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The Ethical Dilemma Of Offering A Financial Incentive For Getting Vaccinated

By Steve Goldstein
Published: Tuesday, February 16, 2021 - 12:21pm
Updated: Tuesday, February 16, 2021 - 12:22pm
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STEVE GOLDSTEIN: The number of coronavirus cases continues to decline in Arizona. Today, [Feb. 16], the state Health Department reports 1,132 new infections and three deaths. And while this is a positive trend, there are still concerns about community spread. Doctors and health professionals are still urging regular handwashing and mask wearing — and if you're able, to get the [COVID-19] vaccine. The city of Phoenix is experiencing near 20% [COVID-19] positivity rate among public employees since the onset of the pandemic. Hardest hit are first responders — firefighters, police and others that are essential to maintaining a functioning community. In an effort to safely return city operations to maximum functionality, City Manager Ed Zuercher is facilitating a $75 bonus for all city employees who provide proof of vaccination. Other cities in the Valley are offering similar incentives — Glendale, Tempe and Peoria are all offering health insurance discounts. Lori Bays, human resources director for the city of Phoenix, is with me to give us some more details about what Phoenix is doing. So, Lori, employees have to receive both vaccine doses to get the financial bonus. What sort of response have you gotten so far?

LORI BAYS: Well, we've just recently launched this program, but we've received a great response so far; we've received several hundred vaccine cards that have been completed by our employees. And we do require, again, the, the two doses to receive the $75. So what that means is we expect that as our employees get those second doses we'll receive many more vaccine cards. We know that a lot of our employees have only had the first dose at this point, but once they receive that second dose, we'll, we anticipate many more employees to be submitting that for the award.

GOLDSTEIN: And obviously, we know how just generally business and operations of all sorts of services, government and private business, has been affected by the pandemic. Is there something specific that has happened in the city of Phoenix? Any services or whatnot that have been impacted by this that made the city feel like it needed to take this action?

BAYS: So we have about 14,000 employees at the city of Phoenix. The vast majority of those, about 75%, because of the, what their job is, need to work on site. And so this is just another example of the city's efforts to promote the safety of our employees and, frankly, their families and the community, because as our employees interact with others, that may impact them. And so we want to make sure that everyone is as safe as possible.

GOLDSTEIN: Other communities, other cities are not offering a strict cash situation. Perhaps they've applied it more to health care fee credits or whatnot. Why did this particular plan seem like a better one for Phoenix than maybe something else?

BAYS: Yeah, that's a great question. This was actually a great plan for us because we already had a safety award program in place for other things that employees do to promote safety in the workplace. So that could be safe driving. That could be occupational health and safety standards and adhering to those. So that's been in place for a long time. And we have a mechanism to award a one time cash incentive to employees for safe behaviors. And so this was just a natural for us to incorporate this vaccine incentive that, as you call it, into the safety award program, because as I've said to many people recently, I can't think of a better way to promote safety right now in the midst of this pandemic than to offer a safety award for a vaccine.

GOLDSTEIN: Lori, will the bonus be retroactively applied to any employees who were able to get vaccinated before the announcement?

BAYS: It will. So anyone who has been vaccinated already or anyone who is vaccinated during the course of this calendar year will be eligible for the safety award.

GOLDSTEIN: Nearly 20% of the city's employees have had the virus. Did that in any way affect how the city went about its business? How much of that concern built up into deciding, "We need to advance a plan?"

BAYS: Right. So as I mentioned, you know, the vast majority of our employees work as frontline employees every day. They're out serving the public as firefighters, police officers. We have operations assistants at Sky Harbor Airport. We've got people working in our pay stations collecting payments. We've got people out repairing the streets. You know, our employees really work in the community. And so it is logical to understand how 20% of our employees have reported that they've tested positive for COVID-19. And absolutely, that is a concern for us. And we want to make sure that our employees are as safe as possible so that as they're interacting in the community, we are, are contributing to the solution of the pandemic. And we have seen challenges throughout this year. It's been a tough year. We've been able to continue to provide great service to our community. And that's because our employees who have, you know, continued to work and fill in for others who may have been out temporarily due to testing positive, you know, everybody has really done their part and stepped up. And so we have seen challenges, but we've been able to continue to provide service and we're really proud of that.

GOLDSTEIN: There is a certain percentage of the population concerned about getting vaccinated or they don't believe in vaccines. Whatever the case may be, are city employees are allowed to refuse to get the vaccine?

BAYS: Yes, absolutely. This is completely at the discretion of the employees. If they choose not to get vaccinated, there is no, you know, penalty or ramification for that. We just want to educate our employees — excuse me — let them know that the vaccine is safe and effective. We have had medical experts provide information to our employees and hopefully they make that decision. And if they don't, that's completely their choice and, and it's not required for any city employee.

