The impact of voluntary COVID-19 vaccinations on the area workforce was the topic of an online Zoom webinar Tuesday morning, May 4, hosted by the Brainerd Lakes Chamber of Commerce.

"We want to get open. We want to reopen and we want to stay open," Chamber President Matt Kilian said.

Kilian was especially focusing on the hospitality industry, which remains under state-imposed limitations.

"That not only impacts our tourism businesses, but our entire economy," he said.

Webinar speakers included Michelle Moritz with Crow Wing County Public Health; Jeri Seegmiller with Cass County Health, Human and Veteran Services; Essentia Health Chief Medical Officer Dr. Peter Henry; Lakewood Health Systems Chief Medical Officer Dr. Christine Albrecht; Cuyuna Regional Medical Center Chief Medical Officer Dr. Robert Westin; attorney Tom Revnew with PRK&A Law; Kristi Westbrock with CTC; and Merrick Dresnin with Grand View Lodge and the Cote Family Companies.

Speakers suggested that COVID-19 vaccinations could prevent worker shortages caused by exposure to the coronavirus and subsequent quarantines, especially among families with multiple children.

"If you are vaccinated and exposed, you don't have to quarantine," said Albrecht. "That's the nice part of this. If they're vaccinated, your workforce can still stay working. If you're not vaccinated and your child gets sick with COVID, then you have to be quarantined from the time your child became sick for 14 days after. If another child gets sick after, you could start the whole thing over again. You could have employees out for months if they have enough kids who get sick in sequence."

"I don't know of a business that can afford to lose employees right now," Kilian said. "Our message at the chamber is to maintain safety measures, but strongly consider the vaccine. We aren't pushing the vaccine, but this webinar is about vaccine options."

Addressing hesitancy about the vaccine, health professionals said even immunity among survivors of the illness might not be enough.

"It's (vaccination) the only proven strategy we have to get this pandemic under control," Albrecht said. "Immunity from natural illness is temporary. We know it's short-lived and only three to five months for some people."

Information is still coming in, however, early vaccine trial members are still showing high immunity much longer.

As with many other vaccinations, the goal is to get approximately 80% of the population vaccinated for what is called "herd immunity." The concept refers to the point at which there are enough people who are immune to an illness that they serve as a barrier for those who are not immune due to immune issues, inability to receive a vaccination or other reasons.

County data

Moritz and Seegmiller provided COVID-19 data on Cass and Crow Wing counties. Cass County has had 2,649 confirmed cases, 187 hospitalizations and 28 deaths. Crow Wing county has had 6,490 diagnosed cases, 339 hospitalizations and 87 confirmed deaths.

After a recent increase in cases at the end of March and early April, cases are now dropping, especially among the elderly, which may coincide with the vaccination rate of those 65 or older. In Cass County, approximately 70% of the population age 65 and older has been vaccinated.

The March/April surge seemed to impact this age group less than the November peak. In fact, the spring surge seemed to occur within the younger age brackets, which have a much lower vaccination rate, Seegmiller said.

Vaccine efficacy, misinformation

The chief medical officers addressed the efficacy of the vaccine, misinformation and other factors.

Albrecht said trials show evidence of 90% effectiveness, though more anecdotal evidence points to a possibly higher effectiveness. This is especially relevant in nursing homes where vaccination rates are close or have met that herd immunity goal.

"We're seeing vaccinated people just aren't getting sick (in homes)," Albrecht said.

"It seems like we aren't seeing failure of the vaccine, but it's just hitting a different population of people in the counties and states that haven't gotten the vaccine," Westin said.

Albrecht warned there are side effects of vaccination, with the large majority of people only experiencing soreness, fatigue, a mild fever and similar symptoms that last for a few days or less. Younger recipients with stronger immune systems, she said, have stronger responses that may last a little longer; however, those responses indicate a stronger level of immunity to the actual disease too.

Albrecht warned of only two very rare reactions, including anaphylaxis among those who are allergic, and in the case of the Johnson and Johnson vaccine there is a very small chance of thrombocytopenia in a specific demographic. However, she said the vaccines are still very safe.

"The safety of the vaccines is unbelievable," Albrecht said. "It's probably one of the safest vaccines that's ever been developed."

