The flu season is fast approaching as the COVID-19 pandemic continues, causing employers and caregivers to worry about how they will differentiate between the two and protect their staff. Employers encourage flu vaccines to alleviate the risk of co-infections and to reduce the symptoms of confusion between flu and coronavirus.
"We know what the challenge is this year and every year for patients, families and healthcare facilities working with influenza and a host of other respiratory diseases … in addition to the situation with COVID-19," says Dr. Lisa Maragakis, Associate Professor of Medicine and Infectious Diseases at Johns Hopkins University School of Medicine. "It is a concern, both from the burden on healthcare facilities and the potential consequences for patients themselves if they are at risk of influenza.
Reports of influenza and COVID-1
Only 62% of employers plan to provide special message to workers about the importance of getting a flu vaccine, which Mercer called "shockingly low given that it is unclear what co-infections of COVID-19 and flu can look like" in a statement announcing the results of its latest study on Tuesday.
Attorney Kevin Troutman, partner in the Houston office of Fisher Phillips LLP and co-chair of the company's national health team, said that many of h, clients are asked to encourage or prescribe flu shots as well as the COVID-19 vaccine when it becomes available.
Although the US Gender Equality Commission in the United States has previously stated that employers can demand flu shots, the need for vaccines should be work-related, such as those working in health care, says Troutman.
However, other industries need to make an assessment of what the risks are with employees getting the flu, what the workers' tasks are, and whether employees work in close contact with each other, he said.
"If you need it and you can not connect it to the employee's job, it will be a more difficult requirement to enforce," Mr. Troutman
But the flu vaccine is even more important than ever given the challenges of trying to determine if a worker has the flu or coronavirus, says Deborah Roy, Falmouth, Maine-based president of SafeTech Consultants Inc. and elected president of SafeTech Consultants Inc. American Society of Safe ty Professionals.
“Although the symptoms are slightly different, they are similar enough to be difficult to assess, and right now, because we are not at a point where COVID testing is fast, simple and accurate, there will be more of a challenge, she said. "Interestingly enough, we have pretty good experience … when it comes to getting a flu vaccine in a pandemic situation."
In 2009, as Head of Health, Safety and Wellness at Freeport, Maine-based LL Bean Inc., Roy was commissioned to run the dealer's pandemic response to the H1N1 pandemic. She decided to provide that vaccine free of charge on the spot to both employees and their adult relatives – a childhood vaccine had not yet become available. The company did not order the vaccine but provided a significant amount of training and created easy, free access to the vaccine, which had a significant impact on vaccination participation, she said.
While people do not often think of 2009 as a pandemic year, 60 million people in the United States developed H1N1 flu according to the US Centers for Disease Control and Prevention. Although not as deadly as coronavirus, many employers created strategies to administer the flu vaccine when it became available later that year, Roy said.
She set up a flu clinic in the corporate office and created a system where employees could leave their stations, walk in a door, receive the vaccine and go out on the other and back to their stations in about 10 minutes. The company handled the vaccines on its own, cleaned commercial refrigerators and installed specialized thermometers to monitor the vaccine's temperature when they arrived. For other, more remote offices, the company tested its own stock of coolers to see who could maintain the most even temperature to maintain the vaccines on the way out to those offices and to keep them running while the flu clinic operated.  "Many employers, such as those with large distribution facilities and manufacturers – they can all pretty much (vaccinate) in the workplace," says Roy. “If you have a large number of employees, it is usually more efficient. It is also much cheaper to vaccinate on the spot and then send someone to the doctor's office.
While some employers may consider making flu vaccines mandatory, Troutman recommends that employers instead strongly encourage the vaccine – a method preferred by the EEOC. If mandatory, employers must consider accommodating workers who reject the shot because of medical reasons or sincere religious beliefs or risk violating Section VII of the Civil Rights Act or the Americans with Disabilities Act, he noted. In general, although it is legal for private employers to mandate vaccines as terms of employment … I do not generally recommend a mandate with any exceptions, says Lindsay Ryan, a shareholder in the Los Angeles office at Polsinelli PC.
Employers who prescribe vaccines must also be prepared to meet resistance from employees, because "even those who do not consider themselves anti-waxers may be reluctant or feel that the employer is invading their privacy," she said. "If employers prescribe vaccination and they find out that employees are suffering from some negative health effects, they may see an increase in workers' claims."
However, Roy said that during her 12 years of vaccinating thousands of LL Bean workers for the flu, she has only seen two minor reactions. These cases were reported to the federal Vaccine Adverse Event Reporting system, where "money is available … to actually protect individuals who have been harmed (by a vaccine)," Roy said.
For employers who strongly encourage vaccination, they may need to consider that reactions to the vaccine may mimic certain coronavirus symptoms, such as low-grade fever or body pain, Dr. Maragakis. To combat this, Johns Hopkins – who requires flu vaccines for his staff – is considering adding a question to his COVID-19 screening asking about a flu vaccine in the last 48 hours to “help provoke reactions to the vaccine from symptoms of COVID- 19. ”
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