Dr. Susan Garfield


April 16, 2021


A year into this pandemic, the Centers for Disease Control and Prevention is reporting that we will go from COVID-19 vaccine supply constrained to surplus by later this spring. That means it’s time to figure out how to get as many of our employees vaccinated as possible, to facilitate safe workplaces and return to a new normal. When the vaccines first became available to priority groups in January, many assumed that all essential employees would seize the opportunity to get vaccinated to protect themselves and their communities. However, the data shows it didn’t quite happen that way. In fact, despite their increased exposure risk, many nursing home, first responders and health care providers opted not to take the vaccine. As we now look to a much broader swath of the population getting access to vaccination, there are clear steps employers can take to help overcome vaccine hesitancy and convenience hurdles to incentivize more comprehensive employee vaccination.

There isn’t a universal answer for how employers should drive vaccination behaviors. Some are considering more directive options via vaccine mandates, while others are rolling out incentives to reinforce behaviors or to overcome specific hurdles. In these cases, renewed focus on the increasingly central health-and-safety mindset for their people is driving employers from across sectors to motivate action with targeted incentive programs that include stipends, paid time off, bonuses, schedule flexibility, gift cards and travel reimbursement for employees who furnish proof of vaccination.

As an employer, what intervention is right for you and your organization? The New England Journal of Medicine highlights that “[u]nderstanding the reasons underlying reluctance … is essential to increasing the likelihood of successful intervention,” which is why developing the best approach to optimizing vaccination rates is not a one-size-fits-all proposition. Instead, the intervention must be aligned to the specific needs of your employee population. To start, consider the two main areas to address in driving vaccination among your employees — vaccine hesitancy and perceptions of convenience.

Vaccine hesitancy or perceptions of convenience

Hesitancy occurs in all types of people for different reasons, including fears of potential long-term side effects, skepticism about the speed of authorization, political misgivings, concerns about fertility and long-held cultural distrust toward the medical profession due to historical disenfranchisement. By contrast, others are reluctant due to more altruistic views, preferring to wait until elderly and immunocompromised populations have all been vaccinated.

Others may choose not to get vaccinated, not because of deep-seated beliefs, but because it is seen as inconvenient or logistically challenging. To understand whether any of these beliefs exist among your employees, now is a good time to conduct “pulse-check” surveys on employee vaccine sentiments, vaccination plans and what they perceive as hurdles to vaccination.

Overcoming barriers

To get ahead of these challenges, many employers have rolled out vaccination incentive programs that offer both general rewards for getting vaccinated as well as more targeted programs to overcome specific hurdles. One major hospital system in the South has offered its employees bonuses tied to vaccination, continuing the resiliency bonuses it provided at the start of the pandemic. In rural America, where vaccine hesitancy is quite common, several meatpacking plants have offered complimentary, on-site vaccination along with financial incentives to facilitate uptake. One major grocery retailer has gone a step further, providing cash bonuses to employees who get vaccinated as well as a separate cash bonus for those who are unable to get the vaccine due to religious or medical reasons if they complete a health and safety education course. Across industries, many employers are also offering between two and four hours of paid time off or teaming with rideshare services to bridge the transportation gap for their employees. Others are permitting excused absences within 48 hours of vaccination for employees who are experiencing side effects. The incentives and supporting programs that work best for your organization will depend on the specific challenges you are attempting to overcome.

Education and engagement, versus incentives alone, are key to overcoming vaccine hesitancy. We know now that when it comes to vaccination, clinical voices are most trusted. Find clinicians in your community who can be trusted sources of information, who represent different members of your employee base and who can serve as resources when your employees have questions. Some companies have chief medical officers who can fill this need; others can team with health systems or leverage public health communications to fill this void. Additionally, to compound the impact of your programs, reinforcing desired behaviors can also be beneficial. For example, celebrating employees who have been vaccinated can both entice others to do the same and reward those who have completed their course.

Bringing it to life

Whether you leverage mandates or incentives, make it easy for your employees to get vaccinated. Partner with pharmacies or other provider organizations to support onsite vaccination clinics or to facilitate in-store appointments. For those with transportation constraints, consider facilitating access to ride-share services to and from vaccination sites. Helping to provide equitable access across your employee population will require that the programs you create meet your employees’ needs and include specific focus on those most at-risk or hesitant. To that end, you will need to recognize and identify when cultural factors are influencing beliefs, which will help you target incentives more effectively.

The next few months are certain to be challenging, but employer participation in vaccination advocacy efforts are likely to be valuable accelerators of uptake and our collective drive towards herd immunity. As you break down barriers to employee vaccination and help team-members transition out of the pandemic, continue to capture best practices and lessons learned to inform future health and wellness programs.

The views expressed by the authors are not necessarily those of Ernst & Young LLP or other members of the global EY organization.

About the authors

Dr. Susan Garfield