Cardiology Coding Alert

COVID-19:

Observe Pros and Cons of Mandatory Versus Optional COVID-19 Vaccines for Employees

Use your flu vaccine policies as a blueprint.

Now that a COVID-19 vaccination is available, you may wonder how you should implement the vaccine for your practice’s staff. For example, you should you make the vaccine mandatory for your employees?

Read on to learn how to handle this issue in your cardiology practice.

Utilize Flu Vaccination Precedent

Knowing your policies on whether you require the flu vaccine can provide a foundation for how you approach the vaccination for SARS-CoV-2, the virus that causes COVID-19.

“Because there is no law or regulation that directly addresses this issue, employers considering a mandatory COVID vaccination policy should analyze how mandatory flu vaccination policies have been interpreted,” recommend attorneys Jan Hensel, Jacqueline Rau, and Thomas W. Hess with law firm Dinsmore & Shohl. “In the absence of state or local law to the contrary, employers may require employees to get vaccinated from the flu,” the attorneys allow in online analysis. But “the Equal Employment Opportunity Commission (EEOC) has emphasized that an employee may be exempt from a mandatory vaccine if the employee has a disability covered by the Americans with Disabilities Act (ADA) that prevents them from taking the vaccine,” they say.

“An employee may also qualify for a religious exemption under Title VII of the Civil Rights Act of 1964,” the Dinsmore attorneys point out.

Mandatory vaccination may also implicate other laws, such as the Rehabilitation Act, the Age Discrimination in Employment Act, and the Genetic Information Nondiscrimination Act, the EEOC says in a question-and-answer set on COVID-19 updated December 16.

Watch out for Possible Liability

On the other hand, employers should consider issues like liability if they don’t require vaccination — although that may be something Congress eventually weighs in on.

“There are risks and benefits attendant to both approaches,” observe attorneys with Hall Render in new legal analysis. “Does an optional vaccine policy result in increased absences due to work-related illness, workers’ compensation claims and/ or professional liability for hospital-acquired conditions that might have otherwise been avoidable? Does mandating the vaccine create new workers’ compensation risks and reasonable accommodation challenges?”

Plus: “Because either approach could negatively impact staff relations and retention during a time in which retention is critical, the employer-employee relationship will be a crucial consideration for healthcare providers during the vaccine policy planning process,” the Hall Render attorneys point out.

The EEOC does allow that “if an employee cannot get vaccinated for COVID-19 because of a disability or sincerely held religious belief, practice, or observance, and there is no reasonable accommodation possible, then it would be lawful for the employer to exclude the employee from the workplace,” the EEOC says in its Q&As. But “this does not mean the employer may automatically terminate the worker. Employers will need to determine if any other rights apply under the EEO laws or other federal, state, and local authorities,” the EEOC points out.

“One of the challenges we’re going to be dealing with … is that there is a shadow of politics over the vaccine,” says L.J. Tan with the Immunization Action Coalition, an advocacy group that supports vaccinations. “As a result, there’s some fear about whether the vaccine can be safe, whether it can be approved appropriately. Because of that shadow, I think it’s going to be extremely difficult for an employer to make COVID-19 vaccination a condition of employment,” Tan told AARP.

Companies requiring the vaccination must be ready to enforce the requirement — including with termination, work with individual cases that require accommodation, and more, attorney Shannon Farmer with Ballard Spahr told the Philadelphia Inquirer newspaper.

Even in healthcare, employers are much more likely to encourage than require vaccination, the Inquirer notes.

Look Into CDC’s Toolkit for Help

The Centers for Disease Control and Prevention (CDC) is offering a “vaccination communication toolkit” for healthcare providers to “use or adapt … to build confidence about COVID-19 vaccination among your healthcare teams and other staff,” it says. Ranging from posters to “I got my COVID-19 vaccination” stickers to sample social media messages, the tools aim to encourage vaccination.

You can find the CDC’s toolkit at www.cdc.gov/vaccines/ covid-19/health-systems-communication-toolkit.html.

Prepare Your Practice to Answer Questions and Concerns

Wise providers “should anticipate questions and concerns from patients and the public such that employers may be well-advised to have media statements prepared to address their employee vaccination policy,” Hall Render recommends.

The Hall Render counselors suggest these steps to tackle the vaccination issue:

  • Establish a planning committee that will determine whether vaccination is mandatory or optional.
  • If mandated, determine for which job classes/facilities; in what order of priority; and identify reasonable accommo­dation alternatives for those who are exempt.
  • If mandated, develop vaccine exemption request forms and a review committee for requests.
  • Develop vaccine policy and procedure, including a tracking system and reporting process.
  • Train managers and supervisors on any new or modified policies.
  • Appoint a designated spokesperson for questions on vaccinations from employees, the community, and the media.

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