• Pre-Collegiate Global Health Review

Vaccine Hesitancy in the American Workplace

By Marko Doce, Antioch High School, Antioch, Tennessee, USA

The recent rollout of COVID-19 vaccines represents a breakthrough in development time but has been met with hesitancy from the general public. Vaccine hesitancy - the delay in acceptance or refusal of vaccines despite adequate supply (WHO) - is typically associated with complacency, ethical concerns, and personal or religious beliefs. But the COVID-19 vaccine is uniquely concerning to some because of its unprecedented rate of production and its novel mechanism of action. Unlike most vaccines, these use messenger RNA (mRNA) as a method of prompting the immune system to produce antibodies.

Furthermore, the Emergency Use Authorization (EUA) status of these two vaccines has caused some to be hesitant to take them. As of December 2020, two producers of the COVID-19 vaccine, Pfizer-BioNTech and Moderna, have received an EUA from the U.S. Food and Drug Administration (FDA). This authorization is given in situations where the FDA chooses to release a drug, device, or test “without all the evidence that would fully establish its effectiveness and safety” (Sharfstein, 2020). However, Dr. Joshua Sharfstein, the former principal deputy commissioner of the FDA and current vice dean of Public Health Practice at the Johns Hopkins Bloomberg School of Public Health, explains that an EUA is granted only if there is strong evidence suggesting clear benefits to the patients from a treatment or test.

Despite assurance from experts that EUA is only granted following strong evidence of benefit, recent studies show that 49% of Americans are hesitant to take a COVID-19 vaccine while 76% of the people hesitant about the vaccine want to learn more about the short and long-term side effects of the vaccine (Tyson, Johnson & Funk, 2020). Tyson et al. also reports that these numbers are expected to go down as more research is conducted about the vaccine and its side effects.

In the case of a pandemic like COVID-19, the risk of transmission poses a threat to the proper functioning of a workplace environment. Does this mean that employers in privately owned businesses may require employees to take the vaccine?

In past but similar situations, members of the FDA and Centers for Disease Control and Prevention (CDC) have said that a vaccine requirement could not be enforced solely under an EUA (Reiss, 2020). As mentioned previously, a vaccine with approval under EUA has not completed all possible testing. This would further render a mandate of said vaccine undesirable (Reiss, 2020).

However, this will most likely change once the COVID-19 vaccine is widely available and granted full FDA approval. Until then, employees can rightfully delay taking the vaccine. Once the vaccines are widely available to the public and are granted full FDA approval, however, employers can reasonably make COVID-19 vaccination mandatory for employees (Hess, 2020). Furthermore, it is even expected that employers will mandate this vaccine more than any other vaccine as some businesses are even beginning to consider a “small financial incentive” to motivate vaccine-hesitant employees (Hess, 2020).

In workplaces, religious, ethical, and personal reasons for exemption from a vaccine mandate are less likely to succeed. Under Title VII of the Civil Rights Act of 1964, the demand for a religious exemption may be disregarded if its accommodation requires more than “de minimis” cost (Buckley, 2020). This stipulation means that an employer can, in fact, require vaccination if the lack of doing so “imposes more than a minimal cost” (Buckley, 2020). These costs come from problems such as legal liability risk and the need for increased safety precautions. In the case of COVID-19, it is likely that providing exemptions would result in these kinds of expenses. Ethical and personal reasons for exemption are even less likely to succeed for a COVID-19 vaccine exemption (Buckley, 2020). Ultimately, it is up to every employer to decide what is best for their employees as we navigate these unprecedented times.


Buckley, S. (2020, August 21). Can You Require Your Employees To Get Vaccinated When A COVID-19 Vaccine Becomes Available? Retrieved December 20, 2020, from https://www.jdsupra.com/legalnews/can-you-require-your-employees-to-get-22440/

Butler, R. (n.d.). Vaccine Hesitancy: What it means and what we need to know in order to tackle it. Retrieved from https://www.who.int/immunization/research/forums_and_initiatives/1_RButler_VH_Threat_Child_Health_gvirf16.pdf?ua=1&scrlybrkr=bd0308ec

COVID-19 Vaccine Image. (2020, September 23). Retrieved December 26, 2020, from https://www.estudosnacionais.com/28887/reino-unido-lanca-suspeitas-sobre-seguranca-da-vacina-de-oxford-contra-a-covid-19/

Hess, A. J. (2020, December 03). Can your employer require you to get a COVID vaccine? Retrieved December 20, 2020, from https://www.cnbc.com/2020/12/03/can-employers-require-covid-vaccine.html?scrlybrkr=8f80f1b4

Reiss, D. (2020, November 30). Under an EUA, Can Businesses Require Employees and Customers to Get Vaccinated? Retrieved December 20, 2020, from https://blog.petrieflom.law.harvard.edu/2020/11/30/covid-vaccine-eua-mandate-business/

Sharfstein, J. (2020, October 20). What Is Emergency Use Authorization? Retrieved December 20, 2020, from https://www.jhsph.edu/covid-19/articles/what-is-emergency-use-authorization.html

Tyson, A., Johnson, C., & Funk, C. (2020, December 21). U.S. Public Now Divided Over Whether To Get COVID-19 Vaccine. Retrieved December 20, 2020, from https://www.pewresearch.org/science/2020/09/17/u-s-public-now-divided-over-whether-to-get-covid-19-vaccine/

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PGHR | ISSN 2766-5453 (Online)