EMPLOYER DILEMMA The Risk of a Twindemic Without Mandatory Flu and Coronavirus Vaccination Policies 768x468 1

The term “twindemic” first appeared in the columns of The New York Times on August 16, 2020. The newspaper coined the expression to designate a scenario that could apply when the annual flu season and the COVID-19 pandemic collide in full force this fall and winter. Given this likely scenario, employer-mandated vaccination policies may soon become vitally important.

Mandatory vaccination policies often spark deeply personal responses, especially at a time when political differences and social justice issues remain at the forefront of the nation’s consciousness.

Is a mandatory vaccination policy the right option for your company? 

There are three main reasons to consider immediate action:

  • Although the common thought is that Coronavirus safety measures would also work to help prevent the flu, the Centers for Disease Control (CDC) has stated that getting the flu vaccine this fall will be important to reduce health risks for individuals, and to conserve the country’s potentially scarce healthcare resources, particularly for respiratory conditions like the flu and COVID-19.
  • One or more COVID-19 vaccines are expected to become available at the end of 2020 or in early 2021, offering possible protection from this worldwide scourge.
  • COVID is such a severe pandemic, government-mandated vaccinations may become law. Getting a jump on vaccination polices with the flu will help when the COVID vaccine becomes a reality.

Employers must balance the rights of individual employees with their duty to maintain a workplace free of recognized dangers. Many employers are unsure if they can even implement a mandatory vaccination policy – but in most cases, they can. Even today, some businesses require flu shots for employees in certain positions, such healthcare workers with patient contact. Healthcare, education, and retail are settings in which employers are relatively accustomed to dealing with mandatory vaccine issues. The possible availability of a COVID-19 vaccine obviously ups the ante. As this will likely be an evolving area of the law, you should stay abreast of developments where you conduct business.

The federal Occupational Safety and Health Administration (OSHA), among other agencies, enforces an employer’s duty to maintain a workplace that is free of recognized hazards.  COVID and the flu are definitely hazards to address.


  • Begin with Flu Shots! Considering the current CDC guidance regarding the importance of flu shots, which should be administered beginning in September or October, you should review and formalize your inoculation policies now. Offering employees free vaccinations tends to achieve the largest compliance rates and might be necessary if a mandatory policy is put in place.
  • Historically, when employers require flu shots, the proportion of workers who get them tends to increase from less than half to well over 90%. Many employers outside of the healthcare industry have encouraged, but not required, flu shots. That choice has primarily been an employee relations issue.
  • Your right to require flu shots is not unlimited. Specifically, the Equal Employment Opportunity Commission (EEOC) has repeatedly emphasized that, even during a pandemic, an employee may be entitled to an exemption from mandatory flu shot requirements based on an ADA-covered disability. Likewise, an employee may be exempted from the requirement if taking the shot would violate their sincerely held religious beliefs, practices or observances.
  • Although the EEOC has advised employers to encourage flu shots rather than requiring them, it has not prohibited employers from requiring the shots, especially when the flu is severe. It is very likely that COVID-19 vaccines will take center stage of that policy.
  • No one knows when a reliable COVID-19 vaccine may be available, but you should be prepared to respond when that happens. Keep in mind while that mandatory flu vaccinations may not be appropriate for every setting. Encouraging vaccinations will help bolster participation and protect your workplace, while also helping reduce demands on the nation’s healthcare system. Recognize that although it may not be feasible to offer on-site flu shots this year, you may still be able to facilitate employees’ access to inoculations.

If you do decide to make vaccination mandatory, ensure that your policies are clear and that they inform employees of how to seek exceptions or accommodations. Additionally, keep in mind that flu shots and COVID-19 vaccines (when available) are distinct inoculations for two different health threats.

Finally, you should ensure that your policies encourage sick workers to stay home without fear of reprisal, especially if they have a fever. Employees who are sick should remain home until they meet applicable return to work standards.

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