Everyone Is Wrong About Vaccine Hesitancy

When Dallas Cowboys quarterback Dak Prescott made himself the butt of 40% of recent Twitter jokes by refusing to say whether he'd been vaccinated against COVID-19, he could be forgiven for not understanding the Health Insurance Portability and Affordability Act (HIPAA) strictures on Protected Health Information (PHI). The whole thing is kind of the full employment act for employment lawyers, and the percentage of Americans who understand it surely doesn't hit the double digits.

So Dak managed to sound a bit dumb and a bit dishonest. But how is that a story when the main character has such a long history of irresponsible behavior on the subject? (In April last year, as COVID-19 ravaged much of the world, he threw a birthday party at his home in Prosper.)

The bigger question is why, when it comes to workplace vaccination requirements, are media outlets almost uniformly focusing on small numbers of holdouts? Male professional sports players, coaches and front office people are hardly known as the vanguard of progressive thought, but all the evidence suggests that they're getting vaccinated at a rate far above the national average in the United States.

What accounts for the NFL's apparent success in getting the large majority of its organization vaccinated? A vaccine lottery for a free TV isn’t likely to be very effective for this bunch of employees. It wasn’t a carrot; it was a considerable stick that appears to have been the deciding factor. Football players care more about not forfeiting games than about their reservations about the vaccine (surely based on extensive epidemiological research).

Why is that success less newsworthy than Arizona Cardinals wide receiver DeAndre Hopkins taking to Twitter and questioning his future in the NFL owing to the league’s vaccine policies, even if he is a five-time Pro Bowler?

"Football players care more about not forfeiting games than about their reservations about the vaccine."

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It’s not just in professional sports that the media gets the vaccine story wrong. When Houston Methodist Hospital made vaccination a condition of employment, story after story was headlined with the number – 150 – of its employees who held out. Of that total, 115 of them ultimately sued and were thrown out of court. Their lawyer probably should have told them that the Equal Employment Opportunity Commission ruled unequivocally that vaccination could be made a term of continued employment.

Wouldn’t readers have been better served by learning that Houston Methodist has more than 24,000 employees, meaning that it had a 99.5% compliance rate with its vaccine mandate? Other questions that are potentially more interesting than a frivolous lawsuit: Do patients feel comfortable receiving care from unvaccinated people? Why have some other health care employers not required vaccination?

In fact, the Houston Methodist story seems to be a blueprint for both workplace safety and fair treatment of workers with vaccine concerns. Director of PR, Communications and Creative Services Stephanie Asin writes:

Implementation was difficult at first as the vaccine was new. But we focused on the science and our obligation as health care workers to safely care for our patients. We offered a $500 bonus and then we rolled out the mandate, which included the threat of getting terminated. All of these combined were effective in getting our employees and physicians vaccinated. In the end, only 153 of 26,000 were terminated.

Asin also shared some of the communications to employees from Houston Methodist CEO Dr. Marc Boom who, in addition to having one of the coolest names in health care management, also sets a standard for respectful communications with workers and commitment to a progressive discipline policy.

I encourage you to read them if you have any interest in how to do large employer communications.

The odd focus on small numbers of vaccine-hesitant workers may be feeding a narrative that vaccine resistance is a larger problem than it actually is. It is certainly true that a vocal group of people is publicly casting doubt on the safety and efficacy of COVID-19 vaccines, but they do not appear to be greater in number or ferocity than previous skeptical advocacy against other vaccines that media roundly ignored.

The difference in the media treatment may be that Republicans are using vaccine skepticism to rally their base. But if that's the case, why are mainstream outlets amplifying this message?

The success of employer mandates contradicts the belief that vaccine hesitancy is a sincere and principled position held by a large percentage of Americans exercising independent judgment.

"The odd focus on small numbers of vaccine-hesitant workers may be feeding a narrative that vaccine resistance is a larger problem than it actually is."

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Polling shows that large shares of unvaccinated people are waiting for triggers, such as full FDA approval, vaccine-related travel restrictions and employer mandates to get the jab. Still, the polling couldn't have predicted the runaway success of employer mandates. Vaccine hesitancy simply isn't about a sincere distrust of vaccines or a principled stance against mandates, regardless of what subjects told pollsters.

So if employer mandates are the magic key to herd immunity, what the hell are governments doing? Obviously, Gov. Greg Abbott has ruled out mandates at the level of Texas' state government. President Joe Biden's administration repeatedly demurred on a mandate for federal workers or even for the military until this week.

Here in Dallas, private health care employers look set to follow Houston Methodist’s example. Baylor Scott & White announced an upcoming mandate, making it the first large employer in North Texas to do so.

But Parkland Hospital likely won't be following suit although they’ve been discussing such a mandate for months, according to an employee who wished to remain anonymous. On Friday, The Dallas Morning News reported that Parkland is barred from issuing a mandate because of an executive order from Gov. Greg Abbott. (Parkland didn’t respond to requests for comment.)

The city of Dallas, with more than 12,000 employees, hasn’t mandated vaccination, either. Not for any of its employees, even first responders. If your immuno-compromised granny phones for an ambulance, how will you feel about unvaccinated paramedics showing up at her house? (Asked about this, the city’s management acknowledged receipt of written questions but didn’t provide answers.)

That said, the government appears to be way behind private industry when it comes to vaccine mandates.

After months of falling and stalling vaccination rates around the country, the success of employer mandates may be catching on. But it’s still unclear whether it can match the media attention given to vaccine hesitancy.

Philip Kingston practices commercial trial law at Stanton LLP frequently including employment matters.