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Employers face a polarized workforce as they address COVID-19 risks

By Steve Nyce and Jeff Levin-Scherz, MD, MBA | March 22, 2022

A majority of employees support vaccine mandates but employees have polarized views of employer COVID-19 pandemic policies.
Health and Benefits|Benessere integrato
Risque de pandémie

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About the series

Dr. Jeff Levin-Scherz provides regular updates on the latest COVID-19 developments with a focus on the implications for employers and guidance on how they can tackle pandemic-related challenges to keep their workplaces safe. Explore the series.

Employers generally get high marks from their employees for keeping them safe during the COVID-19 pandemic. However, as the public’s response has become more divided, employers are increasingly challenged as to how to navigate conflicting beliefs. They have to walk the line between entrenched differences in employees’ positions while navigating applicable laws, regulations and court rulings that often conflict and change unnervingly fast.

We collected online responses from a panel of more than 9,600 U.S. full-time employees from December 1, 2021, to January 3, 2022. The results clarify what employers can expect from their efforts to address the pandemic in the workplace and inform policies that will address safety concerns and make employees feel safe and respected.

Most employees were vaccinated, but COVID-19 infection and long COVID were common

A large majority of employees report that they were fully vaccinated (75%) or partially vaccinated (6%), while 5% say they intend to get vaccinated. However, 14% say they had no plans to get vaccinated. Those not planning to get the vaccine are more likely to be women, Black people, and workers with income under $50,000. (See Figure 1)

overall: 14%, women: 20%, men: 10%, low income: 24%, high income: 4%, poor health: 14%, excellent health: 9%, Black: 20%, Hispanic: 14%

White: 14%, Asian: 10%

Figure 1 - Employees who intend not to get the COVID-19 vaccination

Only one third of the unvaccinated report having had a COVID-19 infection, suggesting that almost one in 10 respondents overall might not have immunity from either vaccination or infection. A quarter of the unvaccinated say they intend to get vaccinated, so there is still an opportunity to encourage worker vaccinations.

COVID-19 has taken a toll on the workforce

Over a quarter (27%) report that they were infected with COVID-19 during the pandemic, and 10% of all surveyed say that they continue to have some symptoms after their initial infection.

Compared to those who did not have COVID-19, those who had COVID-19 without ongoing symptoms report 24% more presenteeism (i.e., reporting for work but not fully functioning), depression and anxiety as well as 49% more absenteeism. Those who say that they have ongoing symptoms from COVID-19 (long COVID) report 95% more absenteeism and 54% more presenteeism and twice as much anxiety and depression. (See Table 1)

Table 1 - Employees experiencing long term effects from COVID-19 report higher absence, lower productivity and more depression and anxiety
No history of COVID-19 COVID-19 without long-term symptoms COVID-19 with long-term symptoms
Portion of population 73% 17% 10%
Days lost to absenteeism 4.1 6.1 8.0
Days lost to presenteeism 12.7 15.8 19.6
Experiencing depression or anxiety 34% 42% 71%

Given these numbers, employers can expect a continued increase in disability claims and the need to accommodate those who continue to have symptoms after COVID-19.

Also, the prevalence of mental health concerns was alarmingly high (34%) even for those who have not had COVID-19, suggesting that the need for additional access to mental health will persist even after the pandemic recedes.

Employees who felt safe at work were more engaged and productive

Employees generally feel their employers have kept them safe from COVID-19 (66%). Remote workers (75%) are most likely to report feeling safe along with those already subject to a vaccine mandate (71%) or regular testing (69%). Those who feel least safe are employees who say their company had no mask, distancing, testing or vaccine requirements (41%).

