DAVID GREENE, HOST:
And now to some legal questions that have come up in the current measles outbreak. When, if ever, can an employer require people to be vaccinated or ask for proof that it's been done?
RENEE MONTAGNE, HOST:
After several employees were infected at Disneyland, that company asked workers to stay home until they could show proof of immunity. The company covered the cost of updating vaccinations, but the idea of mandating vaccines raises a host of concerns.
GREENE: And let's turn to someone who has been covering many of these questions. It's April Dembosky. She's health reporter from member station KQED in San Francisco. April, thanks for coming on and talking about this.
APRIL DEMBOSKY, BYLINE: Happy to.
GREENE: So one big question - I mean, can employers, based on the law, force employees to prove that they have been vaccinated against diseases like measles?
DEMBOSKY: It really depends what industry you work in. So there are some places where this really matters a lot - hospitals. Health care workers are taking care of many people who have compromised immune systems. And so it's very important for them to show proof of immunity from some of these diseases. And so most health care workers - nurses, doctors - before they go into training have to show proof of immunity. Some states do have laws that either require hospitals to offer vaccines to health care workers or to ensure that they are immune.
GREENE: Does that mean that most other places that are not hospitals and sort of in the health care industry - most other places cannot require vaccinations?
DEMBOSKY: It does. There are laws that prevent employers from asking employees for their medical information. The Americans with Disabilities Act, for example, says that employers have to have a specific business reason to ask employees about their medical information. And so you can see in the case of hospitals, for example, that there is a clear business reason.
But for most other employers, for your typical office environment, for example, it's very, very difficult to show that. But from a public health perspective, it really doesn't matter. In your typical workplace, the risk of getting or spreading measles is very low. I talked to UC Berkeley public health professor Art Reingold, and he says there's really no reason for this kind of employer to ask about vaccines.
ART REINGOLD: If you worked at Google, what business is it of, you know, your employer to tell you what vaccines you should have had? You're not at a greater risk because you work at Google of getting measles than you are in the general population.
GREENE: But, April, I can see there being some sort of middle ground. I mean, places like schools, for example - they're not hospitals. But they're a place where a lot of parents would really worry if they thought teachers weren't vaccinated. They wouldn't want to send their kids to school. Does anything apply there?
DEMBOSKY: Schools are an interesting one. They do fall into this middle ground. But here's the thing - it's pretty complicated. Let's get into it and say, yeah, you know, maybe we do want to require teachers to show that they're immune. How would we do that? First, we'd ask teachers to hand over their immunization records. Well, you can just imagine asking a 28-year-old teacher, hey, do you have your immunization record somewhere at home?
GREENE: From when you were a kid, right.
DEMBOSKY: Right, and so if you don't have documentation that shows you've been immunized, well, then you're going to have to start a screening program. And so you can just see how this is going to get both really complicated, and it's also going to get really expensive. And so basically because there is so much effort focused on getting kids immunized, the adult population, when it comes to measles, is for the most part immune from measles already. The CDC says it's about 96 percent of the adult population. And so when you start talking about these complicated systems for screening and showing immunity just to ferret out 4 percent, the cost-benefit analysis just doesn't work out.
GREENE: OK, so there's a cost issue there. But as this whole measles situation has been in the news, there have been stories about some employers who have faced legal challenges for trying to require vaccinations, right?
DEMBOSKY: There have been some lawsuits, even where there was a legitimate business reason, where employees have sued employers who tried to mandate vaccination. These kinds of lawsuits come up often around the flu vaccine because it's an annual vaccine, and so it can get really complicated. You have to do it year after year.
There was an interesting case in Ohio in 2012. There was a nurse. Her employer wanted all the health care workers to get a flu vaccine. But she's a vegan, and flu vaccines can be made with eggs. And she said, well, that goes against my personal beliefs. I don't want that. And the court sided with her.
GREENE: We've been speaking to KQED health reporter April Dembosky. April, thanks very much.
DEMBOSKY: Thanks for having me.
GREENE: And April's reporting comes to us as part of a partnership with NPR, KQED and Kaiser Health News.
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