How plan sponsors can deal with measles in the workplace

Employers already know that a healthy workforce results in a productive workforce but what if a workplace is infected with measles?

That’s why Ajit Sohal believes plan sponsors need to rethink how they approach immunization, especially with the resurgence of vaccine-preventable diseases like measles. While many employers may offer health benefits, there's a critical gap in how outcomes are monitored and measured. He argues that workplaces should exceed the general population in terms of health standards, particularly when it comes to immunization.

“Your workplace ecosystem should be healthier than the general population,” said Sohal, clinical assistant professor at the University of British Columbia and founder of immunize.io, emphasizing that vaccination is a clear and effective way to achieve that goal. Additionally, the cost burden of illness is often absorbed not by the healthcare system, but by the employer through absenteeism and reduced output.

“If employees are healthy, they’re productive, which is good for our economy. And at the same time, it reduces downstream costs for taxpayers,” he added. “It’s a win for everyone.”

Cases of measles continue to climb across the country. In Ontario alone, as of June 3, the province reported a total number of 2,009 measles cases. Cases have also been climbing by the hundreds over the last month, with three-quarters of cases in unvaccinated children, according to Public Health Ontario.

Additionally, last week, a premature baby contracted measles in utero from their unvaccinated mother, which resulted in the first fatality from the outbreak.

Sohal acknowledged that measles can affect anyone, but those without vaccination are especially at risk because they lack the necessary antibodies to fight off infection. He identifies two highly vulnerable groups; individuals with compromised immune systems, such as those who are pregnant, undergoing cancer treatment, or taking immune-suppressing medications and infants under 12 months old.

Sohal warns that measles poses a serious threat due to its extreme contagiousness capable of spreading from a single case to up to 18 others, with the virus lingering in the air for hours.

“You need very high vaccination rates, like over 95 per cent and that needs to be sustained,” he said, stressing the importance of consistent immunization efforts to prevent resurgence.

He draws a sharp contrast between the initial surge of employer-driven vaccination campaigns during COVID-19 and the lack of follow-through afterward.

“There was this sort of perceived fatigue, not necessarily about the vaccine but more of just talking about it,” he said. “I think a lot of employers really were supportive and in ensuring their staff were vaccinated for COVID. There was a whole sort of workplace health initiative behind it, but it was that one thrust. Then after that, we kind of washed our hands of it.”

He asserted that managing vaccine-preventable diseases requires long-term commitment, not short bursts of action, urging employers to treat immunization as a continuous responsibility rather than a temporary campaign.

For Sohal, vaccinations should be embedded within a broader, evolving health strategy. One that adapts to changes in age, medical conditions, and life circumstances. He noted that even basic immunizations like tetanus or diphtheria are often neglected over time.

 “We’ve got to be constant with it in order to get the full benefit,” he said.

Sohal believes employers need to take a two-pronged approach when it comes to measles prevention in the workplace. First, they should encourage employees to confirm their immunization status. This basic step, he argues, is the easiest and most immediate way for companies to protect their workforce.

 “Check your vaccination status, check your records, talk to your doctor, talk to your pharmacist, and make sure that you’re up to date,” he said. “That's the low hanging fruit that employers can do.”

But he also pushes for a more strategic view that goes beyond measles alone. He pointed out that many adults fall through the cracks when it comes to routine immunizations, simply because no one follows up after childhood.

 “Most people are aware and have received their vaccinations in childhood, but as an adult, no one’s following up with us,” he said. “Plan sponsors can certainly support employees through benefits programs by covering recommended unfunded vaccines.”

These “recommended unfunded” vaccines, he explains, are backed by the National Advisory Committee on Immunization (NACI), a panel of infectious disease experts that evaluates population-specific needs. One example is the shingles vaccine, which NACI strongly recommends for adults aged 50 and older.

“The average cost for one case of shingles has been modeled to be about $1,500,” he said, noting that this age group makes up a significant segment of the workforce.

However, despite the recommendation, most provinces in Canada don’t cover the shingles vaccine for working adults. While Ontario covers the vaccine for those aged 65 to 69, British Columbia and Alberta don’t cover it at all, he highlighted, adding that Prince Edward Island may be the only exception for those under 65.

“The long-standing assumption from plan sponsors has been that vaccines are covered by the government, but that's not the case,” he noted. “That’s not the case but progressive coverage plans are covering vaccinations and progressive workplaces are not only covering these vaccines but are also facilitating on site clinics or through partner pharmacies, various outlets to make sure people actually get these vaccines.”  

Sohal suggests that if employers are going to bring vaccination services into the workplace, they should think beyond one-off efforts, and have regular cadence instead, suggesting recurring immunization offerings during key times like flu and respiratory seasons.

He also encourages plan sponsors to treat on-site vaccination as an ongoing part of workplace health, not a reactive measure.

“Just because you have it covered in your benefits plan doesn’t mean it’s going to have an actual benefit to the employee unless that shot goes in their arm,” he added.

He argues cost shouldn’t be a deterrent for including vaccines in employee benefits plans. He pointed out that while some may worry about premium increases, the reality is that vaccine expenses are minor compared to other health-related costs.

Consequently, he argues that the return on investment is substantial, especially when considering the alternative. For instance, a shingles case could lead to missed workdays and additional medication costs covered under drug plans.

“It may be a small incremental cost, but it’s nothing as major as we see with other benefit planning costs,” said Sohal.