Nine percent report that they did not feel either safe or comfortable working onsite. They are more likely to be women, low-income workers, and those who report poor health. The 51% of employees who feel both comfortable and safe in the workplace are most likely to be at workplaces with vaccine mandates, vaccinated and high income. (See Figure 2)

Overall: 51%, vaccine mandate in place: 57% no vaccine mandate in place: 47%, vaccinated: 53%, unvaccinated: 46%

high income (over 100k): 65%, low income (under 50k): 43%

Figure 2 - Employees feeling both safe and comfortable in the workplace

Employers that made their workers feel safer gained a substantial advantage. Employees who report that they feel their employers kept them safe during the pandemic say they are twice as likely to remain with their employers, 10 times as likely to be highly engaged and are twice as likely to say they would remain with their employers for the next two years. They also lost 37% less time due to absence or presenteeism. (See Figure 3)

will remain for next 2 years: 42% not safe and comfortable, 84% both safe and comfortable.

Would move for 5% pay increase elsewhere: 57% not safe and comfortable, 37% both safe and comfortable. Highly engaged: 5% not safe and comfortable, 51% both safe and comfortable. Days lost to absenteeism or presenteeism: 20 days not safe and comfortable, 15.2 days both safe and comfortable.

Figure 3 - Those who feel both safe and comfortable are more productive and more likely to remain

Polarized views about vaccine mandates

Most employees (58%) support workplace vaccine mandates, but support differs based on demographics, current vaccination status and policies of respondents’ current employers.

Men, those with high incomes, those in self-reported good health, the vaccinated and those already subject to vaccine mandates are most likely to support vaccine mandates. Vaccine mandates are supported by a majority in all racial groups. (See Figure 4)

All respondents: 58%, men: 64%, women: 51%, low income: under 50K, high income: over 100K

White: 58%, Black: 54%, Hispanic: 58%, Asian: 67%, excellent health: 64%, poor health, 47%, vaccine mandate in place: 73%, no vaccine mandate in place: 38%

Figure 4 - Support for vaccine mandate for those who work onsite

Retention risk was strongly correlated with employee views on vaccine mandates. One in six (17%) of those who worked at workplaces without vaccine mandates report that they would definitely leave if a mandate was implemented, while one in twenty (5%) of those who were subject to vaccine mandates say they would definitely leave if pandemic restrictions were eliminated.

Respondents likely overstate the chances they would leave their current employers, but the risk of workplace departures looms large for those in a competitive job market. (See Figure 5)

Implement pandemic restrictions at workplace with no current mandate.

Out of all respondents, 17% definitely leave, 12% more likely to leave, 36% neither, 16% more likely to stay, 20% definitely stay. Remove pandemic restrictions at workplace with current vaccine mandate. Out of all respondents, 5% definitely leave, 12% more likely to leave, 33% neither, 28% more likely to stay, 22% definitely stay.

Figure 5 - Potential impact on retention from implementing or removing a vaccine mandate

Five takeaways for employers

  1. A substantial portion of those who had COVID-19 continue to experience symptoms months later. Employers should expect higher mental health, medical and disability costs to continue for years after the pandemic.
  2. While most employees give employers high marks for keeping them safe, employer efforts are less highly rated by women, Black employees, low-wage workers and employees who reported poor health. Employers should design policies and programs to address safety concerns of all segments of their workforces.
  3. Opposition to vaccine mandates is small at those workplaces with a mandate already in place, so there is little pressure to remove them.
  4. Opposition to vaccine mandates is much higher at workplaces where a mandate is not currently in place, and some employers could face employee retention challenges among the unvaccinated if they implement a vaccine mandate.
  5. Given polarization of attitudes toward vaccine mandates among employees, we expect that future employer decisions about vaccine mandates are more likely to be driven by regulations, community transmission rates and hospital capacity constraints rather than by concerns over employee recruitment, satisfaction and retention.

While the Omicron wave of COVID-19 is subsiding, employers can use this data to address decisions around pandemic response now and to help craft contingency plans to mitigate business and health risk in future outbreaks.

1 Responses were weighted by age, gender and income to be representative of U.S. full-time employees


Senior Economist
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Population Health Leader, Health and Benefits, North America

Jeff is an internal medicine physician and has led WTW’s clinical response to COVID-19 and other health-related topics. He has served in leadership roles in provider organizations and a health plan and is an Assistant Professor at Harvard Chan School of Public Health.

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