Health

Vaccine or Test Requirements Increase Work and Cost for Governments

Amanda Kostroski, an emergency dispatcher in Madison, Wisconsin, leaves her busy job once a week to go to the county clinic for a COVID-19 test.

She had been driving 15 minutes from work since late September, when Dane County ordered all staff to be vaccinated or tested weekly. Testing is free, and she usually gets back to work within an hour.

Kostroski is among the 10% of county employees who are unvaccinated and tested weekly. She decided not to get vaccinated because she thinks the vaccines are too new and fears side effects.

Kostroski said she does not understand the need for vaccinations or why vaccinated people are not tested, as they can sometimes transmit the virus as well. “I think it’s pointless,” said 34-year-old Kostroski, who has always tested negative. Vaccinated colleagues told her that they felt burdensome for the people being tested.

Dane is one of several dozen counties, cities, and states that require workers to be vaccinated against COVID or regularly tested. While some employees have complained about the policy, county officials say it helps maintain a safe workplace with little interruptions. They also say vaccinated workers do not need testing because they are less likely to be infected and, if they do, are less likely to contract a severe case of COVID. But it was costly, often requiring governments to use federal dollars for COVID-related aid that they would rather spend elsewhere.

Some private employers have adopted similar policies. And starting January 4, the Biden administration will require private employers with 100 or more workers to insist on vaccinations or weekly tests.

But opposition to these mandates is deeply ingrained among some workers, trade unions and conservative leaders. More than two dozen Republican state attorneys general have sued the administration, arguing that the federal government has no powers. The federal appeals court agreed with them and temporarily blocked the ruling, and the case could be transferred to the Supreme Court.

However, these early efforts by state and local governments provide insight into what Biden’s rule might mean for the broader private sector as companies set up and pay for testing and then monitor the results. This regime adds more work to government leaders even in places like Dane County, where nearly 90% of adults are at least partially vaccinated.

Nationally, about 81% of adults are at least partially vaccinated against COVID, according to the Centers for Disease Control and Prevention, although rates vary widely from state to state.

Jurisdictions run by conservative officials generally have lower vaccination rates and are unlikely to require vaccinations or testing for workers – meaning that experience to date does not reflect areas that have sharply opposed vaccines and other COVID requirements.

The local and state governments that accepted the testing option did so because it balances between creating a safe work environment and giving reluctant employees the ability to opt out of the vaccine without losing their jobs.

Blair Bryant, deputy director of health legislation for the National County Association, said: “It’s too early to give a definitive answer on how well this is going, but for now [we have] have not heard of any major problems. “

Counties rely on free COVID testing in their communities, paying for it with US federal dollars for COVID assistance or forcing their health insurance companies to pay bills.

Local governments have a set of rules about who is subject to a requirement for vaccination or testing and how it is enforced. For example, all unvaccinated employees in San Diego, California who do not work in healthcare facilities must provide their supervisor with confirmation of weekly testing, spokesman Michael Workman said.

Miami-Dade County’s policy applies only to non-union workers, or about 9% of its 29,000 employees. About 380 people are tested weekly. Florida is still in talks with unions to add this requirement.

The Virginia Department of Corrections requires unvaccinated staff working in crowded environments to be tested every three days and others every seven days. And the expense? Testing 442 employees in two days in October cost the department nearly $ 7,000. The state uses federal COVID assistance funds to pay for testing.

Securing hard-to-find test supplies can be difficult. Virginia State Police had to wait over a month to begin the testing program, in part due to delivery delays.

While the Biden administration hoped its rule would encourage more people to get vaccinated, the counties have had mixed results.

Officials in Fairfax County, Virginia, near Washington, D.C., said they have not seen a significant increase in vaccination approvals since its mandatory vaccination policy went into effect in October. More than 80% of the district’s employees are vaccinated.

The district distributes and pays for self-tests for its 2,300 employees who need them, spokeswoman Dawn Nieters said. Costs range from $ 35 for a rapid test to $ 53 for a PCR test, which is considered the gold standard for COVID detection.

In Mecklenburg County, North Carolina, which includes Charlotte, the arrow did move. Employees are responsible for taking their own tests. The vaccination rate jumped from 62% to 85% a month after the requirement was introduced in early September.

George Dunlap, chairman of the Mecklenburg County Board of Commissioners, said he prefers requiring a vaccine or test to requiring only a vaccine because “you have to consider human behavior that may be different from yours.” But he’s not sure the policy will induce anyone else to get vaccinated.

“People I know personally who decide to get tested are still being tested. They have not changed their minds about vaccinations, ”he said.

Some health experts question the value of testing as a backup and prefer mandatory vaccinations instead.

“Vaccination and / or testing policy is second in importance,” said Jeffrey Levy, professor of health management and policy at George Washington University. “Testing policy identifies the problem early. It does not prevent the problem, while the requirement of vaccination helps prevent it. ”

Mark Elrich, executive director of Montgomery County, Maryland, in a suburb of Washington DC, theoretically supports the vaccine-only mandate, but fears that its introduction will result in workers leaving to work in neighboring jurisdictions without similar requirements.

“I would like the federal government to introduce [vaccine-only] Erich said, “Because if the feds did, I wouldn’t have to deal with the possibility of an officer leaving the Montgomery County Police Department, especially in this region, to pretty much every other police department here.”

Robb Pitts, chairman of the Fulton County Board of Commissioners in Atlanta, would also like to ditch the testing option. “But I don’t think my colleagues will necessarily agree with this,” he said. About a third of district employees chose to be tested over vaccinations.

“Why did I compromise? Because I felt like we had to do something, ”Pitts said. “Politics is often the art of compromise.”

Fulton County saw the largest increase in vaccinations from May to September when the vaccination or testing policy was introduced, according to the Pitts office. The vaccination rate now hovers around 72%.

Kaiser Health News is the national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation and is not affiliated with Kaiser Permanente.


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