When news of the successful Covid-19 vaccine trials began to surface last year, my senior staff and I were elated. As the CEO of a large nonprofit that provides health care, social services, and housing to LGBTQ people, we had remained open throughout the pandemic. Although many services were available online, hundreds of our frontline workers — doctors, nurses, security and facilities staff, housing managers, youth services personnel, and more — continued to come in daily, putting their lives on the line to help those most in need during the pandemic.
So the minute most of our staff were eligible, they rushed to get the vaccine. Our own clinic vaccinated scores of them. Still, as was true in the population at large, some chose not to get vaccinated. Their reasoning was a reflection of what’s going on in the broader society: Is the vaccine really safe? It seems like they rushed through the approval process. Shouldn’t they have taken more time to test it? I have a friend who got the vaccine and got really sick.
Like many organizations across the country, we grappled with whether to require employees to get vaccinated against Covid-19. Our journey — and our recent decision to require vaccines as a condition of employment — may provide lessons for other nonprofits wrestling with this issue.
Once the vaccine started to become widely available, my senior colleagues and I at the Los Angeles LGBT Center began discussing a plan to bring people back to the office and resume in-person services that had been suspended or gone virtual. As an employer of nearly 800 people, this was no small task. Almost immediately we came up against this question: Should we require all staff to get vaccinated? And then the inevitable follow-up: If some staff members refuse to get vaccinated, would we be willing to draw a line and say we would no longer employ them?
This was a more complicated question than might first be apparent. Like other employers, we were considering a hybrid approach for returning to work. For those few people who could continue to do their jobs from home, it could be argued that there was little rationale for a vaccine requirement. For others, if they refused to get vaccinated, was it possible to find a way to accommodate them?
For the senior staff, many of the considerations raised essential questions about equity. How do we justify requiring vaccinations for people who must do their jobs in person because of the nature of their work — direct health services, maintenance, security, and housing support — but not apply the same rules to those fortunate enough to have jobs they could do from home? This was not just an intellectual exercise, given that across all fields white collar, higher-paid workers were most likely to work from home during the pandemic.
Sticking to Our Values
Other concerns centered on the nature of our work. How could an organization that advocates for civil liberties protections for LGBTQ people require employees to undergo a medical procedure they didn’t want? This was a bit easier to answer. We already have such requirements. For example, all staff must take a TB test. Anyone who works with youths must go through a background check. While we are careful to respect a staff member’s personal integrity and civil liberties, we are committed in certain instances to requirements that protect the health and safety of the larger community.
In short, public health overrides many of those concerns, particularly since some of our clients, due to lack of access or social and economic barriers to health care, may not be vaccinated. If our own staff is unvaccinated, we expose our clients to unnecessary risk — a risk we simply cannot take.
After conversations with hundreds of staff — one-on-one, in small groups and department meetings, and in formal and informal sessions led by our medical staff — we concluded that a fully vaccinated work force was the right policy for our employees, clients, and the health of our community. These conversations confirmed for us what we suspected: the vast majority of our staff agreed this was the right decision.
On June 15, we announced that for everyone’s safety, vaccines would be required as a condition of working at the center. All staff would need to provide proof of vaccination by July 15. Those who could not be vaccinated because of, say, an underlying medical condition confirmed by a doctor, were asked to contact human resources staff to discuss whether reasonable accommodations were possible.
Nine People Quit
As we approached the deadline, many who had been hesitant changed their minds and got vaccinated. By July 15, all but 12 of our staff were vaccinated. The three who had letters from their doctors advising against the vaccine, but who also had jobs that could not be done from home, were placed on unpaid leave with the hope that they’ll be able to get the vaccine soon and return to work. The remaining nine, who either hadn’t provided a letter from their doctor or had asserted religious objections, chose to leave their jobs rather than get vaccinated. Providing reasonable accommodations was not feasible for any of them since their jobs could not be done from home.
We were saddened that nine people chose to leave rather than protect themselves and others by getting the vaccine. But as a public health organization, we felt it was necessary to stand behind the facts: Vaccines are safe and effective. This was not a decision taken lightly. We spent months looking at this from every perspective. Our final decision was guided by the overwhelming scientific evidence about the safety and efficacy of the vaccine and the belief that public health must come first.
Something of a turning point came when we looked at this decision in the broader context of the past year. In the early months of the pandemic, we knew so little about how the virus spread. But we also knew that we needed to continue serving our community — and in many cases, that meant in person. Our medical personnel continued to treat people. Our housing staff continued to create safe living environments for homeless youths and affordable housing for seniors. Our facilities and security staffs came in every day to keep our buildings safe and clean.
They all continued to do their jobs despite the risk and with no vaccine or cure in sight. Now that a safe and effective way to keep people healthy was available, how could we not use every tool at our disposal to make sure the risks taken months earlier were not in vain? How could we look clients in the eye if we weren’t absolutely certain we had done all we could to ensure their safety when they interact with our staff? And if we didn’t do everything possible to protect people, how could we keep faith with those who put so much on the line in the early days of the pandemic when there were no alternatives?
This wasn’t an easy decision, but it was the right one. When more of us are vaccinated, our lives can return to some semblance of normalcy. In the meantime, we will continue to do whatever it takes to keep our staff, clients, and community safe as we navigate the continuing challenges of a deadly virus.
