Guide to Vaccinating Workers
Workers, who are vital for keeping necessary services and resources open and available, should continue to be a focus of COVID-19 vaccination efforts, especially as vaccine availability increases. Likewise, specific outreach to worker populations may be an effective way to increase vaccine uptake in populations with lagging vaccination rates. However, jurisdictional vaccination programs may not have experience engaging with workers and employers. This 10-step guide is intended to help jurisdictions identify and quantify sub-populations of workers and create a specific plan to arrange locations, providers, and supplies to vaccinate them. A well-prepared plan can help you monitor progress and make changes as necessary. This guide also includes links to resources from CDC and trusted partners.
10 steps to vaccinate workers
1. Identify which group(s) of workers need additional outreach.
- Start by considering which workers have previously not been eligible for vaccination or have been prioritized but have lower than expected uptake. For example:
- Healthcare workers
- Veterinarians and support staff
- Healthcare staff in the community
- Frontline workers
- Grocery store employees
- Retail workers
- Food systems workers (e.g., agriculture, food processing, fishing, migrant workers)
- Other service workers
- Seasonal shift workers
- Healthcare workers
- Use the Interim List of Categories of Essential Workers Mapped to Standardized Industry Codes and Titles to identify industries with workers who may require additional outreach.
- Data from the Behavioral Risk Factor Surveillance System identifies influenza vaccine prevalence by industry and occupation. Consider using this data to help target industries with workers who historically may have a low vaccine uptake.
- Prioritization for vaccination within a workplace should not be done by work arrangement (e.g., permanent, temporary, contractor).
- Additional resources for identifying worker populations include:
- State Health Department Occupational Safety and Health Contacts, who may be able to help jurisdictions provide vaccination services for workers and can offer guidance on other worker-related issues
- State Departments of Agricultureexternal icon and/or Association of Food and Drug Officialsexternal icon (AFDO), who may also be able to help with identification of workers (and other steps) for food systems and agriculture industries. The U.S. Department of Health and Human Services’ Tiberius platform includes suggested prioritization for S. Food and Drug Administration-regulated facilities.
2. Estimate how many essential workers are in your jurisdiction.
- Use existing data sets to develop estimates.
- Review this map and accompanying data to find the approximate number of workers in each state by Advisory Committee on Immunization Practices worker category. Change the filter to see your state. Note that these counts exclude self-employed workers and some other groups, such as unpaid family members and certain farm and domestic workers.
- Estimated numbers of workers in broader industry categories are available by countyexternal icon from the Bureau of Labor Statistics.
3. Connect with employers.
- If you are not sure who these employers are or how to get in contact with them, others in your state, city, or county may be able to help:
- For food systems and agriculture workers, the Departments of Agricultureexternal icon and/or AFDOexternal icon or state food and drug officialsexternal icon may be able to provide connections.
- Local chambers of commerceexternal icon may be able to help you connect with small businesses. Refer to Working with Small Businesses to Get COVID-19 Vaccinations for Essential Workers for more tips.
- Local and regional Occupational Safety and Health Administration officesexternal icon may be a resource for identifying businesses in your jurisdiction.
4. Promote vaccine confidence among employers and workers.
- Use the COVID-19 Vaccination Communication Toolkit for Essential Workers to help employers build confidence in these important new vaccines. The toolkit contains materials to help employers across various industries educate their workforces about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.
- Share the Workplace Vaccination Program page with employers. It has more information to raise awareness among employees and offers suggested practices and policies employers can implement to promote vaccination.
- Use CDC’s Vaccinate with Confidence framework for COVID-19 vaccines as a guide on how to build vaccine confidence at the jurisdiction level.
- For health systems, share the toolkit How to Build Confidence in COVID-19 Vaccines: A Short Guide for Immunization Coordinators in Medical Centers and Clinics.
