Study Links Paid Sick Leave and Higher Vaccination Rates

December 1, 2022

Pandemic paid sick leave expired in December 2020, leaving the U.S. without a national paid sick leave program. A new study published in Health Affairs, co-authored by Drexel University and Boston University School of Public Health researchers, finds that vaccination rates may be 17 percent higher in cities with paid sick leave policies compared to cities without such policies. 

ALINA SCHNAKE-MAHL; as5494@drexel.edu 
    Schnake-Mahl is an assistant professor in the Urban Health Collaborative and the Department of Health Policy and Management at Drexel University’s Dornsife School of Public Health. 

JULIA RAIFMAN; jraifman@bu.edu
    Raifman is an assistant professor of health law, policy and management at Boston University’s School of Public Health.

Schnake-Mahl, a co-author of the study, said: “We found a 17 percent difference” in vaccination rates between cities with and without paid sick leave policies. “It’s not just how progressive a city is,” Schnake-Mahl said. “Paid sick leave correlates with higher vaccination rates,” even after the group is controlled for various factors that could otherwise account for differences in vaccination, such as political context. 

Researchers also found “the strongest impacts” of paid sick leave policy “in the most socially vulnerable neighborhoods.” (The group used CDC measurements for social vulnerability.) Regardless of whether a city has paid sick leave or not, socially vulnerable neighborhoods have lower vaccination rates. But Schnake-Mahl emphasizes that in cities with a comprehensive paid sick leave policy, the authors found a “smaller gap in vaccination between the least and most socially vulnerable neighborhoods”––meaning that the policy also works to lessen the disparities within cities. 

Raifman, another co-author, added: “We’ve identified paid sick leave as a really important policy” for people with low wealth––people who are “living paycheck to paycheck, with little flexibility to meet immediate needs when they miss work due to illness. In my prior work with the Urban Institute, we found that when people reported missing work due to Covid illness or caregiving, they also reported food insufficiency. Paid sick leave is a policy that helps people avoid a health and an economic hit.

“People with the lowest income and lowest wealth, who most need paid sick leave, are also the least likely to have it. It’s really important that paid sick leave policies cover low-income, self-employed and part-time workers. The policy benefits all of society. Employers may look at it and see the upfront cost, but it is associated with a preventative benefit” by allowing people to get vaccinated more easily. And vaccination then reduces the risk of long Covid and the duration of illness, which both disrupt workers’ ability to go back to work.