Kate, who asked that her full name not be used because she fears reprisal at work, said her vaccine experience took more than two hours: an hour of driving, an hour of waiting, and 15 minutes of mandatory observation time afterward. “I was in a rush to get out of there,” she said, because her job requires her to clock in.
Kate said her employer gives her 14 days of paid time off per year, including sick days, and it denied requests that she and her co-workers be given an additional two days of time off specifically to get the COVID-19 vaccine. “They said, ‘We’re already so generous with our PTO,’” Kate said. “Obviously if we’re asking for the time, then we don’t have it.“
The day after her shot, Kate experienced side effects. “I was so out of it. I was achy all over, I was exhausted. I could barely work,” she said. “It’s like, ‘Why am I here? I’m not even helping.’” Because Kate was given the Pfizer vaccine, she still needs a second dose and is uncertain how she’ll schedule it around her workday. “I don’t know what I’m going to do. I guess take an unpaid day of vacation for that?”
Kate wishes her employer had been open to designating specific PTO for coronavirus-related appointments so she didn’t have to use her limited time off for getting COVID-19 tests and the vaccine. “It doesn’t make sense to not give that,” she said. “People are so burnt out. We’ve been working for a year in a pandemic.”
Her experience underscores the fact that although the COVID-19 vaccine itself is currently free in the United States, there are other financial, psychological and emotional costs to getting the shot that some employers are making worse.
Getting paid time off for your vaccine appointment depends on where you live and who you work for.
The Centers for Disease Control and Prevention recommends that employers give employees paid sick leave for COVID-19 vaccine recovery, but it is not required by federal law. The American Rescue Plan Act, the stimulus bill signed into law March 11, doesn’t require paid leave for vaccinations but does give a tax credit to certain employers who offer it. As a result, paid time off for COVID-19 vaccination is left up to the discretion of states, cities and individual employers.
“If paid time off was based on the recovery time needed by those who participated in clinical trials for COVID-19 vaccines, it should be 48 hours for most people.”
In New York state, for example, workers are entitled to at least four hours of paid time off per shot. In California, full-time employees can get up to 80 hours of paid time off for vaccine-related self-care, including recovery from side effects. McDonald’s mandated four hours of paid time off for vaccination, while Starbucks is offering two hours of paid time off per dose and Walmart says associates can get up to up to three days of PTO if they have adverse side effects. At Amazon, workers who experience side effects from the COVID-19 vaccine can take time off, but won’t be paid for it.
If paid time off was based on the recovery time needed by those who participated in clinical trials for COVID-19 vaccines, it should be 48 hours for most people, according to Deborah Fuller, a microbiologist at the University of Washington School of Medicine, who is working on coronavirus vaccines.
“It’s that 48 hours where the peak reactogenicity [happens]. And by that, I mean fever, feeling kind of crappy, soreness, even chills,” Fuller said. “By 72 hours, you can actually see in the data that all the stuff is just disappearing.”
Compared to how much productivity employers would lose if their employees contract COVID-19, providing at least two days off for vaccine recovery is “a drop in the bucket,” Fuller said.
Getting a vaccine shouldn’t impact existing sick leave or vacation time, like it did for Kate. “Most of the sick leave we have in the United States is not very high to start with,” said Dorit Rubinstein Reiss, a law professor at the University of California Hastings College of the Law. As a result, when employers ask employees to use paid time off to get a vaccine, she said, “You’re asking them to actually sacrifice something that is meaningful.”
Kate said she understands that employers may be anxious that staff will use vaccine PTO to shirk work, but points out that it’s an easy appointment to confirm: “There’s ways to verify that, right? Like your leader confirms with a picture of your vaccination record.”
Determining what constitutes equitable vaccine PTO would mean listening to employees about what they think would be fair, said Faith E. Fletcher, an assistant professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine.
Using PTO to be vaccinated can have a different impact for hourly workers than those with corporate salaries and benefits, she said.
“That’s the part that is very concerning. People who have multiple barriers to securing vaccines or accessing health care broadly are also the ones who could potentially be more disadvantaged by policies by not having flexibility, by not having additional PTO or sick leave,” Fletcher said. “Health equity does not implement a one-size-fits-all approach. Equality does not equate to equity.”
“Everyone I know is desperate for the vaccine but also desperate to keep their job. It’s a hard choice.”
PTO is ideal, but it’s not the only way to help make vaccination accessible and equitable.
Paid time off for vaccination not only helps employees, but their families, too. For Magdalena, a San Francisco-based professional who quit their job to parent full-time during the pandemic, it was their partner’s paid time off that helped them get a vaccine.
“There is no way we could have gotten the shot without the PTO. Our son just started crawling and climbing everywhere and needs to be supervised,” said Magdalena. When the couple found out they were eligible for a vaccine, Magdalena’s partner took time off to care for their son while Magdalena worked out the logistics. “It took three hours,” Magdalena said. “One of those hours was me being on hold to get an appointment. The rest, research.”
Still, paid time off is really just a starting point to making vaccine access more equitable. That requires looking beyond PTO and toward addressing long-standing inequalities that prevent people from securing and accessing health care in general, such as a lack of child care, transportation and interpretation services.
For COVID-19 vaccination in particular, informed decision-making is key to achieving equity. Employers should not promote the single-shot Johnson & Johnson vaccine over the other two vaccines as a way to reduce time away from the office, Fletcher said. Instead, companies should provide wide-ranging information on how to get vaccinated, including identifying sites with accommodations such as language interpreters or handrails and ramps. And compensation shouldn’t be limited to time off: As many people may lack adequate transportation, Target is giving all U.S. workers up to $15 for Lyft rides to and from appointments.
Such barriers are an equity issue, Fletcher said, but “vaccine equity also seeks to ensure that new inequities are not created and imposed through policies and practices.” Denying workers paid time off to be vaccinated, for example, creates one more kind of inequity for people to deal with during a pandemic.
“Everyone I know is desperate for the vaccine but also desperate to keep their job,” said Magdalena. “It’s a hard choice, right up there with me quitting my job to care for our baby. … It’s not hesitancy, it’s an equity issue.”