Contrary to popular belief, she said the vaccine has been more thoroughly tested in a large population and for a longer period of time than would normally be required.

Albrecht also warned that without herd immunity, there is a risk of an increase of mutations developing among those who catch the illness.

Henry addressed the issue of misinformation and warned that there is an "infodemic," making it difficult to find reputable information among information being provided by individuals without the necessary backgrounds.

"Please open the conversation with your staff," Henry said. "Getting us back to normalcy of group settings and shopping and getting children back in school is really going to be dependent on many of us getting vaccinated. About 11% of people in Minnesota say they don't think they will get the vaccine and half of them say they will not get the vaccine."

Henry recommended focusing on individuals who are delaying vaccination as opposed to employees who may be entirely unwilling to vaccinate. He suggested getting accurate information may be as simple as talking to your regular health care provider.

"If you have people with questions, ask them to meet with their primary care physician," Henry said.

Speaking on the efforts so far to limit the flow of individuals into the hospital system, Westin compared treatment in the hospital to reservations in a hospitality setting.

"We have X number of beds and X number of people in the hospital," Westin said. "Typically of that percentage some of them are very sick and some aren't as sick and you plan your days and your staffing around that. The problem with COVID is when they get sick with this, they are very sick and they are sick for a long time.

"It takes a lot of resources similar to what maybe a person coming into the hospitality industry that's more of a demanding patient or family wants more of your staff," he said. "If you have more of those in your system, they are really going to take down what you can provide."

Legalities

Revnew addressed the options some businesses have concerning the vaccine, such as what information employers can request about vaccination status, what employers can do regarding vaccination and other issues. He provided the following guidelines:

• Employers can ask whether employees have been vaccinated, though they cannot ask an employee why they have not gotten vaccinated.
• Employers can mandate vaccinations, but they must provide reasonable accommodations for those who choose not to vaccinate due to health or religious reasons.
• Managers should not make a habit of asking employees about their vaccination status unless they are the company's designated person.
• Employers can technically terminate a position for not following a mandate; however, they are recommended to work with employees to find a reasonable accommodation instead or at least to seek legal advice first to avoid complicated legal problems.
• Consider incentivizing vaccination rather than mandating it.

Revnew recommended that if a company plans to ask employees about vaccination status, they should decide as a company and then assign one person, likely in human resources, to be in charge of asking. Any documents provided for incentives or as proof of vaccination should only be given to that person and stored as confidential medical information.
Consolidated Telecommunications Company is one local company that incentivized vaccination by offering a $100 bonus to employees who are vaccinated before Memorial Day. The company came up with the incentive after approximately 30% of employees completed their vaccination. When the company noticed that number plateauing, they offered the incentive and have since reached just over 50% of the workforce.

CTC decided on the incentive because of how many staff members are customer facing and go into customers' homes and businesses.

Revnew warned that while there isn't much guidance at this point pertaining to incentivizing vaccinations, there might be discussions regarding the legality of incentives as they relate to those who cannot get vaccinated due to disability or religion. Again, he recommended working with those who need accommodation.

Requirements changing

There are changes in vaccine efforts now. Age limits are changing with some vaccines now available to those age 16 (with parental consent) and older and an expected expansion to include ages 12 or older soon.

Now that the vaccines are available in larger numbers, county and health care providers are organizing vaccination clinics on site with certain companies, though there must be at least 10 interested individuals. Some smaller businesses are joining with other businesses to organize clinics for their employees.

There are many details still emerging pertaining to the vaccines, including whether boosters will be needed. Additional tests for long-term immunity are being done all the time.

"I don't think the answer is out on that," Henry said. "Most literature I have read has said we will likely require a booster similar to what we get for influenza, but we haven't determined it at this time."

There may also be boosters to provide immunity to new variants, though the current vaccines are proving effective against all the present variants at this time. Another uncertainty is whether this pandemic could become endemic with or without herd immunity.

The difference is that an illness that is endemic will continue to circulate through populations, returning over time and requiring re-immunization. The hope is that a high enough vaccination rate could eliminate the illness or that the virus itself might mutate in a way that it no longer is a problem. However, it is too early to know.

Travis Grimler may be reached at 218-855-5853 or travis.grimler@pineandlakes.com. Follow him on Facebook and on Twitter at www.twitter.com/@PEJ_Travis.