5. Identify locations where workers can be vaccinated.
- Use the decision tree in the COVID-19 Vaccination Program Interim Playbook for Jurisdictions Operations Annex to help identify locations to vaccinate workers. The best location may vary depending on the working population. Some options include
- Existing workplace clinics
- Employer-run temporary vaccination clinics at the workplace
- Mobile vaccination clinics
- Temporary vaccination clinics set up at community location (closed or open to the public)
- Personal healthcare providers or community clinics
- Consider providing more direct access to vaccination through on-site vaccination clinics in occupational settings or mobile vaccination units that travel within communities or rural areas for select worker populations who require more intense outreach
6. Identify appropriate vaccination providers.
- Options beyond health department and pharmacy staff may include:
- Company occupational/employee health staff
- Local, non-company-based occupational health professionals
- Healthcare personnel from community clinics/health systems/home health agencies
- Volunteers/Medical Reserve Corpsexternal icon
- Emergency medical services providers, as allowed by law
7. Consider important factors when implementing vaccination clinics.
- Consult the following sections of the COVID-19 Vaccination Program Interim Operational Guidance Jurisdictional Operations:
- Refer to the Guidance for Planning Vaccination Clinics when planning clinics held at satellite, temporary or offsite locations.
- Make sure vaccination providers prepare to manage potential anaphylaxis after vaccination.
- Discuss Implementing a Workplace COVID-19 Vaccination Program with employers.
- If an employer chooses to run a vaccination clinic, they must enroll with their jurisdiction immunization program as a vaccination provider and must train staff appropriately or engage an enrolled vaccination provider. They must also have sufficient physical space to keep 6 feet of distance between workers during vaccination and during the observation period following vaccination. If an employer cannot offer COVID-19 vaccination on site or does not have a suitable location for a vaccination clinic, they should encourage employees to seek COVID-19 vaccination in their community and provide them with information about where they can get vaccinated.
- Include input from management, human resources, employees, and labor representatives, if present.
- Also refer to the National Institutes of Health’s Key Elements of a Model Workplace Safety and Health COVID-19 Vaccination Programexternal icon.
8. Provide a supportive environment for workers to get vaccinated.
- Encourage employers to remind workers they are entitled to vaccination regardless of their immigration or health insurance statusexternal icon.
- Consider reducing administrative paperwork where possible and collecting only the personal information needed for vaccine administration documentation and reporting. Encourage employers to be transparent about how that information will be used.
- Promote equitable access to vaccines (for example, by setting up clinics near public transportation to overcome transportation barriers). Vaccination clinics should also offer convenient hours for all workers (including shift workers) and be equipped to meet the needs of a wide variety of worker populations. This includes being able to communicate in languages other than English and providing educational materials tailored for different literacy levels.
- Encourage employers to be flexible in their human resources policies—for example, by allowing employees to get vaccinated during work hours or offering paid leave for employees who seek COVID-19 vaccination in the community. Employers should consider offering flexible leave policies for those who may have post-vaccination symptoms. They are also encouraged to support transportation to off-site vaccination clinics.
- Encourage employers to provide easy access to vaccination for all people working at the workplace, regardless of their status as a contract or temporary employee.
- Encourage employers to stagger employee vaccination to avoid potential worker shortages due to vaccine side effects. Refer to CDC guidance on post-vaccination considerations for more details.
- Allow time for vaccine confidence to grow. Workers who are hesitant at first may become more confident after seeing coworkers get vaccinated. Employers with an on-site clinic should offer more than one opportunity for vaccination. Mobile clinics can return to a work site multiple times on a rotating schedule. Employers using community locations can provide supportive policies, such as paid leave or transportation support, for an extended period.
9. Continue to monitor vaccine uptake.
- Measure vaccine uptake by including questions about worker status/group in vaccination registration and/or reporting systems.
- Track the percent of the worker population(s) identified in Step 2 who register for, receive, or decline vaccination.
10. Evaluate your processes and make needed changes.
- Conduct training, site visits, and other oversight measures to maintain or improve vaccination providers’ adherence to jurisdiction requirements (refer to COVID-19 Vaccination Program Interim Playbook for Jurisdictions Operations Annex). Site visits, in particular, are key opportunities to further develop and strengthen relationships with enrolled vaccination providers.
- Invite feedback from key partners and create opportunities for jurisdiction staff to reflect on current processes and discuss how they might be improved. Identify barriers to implementation, including vaccine hesitancy, and take specific actions to address each one.