Measles Outbreak: What’s an Employer to Do?

By Kathy Gurchiek Feb 19, 2015

​Editor's note: This story was updated Feb. 23, 2015.

The ongoing multistate outbreak of measles in the U.S. is raising questions as to what steps employers can take to keep their workplaces healthy.

Measles are so contagious “that if one person has it, 90 percent of the people close to the person who aren’t immune will also be infected,” said Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases, during a Jan. 29, 2015, press conference.

People don’t always know when they are infectious, she explained, because an infected person can spread the measles—through breathing, coughing or sneezing—before the accompanying rash is evident.

Though measles was declared eliminated from the U.S. 15 years ago because of the nation’s effective vaccine and high vaccination rate, there has been a resurgence of the highly contagious, airborne disease. 

Between Jan. 1, 2015, and Feb. 20, 2015, 154 people from 17 states and the District of Columbia were reported to have contracted measles, according to figures the CDC released Feb. 23. 

This most recent outbreak, 80 percent of which the CDC says is linked to an outbreak at the Disneyland resort theme parks in Anaheim, Calif., “illustrates that measles spreads quickly among unvaccinated people and can spread quickly from state to state or around the world,” Schuchat said.

“You can catch it just by being in the same room as a person with measles—even if that person left the room—because the virus can hang around for a couple of hours.” 

In the U.S., children are required to be vaccinated to attend public school but the CDC is seeing more adults than ever in a typical outbreak. The majority of those who contracted measles recently were unvaccinated, according to the CDC, which notes on its website that people who received two doses of the vaccine as children are considered protected for life. 

“It’s not just young children that need to be up-to-date on their vaccines, and we are starting to see more adults get measles and spread it,” Schuchat said.

She advised adults to get vaccinated if they are unsure if they ever received the vaccine or if they have ever had measles. Additionally, “there is no harm in getting another [measles, mumps, rubella] vaccine if you have already been vaccinated,” she said. 

In the Workplace

Employers may be able to require employees to get vaccinated and fire workers for not complying, since most employment is at will, according to experts. However, most such vaccine policies are set up by health care employers for workers most at risk for exposure to the disease.

There are exemptions, although they tend to apply to children. Forty-eight states have a religious exemption to mandatory vaccinations; Christian Scientists, for example, consider medical interventions unnecessary. Eighteen states have a personal-belief exemption and Missouri and West Virginia have a medical exemption, which might come into play in the event that a child's immune status would be compromised. 

There may be situations that would result in an exemption for an adult; pregnant women and people with compromising health conditions such as leukemia cannot receive the vaccine, according to Schuchat.

Lisa Orndorff, SHRM-SCP, HR manager for the Society for Human Resource Management, advises HR professionals and employers to tread lightly.

“I wouldn’t require [mandatory vaccination] unless you consult your legal counsel,” she said. For instance, a collective bargaining agreement the employer has with a union could contain wording that prohibits mandatory vaccination. 

Orndorff suggested employers looking to prevent or stem a measles outbreak may want to:​

  • Offer voluntary immunization, as many do for influenza, for those who have never been immunized.
  • Provide information on where employees can receive the vaccination and remind them what their insurance covers.
  • Offer telecommuting as a work option, where appropriate, to prevent the spread of the disease. “It’s always great to have that option available,” Orndorff said. “It allows the infected employee to continue to work, or to stay home to care for an infected family member.”
  • Send ill employees home.

She pointed to the Occupational Safety and Health Administration’s general duty clause, which requires employers to provide a workplace free from recognized hazards. That could include sending sick employees home, she noted.

“We think employers have a lot of potential to improve health in the workplace and health among [their] employees,” Schuchat said during a Feb. 23 press conference. That includes using company newsletters to remind workers about vaccines. 

“Based on the Affordable Care Act, health insurance has to cover preventive services including vaccines—without co-pays—as long as they get the vaccine within that [insurance] provider."

Above all, Orndorff urged HR professionals to be aware and keep calm.

“It’s [HR’s] duty and responsibility to stay informed,” she said. 

Kathy Gurchiek is the associate editor at HR News. Follow her @SHRMwriter.

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