COVID Update: With requirements rolling across the country, I called a company that implemented vaccine requirements last month.

Here is the experience & lessons for the rest of us. 1/
Background first. The company is based in the Midwest with 6000 people.

The workforce has salaried, factory workers and service center workers.

Their starting point was 70% of the staff vaccinated.

The CEO announced that by 10/1 everyone needed to be vaccinated. 2/
The first reaction was a 10% reduction in their employee satisfaction surveys— the first reduction in the history of the company.

Some people were quite upset. So the CEO began to try to understand people’s reasons for being unvaccinated & their objections. 3/
He asked trusted people in the company (but never a person’s boss) to call and offer to consult with people who were unvaccinated about the decision.

Themes emerged about why & 90% of the time, the reasons were NOT a strongly held concern about the vaccine. 4/
The most common answers people gave.

“It was inconvenient”
“I’ve been on the fence”
“I’m young/not at risk/have had COVID”

One of the most common was:

“Other people were getting vaccinated so I didn’t feel like I needed to” 5/
As we crept into September, the percentage of people vaccinated climbed from 70% to where they are today— 95%.

The vast majority of people needed a nudge & got vaccinated without protest. A lot of feedback was they felt good about the decision. 6/
The remaining 5% of the company gave a single word most commonly for why they say they won’t get vaccinated.

“Freedom”— the 5% don’t want to be coerced into putting something in their bodies. They expressed few concerns about vaccines or side effects. 7/
The CEO talked to the company explicitly about one of their company values.

“None of us individually are more important than all of us.”

He told people that he didn’t want to lose them, but that if they weren’t in alignment over this, they were free to find a new employer. 8/
He relayed a conversation he had with 1 person who said they didn’t believe the risk of a side effect was high, but that he wanted to make the choice himself on principal.

He seemed to understand why the company was making the decision it was.9/
And the company in return was completely understanding that the person would need to look for new work as a consequence of his decision not to be vaccinated.

And that’s what he will be doing. 10/
The CEO told me he has too many employees with kids who have had cancer & have elderly parents at home to respect the concern every individual over all the people in forced difficult situations.

Not a close call. 11/
As it stands today, the company may lose as many as 300 people. People who have put years and blood & sweat into building this company (which has invented technologies to prevent cancer).

The CEO desperately hopes many more come on board before the end of the month. 12/
He has asked for my help in communicating to people about the virus along the way & again today. Here’s what I glean from this situation and other things I’ve learned along the way. 13/
1. Requiring a COVID vaccine falls into the same category as many things we ask of people at work— take a drug test, stay home when you’re sick, don’t harass other people.

This policy has plenty of precedent & is quite reasonable. 14/
All changes are disruptive and need to be explained to people. Start with the “why” not the “what” or “how.” It’s ok to be firm about a strongly held belief, rooted in your values, even if others don’t agree. 15/
Many people simply don’t care very much and will get vaccinated— maybe the majority. They have logistical concerns— time off, transportation, etc. Make it easy. 16/
Be willing to listen & talk to people 1:1 if need be. Make them feel heard. Ask them who they trust for information. Get reliable information to them through those sources when possible. Provide the source for answers to their questions. 17/
You will not get everybody. That’s impossible. It is possible to treat everyone respectfully and make every effort to provide them information to make an informed decision. 18/
This is not a popularity contest. Some people are going to be unhappy. Other people are going to be able to live. These are called decisions and not making them is making them in favor of fear of the loudest voice. Don’t do that. 19/
People who are deeply entrenched in not getting the shot often state that they don’t know anyone or many who are getting the shot. The echo chamber has an impact.

If you know someone who isn’t vaccinated, it’s a pain, but talk to them. 20/
Do it because you care about them.

There is someone we know who wanted to get vaccinated but his wife was opposed. We have been trying to persuade him. He was afraid of the marital strife.

He’s now hospitalized. He got it from her. 21/
The investment in time & effort to understand his issues & concerns felt really idiosyncratic. At the time I wondered if talking to him was worth the effort. If he wasn’t in the situation he’s in now, I’d be less likely to say it makes sense to have this meddling convo. 22/
It can all be so exhausting. But vaccines without vaccinations is going to land us where we are— an embarrassment of resources & the world’s ongoing hot spot. 23/
Lose a friendship. Lose an employee. Lose some popularity.

Life will have losses. But be willing to lose a lot of things before being willing to lose lives that we don’t have to lose. /end

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More from @ASlavitt

15 Sep
COVID Update: There is an amazing array of efforts, some not very visible, to tackle COVID.

If you want to know how COVID plays out, the variables are here. But there’s the fatal flaw: us. 1/
I can try to classify many of the efforts to address COVID as now (high impact progress we are working on now), med term (things underway but not immediate), and long term (potential big game changers). 2/
The now items are critical to saving lives today & reducing the odds of future variants.

Number one on that list is to vaccinate the majority of the globe by the first quarter. 3/
Read 25 tweets
12 Sep
This chart is interesting.
What it says is that Delta is spreading within households (that’s what Secondary Attack Rate means) at the same level as peak flu season.
Note the increase over last September.

It implies at least 3 things we should try to understand better. 1/
First, kids are getting COVID at school and infecting family members.

Policies preventing schools from protecting kids are failing the entire family including seriously at risk adults. 2/
Second, household infections are going to grow over the Fall and early Winter without more layered interventions. 3/
Read 4 tweets
12 Sep
COVID Update: Watching the reactions & meltdowns to the proposal that Americans are required to get vaccinated (or tested) to be around others.

There is so little actually controversial here but the sideshow is first rate. 1/
Real people by large majorities support vaccine requirements. We’ve had them for decades, even centuries with little controversy.

No governor has threatened to light himself on fire & blow himself up (until now). 2/
Like traffic lights, as inconvenient as they sometimes are, people are pretty ok with rules if they do things like keep kids safe, reduce deaths, and allow businesses to be open safely. 3/
Read 20 tweets
9 Sep
COVID Update: After recent FDA approval, society is moving towards, requiring vaccines at a rapid pace.

And that’s about to get another jolt. 1/
Over 5.5 billion vaccines have been administered around the world. Think about this from a safety standpoint. Rare things happen when they occur a few times per MILLION. So we’ve seen it all.

At this point the safety record would have to be called impeccable. 2/
Over 5.5 billion shots, given to people of all ages & health, you would expect everything to occur. Yet there are only very modest & rare adverse events.

Even anti-vax strategies seem to acknowledge this reality. 3/
Read 20 tweets
7 Sep
COVID Update: How big a problem will future variants be?

I got an update from several top scientists. 1/
Quick review. Viruses continually mutate but can only mutate when they replicate. And so far we’re giving SARS-CoV-2 plenty of opportunities to replicate. 2/
Most mutations aren’t worth noting. They don’t increase hospitalizations. They don’t increase infectiousness. And they don’t cause problems for prior immunity. 3/
Read 26 tweets
4 Sep
COVID Update: Over the long term the US could be among the countries with the highest cases, greatest risks of outbreaks, and largest home to new variants.

With people refusing vaccinations here, the globe is lapping the US very quickly.

1/
We’ve now given out 5.4 billion shots across the globe.

45 countries, almost all of whom began well after the US, have now fully vaccinated more of their population than the US. 2/
Our low vaccination rates relative to the globe has put the US up there with 3-4 mostly unvaxxed nations as a leading hot spot.

And because of our lower vaccination rate, unlike other early vaccinated countries like Israel & the UK, US death rates are 2-3x higher. 3/
Read 16 tweets

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