When the vaccine for the COVID-19 virus becomes widely available, will people in rural Arkansas even want it? It’s a question on the minds of conscientious objectors citing personal freedom, those who have deeply held religious beliefs, skeptics, those who simply haven’t made up their minds yet, and many in between.

We asked Craig Wilson, director of health policy for the Arkansas Center for Health Improvement (ACHI) about vaccination hesitancy.

“Take politics out of this. Taking care of yourself is not a political issue. It’s important to take care of the physical body along with the spiritual body,” Wilson said.

For some workers, continuing to get a paycheck might be the deciding factor in whether or not they get the vaccine.

Employers can take a wide range of actions to protect the workplace, including requirements for employees to be vaccinated.

Arkansas is an “at will” state when it comes to employment, which means that employers can set working conditions, including mandatory vaccinations. The general rule is that employers can terminate an employee or reject an applicant for refusing to be vaccinated. Employers do not have to offer accommodation that would present an “undue hardship” to the employer.

There are a couple of exceptions for employers subject to the Americans with Disabilities Act (ADA) and Title VII of the Civil Rights Act of 1964. If an employee has a medical reason or sincerely held religious belief that prevents him or her from being vaccinated, the employer must offer reasonable accommodation to continue to work.

The accommodation can vary depending on the work environment. Some employers may continue to offer on-site work, but in an isolated location. In an office-based work environment, remote work could be an option.

Under the ADA, an employer may exclude an employee from the workplace if the employee’s presence is a “direct threat to the health or safety of individuals in the workplace.”

To determine whether a “direct threat” exists, the employer assesses the following four factors: the duration of the risk, the nature and severity of the potential harm, the likelihood that the potential harm will occur, and the imminence of the potential harm.

An airborne, highly contagious virus like COVID-19 is likely to meet this test. It’s up to the employer to assess whether the employee has rights under any other laws prior to taking any additional adverse action.

Beside keeping the workforce population healthy, Wilson said vaccinations are important for customers too. Wilson said business leaders who want to have their employees vaccinated should make efforts to educate employees and help employees get vaccinated, either by planning to have vaccinations onsite or helping them arrange appointments to get vaccinated. Educating faith leaders is an important way to reach rural Arkansans and overcome cultural and linguistic challenges in the workforce.

ACHI, the Arkansas Municipal League and the Arkansas Department of Health have presentations about the pandemic and the vaccines to help educate leaders in the private and public sectors including faith leaders and business leaders.

“Local community pharmacists and local physicians would be helpful in educating and making employees aware of the advantages of getting vaccinated,” Wilson said.

Until COVID-19 vaccinations receive full licensure by the U.S. Food and Drug Administration (as opposed to the current emergency use authorization status), employers are unlikely to require vaccination. Education and encouragement are what many businesses are offering now. Nudges for vaccinations such as incentive payments or gift cards of varying amounts, while others are offering additional leave time or incorporating vaccination into their wellness programs. Regardless of the type of incentive, employers will need to assess the potential for discriminatory effects associated with the incentive, just as they would a vaccine requirement.

Additionally, other businesses (for example concert venues or cruise ships) might require proof of immunization as part of the ticketing process.

In the weekly briefing on the pandemic, Gov. Asa Hutchinson said while local pharmacies and hospitals are trying to plan ahead regarding the best ways to distribute the vaccine to a broader group of people when the additional phases of availability begin, he noted that planning is currently constrained by supply. He added the state is working towards a balance of efficiency and equity, to make sure rural areas have an equal amount of vaccine availability compared to urban areas.

Wilson holds a doctorate and masters in public administration and works at ACHI, which is an independent, nonpartisan health policy center in Little Rock.

Wilson holds a doctorate and masters in public administration and works at ACHI, which is an independent, nonpartisan health policy center in Little Rock.

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