Report Publish Date: November 2022
This journal article describes a study looking at the association between paid sick leave policies and COVID-19 vaccination rates in 37 U.S. cities in 2021.
Among 18- to 64-year-olds, vaccination rates were 17% higher in cities with paid sick leave policies. The authors also found that cities with paid sick leave had narrower disparities between vaccination rates in the least vulnerable neighborhoods and the most vulnerable. Vaccination rates in the least vulnerable areas were 29% higher than those in the most vulnerable areas in cities with paid sick leave policies and 72% higher in cities without paid sick leave.
Having paid sick leave makes it easier for workers to get vaccinated and recover from the side effects of shots. But unlike many other countries, the U.S. does not have a national sick leave policy. Instead, we have a patchwork of state and local policies. And low-wage workers are less likely than higher-paid workers to have paid leave and to be able to use it.
When COVID-19 vaccines became available, it was important to ensure as many people as possible were able to get vaccinated. The authors wanted to know whether city-enacted paid leave policies increased vaccination rates, especially among people living in parts of the city that were most vulnerable to COVID-19 infection.
“We hypothesized that US cities with paid sick leave would have higher COVID-19 vaccination coverage and narrower coverage disparities than those without such policies,” the authors write. They used data from 37 of the largest US cities. Data came from the Centers for Disease Control and Prevention, Drexel University’s COVID-19 Health Inequities in Cities dashboard, and Temple University’s State and City Earned Sick Leave Laws databases. To control for factors that might confound the relationship between sick leave policies and vaccination, the researchers used data from the Census Bureau’s American Community Survey, MIT’s Election Data + Science Lab, and other sources.
“Even in places with paid sick leave policies, there are often disparities in paid sick leave use.”
— Alina S. Schnake-Mahl, Gabriella O’Leary, Pricila H. Mullachery, Jennifer Kolker, Ana V. Diez Roux, and Usama Bilal, Drexel University; and Alexandra Skinner and Julia R. Raifman, Boston University
“To encourage vaccination, reduce disparities in vaccination, and prevent further morbidity and mortality due to COVID-19 and other infectious diseases, Congress and the president should approve legislation to provide paid sick leave to all workers,“ the authors write. “Absent federal policies, states should retract their preemptions of local paid sick leave policies, and cities and states without these policies should consider enacting them.”
Paid sick leave provides workers with paid time off to receive COVID-19 vaccines and to recover from potential vaccine adverse effects. We hypothesized that US cities with paid sick leave would have higher COVID-19 vaccination coverage and narrower coverage disparities than those without such policies. Using county-level vaccination data and paid sick leave data from thirty-seven large U.S. cities in 2021, we estimated the association between city-level paid sick leave policies and vaccination coverage in the working-age population and repeated the analysis using coverage in the population ages sixty-five and older as a negative control. We also examined associations by neighborhood social vulnerability. Cities with a paid sick leave policy had 17 percent higher vaccination coverage than cities without such a policy. We found stronger associations between paid sick leave and vaccination in the most socially vulnerable neighborhoods compared with the least socially vulnerable ones, and no association in the population ages sixty-five and older. Paid sick leave policies are associated with higher COVID-19 vaccination coverage and narrower coverage disparities. Increasing access to these policies may help increase vaccination and reduce inequities in coverage.
Health Affairs, November 2022.
This study and report was conducted and created by the following people.
