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Inability to miss work contributes to vaccine hesitancy and likely, lower vaccination rates

May 10, 2021
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By: Kate Warren, kwarren@communitysolutions.com

Taneisha Fair, tfair@communitysolutions.com

Loren Anthes, lanthes@communitysolutions.com

With about 41 percent of Ohioans having started the COVID-19 vaccine as of May 7, and weekly vaccinations slowing, it remains important to understand what barriers exist for people to get vaccinated. Attitudes and behaviors around the vaccine are complex, and it would be impossible to pinpoint one reason that explains why many people still have not received a vaccine. One barrier that deserves more attention, however, is that many people would be unable to miss work if vaccine side-effects made them feel sick or fatigued. While concern about side effects is normal, it is incumbent upon employers and providers to make the vaccine as accessible as possible to people, regardless of the type of work they do. In this case, that means paying them for missed work due to vaccine side effects, which the American Rescue Plan can help with.

 In several ZIP codes in the City of Cleveland, particularly in east-side neighborhoods, vaccination rates are still below 25 percent

Why are s ome Ohioans h esitant to g et the COVID-19 v accine?

According to Census Pulse Data, fewer Ohioans were hesitant to get the COVID-19 vaccine by the end of March than they were at the beginning of the year. In January, 26 percent of Ohio adults said they probably or definitely would not get a vaccine, while by the end of March, that number had dropped to 20 percent. All along, the two most common reasons for vaccine hesitancy among all Ohioans were: 1) being “concerned about possible side effects” and 2) deciding to “wait and see if it was safe.”  

There are differences in terms of how different racial and ethnic groups view the vaccine, how hesitant they are and the reasons for that hesitancy. According to the latest data, Black and Latino Ohioans were more likely than white Ohioans to be hesitant to get the vaccine. Note: this dataset estimated no Asian Ohioans who were vaccine hesitant.  

Source: Ohio Department of Health, Rates Calculated With ACS 2019 5-Year Population Estimates  

But race and ethnicity do not tell the whole story. Census Pulse asked individuals if they trusted the COVID-19 vaccine, and among those who were hesitant, mistrust of the vaccine was the third most common reason given. Mistrust of the vaccine and of the government were big contributors to hesitancy among Latino Ohioans, but for the rest of the racial and ethnic groups, concern about side effects wa s the most common reason for hesitancy.

 …one theme that arose was an inability to miss work due to vaccine side effects.

A c loser l ook at v accination s in Cuyahoga County

To get more local, we looked at vaccinations by ZIP code in Cuyahoga County, and found that there are geographic disparities across the county when it comes to the percent of the population that has been vaccinated. While more than 50 percent of people who live in many suburban and outlying ZIP codes have been vaccinated , in several ZIP codes in the C ity of Cleveland, particularly in east-side neighborhoods, vaccination rates are still below 25 percent.  

Source: Ohio Department of Health, rates calculated with ACS 2019 5-Year Population Estimates  

Cleveland Documenters conducted interviews with Clevelanders about their views on the COVID-19 vaccine, and one theme that arose was a n inability to miss work due to vaccine side effects. This theme also came up in national research tracking public opinion on vaccinations by the Kaiser Family Foundation.  

Assuming that hourly and low-wage workers are less likely than salaried and higher-wage workers to have paid time off if they get sick from vaccine side effects, we looked at work status by ZIP code in Cuyahoga County and compared it to vaccination rates.  

Source: U.S. Census Bureau, ACS 2019 5-Year Estimates  

We looked at statistical relationships between vaccination rates and the percent of the population who are either part-time/seasonal workers or work full-time with annual incomes below $35,000 (using this as a proxy for hourly workers). What we found was a strong relationship between the two variables. Z IP codes w here high er rates of hourly workers lived were more likely to have low er vaccination rates. There is also a relationship between race and vaccination rates, but hourly work is a stronger predictor (R2 = 83 percent) of lower vaccination rates than race or ethnicity alone. This analysis does not prove causation, but there is a correlation between work status and vaccination, which is bolstered by the qualitative data that asked people about their hesitations.

 On April 21, President Joe Biden announced that for employers with fewer than 500 employees, the federal government would provide a tax credit to cover paid time off for employees who need it due to vaccine side effects.

What can be done to increase access to the vaccine for people who can’t miss work?

The Biden administration anticipated this need for paid time off as the push to get America vaccinated moves forward. On April 21, President Joe Biden announced that for employers with fewer than 500 employees, the federal government would provide a tax credit to cover paid time off (PTO) for employees who need it due to vaccine side effects. There is still work to do to ensure that employers are aware of the credit, make the PTO available to their employees and have the information they need to access the credit. Read more about the tax credit, a provision of the American Rescue Plan, here.  

Ensuring that workers can take the time off they need without losing essential pay is an important piece of the puzzle to reach herd immunity in Cuyahoga County. This, combined with providers’ ongoing efforts to reach people in convenient and trusted locations, will contribute to higher vaccination coverage in Cleveland.

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