated and tired with just asking,” he said. “Companies think if they just ask nicely and tell the upside, employees will do it. But there’s going to be some holdouts.”

He points to the evolution over requiring masks. Many elected leaders, including Texas Gov. Greg Abbott, merely recommended that people wear face coverings in public. But as COVID-19 outbreaks grew, Abbott and others imposed mask mandates.

No one’s in a rush to announce a policy on the COVID vaccine, but some companies may become pioneers. Restaurants, for example, could stand apart by having all employees vaccinated — and bragging about COVID-safe policies. They already tout their approach to cleaning surfaces and providing curbside pickup.

“Economic factors will have a lot to do with how this unfolds, especially among workers who are facing the public,” said Robert Field, a law professor and health regulation expert at Drexel University in Philadelphia.

He said companies often require drug tests for employees and say the policy improves public safety. Requiring a vaccine could be considered in a similar light, especially if public recommendations don’t cut it.

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“If political leaders are ambivalent about a vaccine, that’s going to translate into public ambivalence,” Field said.

In Texas — a laggard on adult vaccinations, ranking dead last with Louisiana in a recent ranking by the Commonwealth Fund — just 25% of adults had the recommended flu and pneumonia vaccines in 2018

Most people won’t be able to get a COVID-19 vaccine for a while because health workers and other vulnerable groups will snap up early doses, said Tan of the Immunization Action Coalition. That will give private employers more time to assess the progress and determine how far they need to go.

“If 50% to 70% of their workers get vaccinated, employers won’t have to do much more,” Tan said. “But if it’s just 10% or 15%, then it may become a moral and ethical imperative. They may need to do something more dramatic to make sure their people are protected.”

More on the COVID-19 pandemic

(Jennifer Luxton / The Seattle Times)

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