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Should employers make vaccination mandatory? Yes, here’s why. | COMMENTARY

Georgia Tech employee Adam Jackson receives a Pfizer COVID-19 vaccination on campus in Atlanta. U.S. colleges are weighing vaccine mandates for students and staff, an issue that employers across the nation are grappling with. (AP Photo/Danny Karnik)
Georgia Tech employee Adam Jackson receives a Pfizer COVID-19 vaccination on campus in Atlanta. U.S. colleges are weighing vaccine mandates for students and staff, an issue that employers across the nation are grappling with. (AP Photo/Danny Karnik) (Danny Karnik/AP)

COVID vaccines hesitancy will likely further decrease as outreach continues, more people see family and friends choosing vaccination and more “perks” — from free doughnuts and beer to going maskless in public places and seeing sports teams in person — are offered to the vaccinated. But hesitancy will not disappear.

Because some Americans consistently report not wanting to be vaccinated, questions are mounting whether employers should make vaccination mandatory. Already, more than 100 colleges and universities have announced that students must be vaccinated (or receive an exemption) to return to campus this fall, with some mandating for faculty and staff as well. Employers — from K-12 schools to office-based companies — are considering the same. And there is public support for this. Not only does the majority of the U.S. population want to get vaccinated; the majority say they want their employers to mandate vaccination for all employees for them to return to work.

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Still, some Americans do not want to be vaccinated, with many bristling at the prospect of others telling them what to do. Individual liberty is a foundational American ideal. This underscores the critical importance of addressing directly whether workplace vaccine mandates are defensible.

Our answer is: Yes, employers are ethically justified mandating that employees get vaccinated — especially when community transmission rates are high, and a sizable percentage of workers remain unvaccinated.

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Employers have long-standing obligations to their employees to provide a workplace free from recognizable hazards. Because of this, employers must ask if there is a workplace-related risk to vaccinated employees if some co-workers continue not to be vaccinated. It turns out, there is.

The Centers for Disease Control rightly point out that vaccinated people have very high protection. But “breakthrough” infections — most likely transmitted by someone who was not vaccinated — occur even with vaccines that are 95% effective. And such breakthrough infections may become less rare with newer variants, which are also more likely introduced by those not vaccinated. Although most vaccinated people who become infected do not develop serious disease, some have needed to be hospitalized, and some have died. And those with mild COVID cases can develop long haul symptoms, a complex and often terrifying array of conditions that may become a serious chronic concern.

Also relevant to employees’ welfare are risks to their families. Some vaccinated employees will have household members who are not vaccinated, either children too young to be or adults who medically cannot be. And some employees themselves cannot safely be vaccinated. These employees deserve a safe workplace as well. The more people in a workplace choosing not to be vaccinated — particularly where employees are in closer proximity for sustained periods — the more real these risks become.

Employers’ obligations to provide a safe environment also extend to everyone who enters the workplace, not just employees. Those who serve others — schools with students, health care institutions with patients, or retail businesses with in-store customers — must be concerned about the risk unvaccinated employees pose to those they serve.

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Finally, unvaccinated employees can threaten continuity, competitiveness and profitability of business operations, especially for smaller employers. A fully vaccinated workplace can be impactful for hiring and retention, and in attracting customers.

But what about individual liberty? Even if unvaccinated people pose a threat to employees, customers, and the bottom line, don’t people who object to vaccination also have rights? Yes, and importantly so. But these rights are not absolute. Even libertarians acknowledge that harm to the interests or freedoms of other people can justify constraints on individual choice. You don’t have the right to run a red light, much as you might want to get to your destination faster. People are free to smoke, but not in settings that impose smoking-related risks on others. This distinction is key. People can refuse to take their blood pressure medicine or disregard doctors’ advice about exercise or surgery. But when these choices threaten the serious interests and freedom of others, the picture changes. It is a long-standing paradox of public health that some interventions, required of all, become the ticket to the freedoms we all desperately seek.

Ruth Faden (rfaden@jhu.edu) and Nancy Kass (nkass@jhu.edu) are faculty members at the Johns Hopkins Berman Institute of Bioethics.

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