Opinion: Workers With COVID-19 Vaccine Side Effects Deserve Time Off To Recover

February 5, 2021

Dorit Rubinstein Reiss and Arthur L. Caplan contributed a recent editorial to Health Affairs discussing how healthcare workers with temporary, unpleasant side effect from COVID-19 vaccines deserve appropriate time off without having to use up their regular sick leave or paid time off.

Healthcare workers with temporary, unpleasant side effect from COVID-19 vaccines deserve appropriate time off without having to use up their regular sick leave or paid time off.

At a time when over 2,000 people in the United States are dying from COVID-19 each day and many more are harmed by it, we have started to roll out COVID-19 vaccines that may be the key to helping us out of the crisis.

Two independent expert committees, one in the Centers for Disease Control and Prevention and one in the Food and Drug Administration, concluded that the two first vaccines to have data behind them are very safe and very effective. Safe, in this case, means that in large trials consisting of tens of thousands of people there was no signal to suggest that COVID-19 vaccines cause serious, long term or life-threatening harms.

We may still find out that the COVID-19 vaccines cause harm in one per a hundred thousand or one per a million cases, but we already know serious issues are likely to be rare, and certainly much rarer than with the virus.

However, we also know, from the trials and early experience with COVID-19 vaccine administration, that the vaccines have high rates of temporary and unpleasant—but not dangerous—side effects. The vaccines cause sore arms at high rates, and they can cause swelling, mild fevers, fatigue, and aches. That is not a bad sign; that means the recipient’s immune system is vigorously responding to the vaccine, building immunity that can protect the recipient, which is what we want.

But these side effects can be debilitating. Vaccine recipients may need to take a couple of days to rest. This is what we are seeing now, among the health care workers, older Americans, and others that are the first recipients.

Unfortunately, not all hospitals or healthcare providers are making it easy for workers to take that needed leave. Some are: the Veterans’ Administration provided two days of paid sick leave. But some hospitals are making their employees use their paid time off or regular sick leave, which means fewer sick days or days off are available for the employee if something happens that requires leave.

Any new COVID relief legislation should allow employees to take paid time off for vaccine side effects. Although employers are no longer required to provide such leave under the Families First Act, they should. Such leave fits the Act’s purpose: COVID-19 vaccines would not be needed if it were not for COVID-19, and the few days of reactions are directly connected to the pandemic. Moreover, it is in our public health interest for people to get COVID-19 vaccines—it is our way out of the pandemic.

In addition, employers benefit from a highly vaccinated workforce, since other employees and patients are then less likely to get COVID-19, too. Hospitals and healthcare providers will face fewer worker shortages and fewer outbreaks among their staff if vaccination rates are high.

Practically, not allowing employees suffering vaccine side effects to leave work, or forcing them to use time off, can make staff hesitate to take the vaccine (undermining herd immunity) or push them to tailor it for a weekend. That latter option could lead to an imbalance in the burden on vaccine clinics, or strengthen vaccine hesitancy by workers who do not have open weekends, for example because of caregiving responsibilities.

Alternatively, attending work while suffering from vaccine side effects can impair healthcare workers’ performance at a time when we need them to be at the top of their game more than ever. Ethically, it is unjust to make employees pay—through lost sick days of days off—for getting vaccinated, an act that protects them but is also in the public interest.

Employees deserve to have the few days they need to recover from temporary, but unpleasant, COVID-19 vaccine side effects. If hospitals do not provide that themselves, we call on state and federal policy makers to require it.