GOLDSTEIN: All right, Lori Bays is human resources director for the city of Phoenix. Lori, thank you. And stay well.

BAYS: Thank you so much. You too.

GOLDSTEIN: But the idea of offering a cash incentive for any sort of vaccinations has some observers worried about a slippery slope. Earlier, I spoke with Dave Blanchard. He is editor-in-chief of EHS Today. And since he covers safety issues, I began by asking him for the point of view of safety professionals.

DAVE BLANCHARD: So the idea of incentivizing employees to do things that you wouldn't think they needed to be incentivized for — you know, like wearing your PPE, for instance, or driving safely or things like that — they're, they're used to that debate. That's a long-standing debate — just the idea of incentivizing employees. [COVID-19], of course, is a completely unique situation. It affects everybody on the planet. Everybody is at risk of, of catching it. And everybody, ideally, you want to make sure that no one will ever catch it again so it won't spread anymore. And then people can go back to their normal jobs. But the idea of incentivizing employees to get the vaccine, there's a couple different things going on there. One is, of course, so many employees have been away from the workforce for a long time, some since March, when, when it was declared a pandemic, have been working from home or have gone into the office on a staggered basis or they've been, you know, at least 6 feet separated from their closest coworker, things like that.

GOLDSTEIN: So let's say 75% of your workforce wants to get vaccinated or is comfortable getting vaccinated. You're never, we know you're never gonna get 100%. But of the other 25% percent, 10 to 15% can be convinced to get vaccinated with an incentive. How do you think that could affect the 75% that wanted to get vaccinated in the first place before an incentive? Does that cause issues?

BLANCHARD: Yes, it does. It causes complications not only with, with the [COVID-19], but down the road. You know, if you have to incentivize people to be vaccinated against the biggest health crisis of anybody's lifetime, what are you going to have to incentivize them for next time? When a company or a city like Phoenix or organizations, we're going to pay money to our employees. Because incentives can mean a lot of things. It could mean, you know, we'll, we'll give you a T-shirt or our company logo cap or, you know, a gift card. But to give people $75 or whatever amount of money they think they need to pay them to have them be vaccinated on top of giving them the vaccine already for free and making it possible for them to get the vaccine — some companies are bringing the vaccines right onto the premises and bringing the health care people with them — you know, that's, that's going a long way towards — well, I think it just illustrates how very, very much companies need to get all their employees back to work, so whatever. They're going for whatever they can do. If so many people are uneasy about the vaccine — you know, it was rushed through — although all indications seem to be that the companies that created the vaccine did a great job — these vaccines seem to be working. But, you know, people are, are skeptical of everything in this country. So there being a lot of people skeptical about the vaccine is not a surprise or should be to anybody. If, if it's going to take incentivizing them to get a company back to close to full employment, it looks like that might be what's going to happen.

GOLDSTEIN: Would it possibly make sense to tie any incentive to what an employee's health plan may be? In the past, we've seen this with the flu vaccine, even if perhaps it wasn't called an incentive. What would you make of an incentive specifically tied to health?

BLANCHARD: You know, a lot of companies do have incentive programs around their wellness programs. I mean, the goal is twofold — it's to have healthier employees. But the company also benefits by having lower worker's comp costs, fewer sick days of their employees — having more people come to work. If, you know, if you're, if you're incentivizing them, that doesn't necessarily mean paying the money, but incentivizing them to eat better and exercise more and to get more sleep at night and not to drink or smoke or all those sorts of things. You know, the company benefits and the employee benefits. The, the reality is sometimes you just have to pay people to do that. Now in the safety field. A lot of the the companies — and with our magazine, we have an annual program called America's Safest Companies, and we look at how companies develop a safety culture. And in many of these companies, what you'll find out is they don't actually necessarily believe in the idea of incentivizing safety at all. They believe in developing a culture of each employee looks out for themselves and for each other, and they're accountable from the top of the company, you know, the top person at the company down to every level. So it becomes ingrained in that company's character or its culture, if you will, that safety is something that they take very import — very seriously. Take it very import — it's very important to them. And I think those sorts of companies where the employees already have a good connection with the company in terms of believing that the company is looking out for the best interests, I think they're probably the ones that aren't having to worry about incentivizing their employees because their employees were, would be the ones first in line to get a vaccination or at least to trust that their company is not trying to force them to do something that they don't believe in. Companies where you see really high workers' comp claims and you know, high turnover rates and those sorts of things, these tend to be the kind of companies where, yeah, you do have to incentivize people. Because just the cost of hiring and training new employees is so prohibitive that they're better off, you know, spending $75 per head to get people to stay with the company and come back to work.

GOLDSTEIN: That is Dave Blanchard. He is editor-in-chief of EHS Today, an occupational safety and health publication.

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