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Swine Flu Vaccine for Some; for Everyone Else, Theres Prevention

October 13, 2009
Related Topics: Benefit Design and Communication, Health and Wellness, Featured Article, Compensation
The prevalence of H1N1 flu, which the Centers for Disease Control and Prevention labeled a pandemic earlier this year, has stirred concerns among employers. But since first doses of the vaccine to prevent swine flu will go to high-risk groups, most employers stand at the back of the line when it comes to providing employees with inoculations.

That has made prevention the best cure for employers that are worried about office outbreaks.

“We’ll have to wait until the government says ‘You’ve administered to all the biggest risk groups. Now you can give it to healthy employees,’ ” says Richard Penington, president and CEO of Summit Health, a flu-shot provider based in Southfield, Michigan.

The seasonal flu shot, which is also in high demand and short supply, does not treat the H1N1 strain, health officials say.

Health plans and flu experts are working to answer questions about the flu and the availability of the vaccine, but there are simple steps employers can take to keep their workforces healthy. At the top of the list is what could be called the schoolmarm’s golden rule: If you have to cough, cover your mouth. And don’t forget to wash your hands.

When doctors say “Wash your hands,” this is what they mean: Take a quarter-sized dollop of antibacterial soap and wash while singing “Happy Birthday,” twice. That will be the 15 to 20 seconds required for thorough cleaning.

“It’s common sense, but a reminder doesn’t hurt,” says Wendy Morphew, a spokeswoman for Aetna, one of the health care benefits companies that is providing members with information on flu prevention.

Companies that want to do more can provide antibacterial hand sanitizer and direct employees to information, available on the CDC’s Web site and from health plans, on topics including good office hygiene, the risk of getting swine flu, its symptoms, guides on whether to come to work when sick and an explanation of why employers are last in line when receiving the vaccine. (Links to the CDC’s site for employers and other information sources can be found in the sidebars to this story.)

Flu facts
Despite widespread concern about the H1N1 virus, swine flu is less lethal than seasonal flu, which kills about 36,000 people in the U.S. annually, with most victims being more than 80 years old. About 4,500 people worldwide have died from swine flu so far.

Swine flu, although relatively mild, is easily spread from human to human through the coughing and sneezing of infected people. Thanks to that ease of transmission, swine flu is widespread in 37 states, health authorities say. That’s on top of the presence of seasonal flu.

Unlike the avian flu of several years ago, which was not easily spread but was deadly, the swine flu pandemic has not necessitated workplace measures such as restricted travel, office shutdowns or the barring of workers thought to be ill from coming to work.

“Our social distancing and gate screening would happen based on severity of the illness,” says Michael Taylor, medical director for health promotion at Caterpillar in Peoria, Illinois. Still, the company’s pandemic preparedness team has begun to meet regularly now that the flu season is under way.

Most people who are infected with swine flu experience nothing more than usual flu symptoms—aches, fever, cough, sore throat and a runny nose. Employers are advising employees with symptoms to stay home.

“What we tell associates is if you have the symptoms of the flu, if you think you have the flu or you know you have the flu, obviously we do not want you to report to work,” says Stephen Holmes, a spokesman for Home Depot in Atlanta. “If you have H1N1 and that’s been confirmed by the physician, you need to be cleared by your physician to come back to work.”

Employees whose employers do not offer paid time off or sick days will likely be protected from losing their jobs by the Family and Medical Leave Act if they do take time off because of swine flu, says Tom Klett, a consultant at Watson Wyatt Worldwide who focuses on leave and disability issues.

Hoping to avoid sickness, and concerned that employees will take time off if they do get sick, many employers— especially those like UPS and Home Depot whose employees interact with the public—have tried to line up H1N1 flu-shot clinics.

“We are certainly going to look at options to provide it to associates, as we do the seasonal flu [vaccine],” says Holmes of Home Depot.

Health officials say it is unclear whether and when the vaccine will be available for work-site flu clinics. State health officials in New York said their first doses were going to hospitals, local health departments and federally qualified health centers.

“We want to make sure vaccine gets to those who are most at risk,” says Claire Pospisil, a spokeswoman for the New York State Department of Health.

Those organizations that receive the vaccine must sign an agreement that they will provide the shots to those considered at risk, Pospisil says. That group includes pregnant women, people who live with or care for children younger than 6 months, health care and emergency medical services workers, people ages 6 months to 24 years, and people ages 25 to 64 who have chronic health disorders or compromised immune systems.

Workers who are not employed by health care organizations are generally not considered at high risk of getting the swine flu.

While the cost of the vaccine is being covered by the federal government, the cost of administering the shot will fall to self-insured employers and insurers.

For smaller businesses that are fully insured, Aetna, Cigna and other health plans say they will cover the cost of the administration, in most cases, and that individuals will not have to pay any out-of-pocket costs.

“Because this is a pandemic and there is a national effort, and to the extent we can reduce the spread of disease, we have liberalized our coverage policies,” Aetna’s Morphew says. “For fully insured customers who do not have preventive coverage, we will cover administration for all our members.”

Self-insured plans, which are set up to pay for their own medical services, will automatically be billed for the flu shots—around $20—unless they opt out, insurers say. For instance, self-insured employers who are customers of Cigna had until October 9 to opt out, spokesman Mark Slitt says.

In the meantime, health experts say, good office hygiene should be enough to keep low-risk workers healthy. If that fails, though, employers might be forced to turn to their pandemic preparedness plans, requiring workers to stay at home and avoid travel, says Klett of Watson Wyatt.

“Right now it’s a concern, not a crisis,” Klett says. “If some employers started getting hammered [by sickness], I think you’d see many employers respond differently.”

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