Have the Conversation: Talk to Your Employees About Getting a Flu Shot in the COVID-19 Pandemic

Michelle Hopkins

October is typically the start of “flu season” with an increase in influenza viruses that circulate all year. You worry about the health of your workforce. As we plan for the 2021-2022 flu season, these questions arise: How will months of coping with the COVID-19 pandemic affect employee response to annual flu vaccination campaigns? What factors will motivate individuals to get a flu shot? What factors will serve as barriers? The answers to these questions may depend, in part, on how you talk to your teams, listen to their concerns, and respond to their questions. This article is intended to help you have that conversation.

Reasons for seasonal flu vaccine hesitancy

An extensive research study showed there are three general reasons for reluctance to be vaccinated.1 They are:

  1. Personal invincibility. The individual questions the risk of getting sick.
  2. Safety and effectiveness. The individual doubts the vaccine will work or be safe.
  3. Trust, support, or logistics. The individual needs something more: financial or transportation support or encouragement. 

The factors in this table are derived from the following research study: Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy, 2005 – 2016. PLoS One. 2017; 12(1): e0170550. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268454/

Group 1 Beliefs: Personal Invincibility

Some employees are healthier than others, and this may cause them to embrace beliefs in Group 1 in the table. Their good health may be reflected in good attendance and strong productivity. But no one is invincible. Circulating influenza viruses change continuously, and the flu bug may find a way to vault over the wall of any immune system response. Encourage your employees in healthy practices – whatever their health record – and explain about constantly evolving flu viruses. Since a flu vaccination is available, why not use it as a first line of protection? It is also worth mentioning to them that the CDC has consistently said “a flu vaccine is the first and best way to reduce your chances of getting the flu.”2

Let your employees know you value them and want to protect their health to the best of your ability. Discuss any extra safety measures new in the workplace because of the COVID-19 pandemic; those practices (social distancing, hand/sneeze/cough hygiene, etc.) may also help stymie potential transmission of influenza. But the flu shot is a valuable line of defense, as well.

Group 2 Beliefs: Concerns About the Flu Vaccine’s Safety, Effectiveness

This group of beliefs is highly complex, and that’s a good reason to enlist the help of the occupational health experts at Concentra. Before tackling the topics of vaccine safety and effectiveness, it’s wise to set a ground rule that all views will be given a respectful hearing. There are a variety of reasons for vaccine hesitancy and a Swedish bioethics researcher has found that only respectful communication can foster and maintain trust, as well as leave open the door for people who are vaccine hesitant to change their minds.3

First, address safety. The CDC says “flu vaccines have a good safety record. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and there has been extensive research supporting the safety of flu vaccines.”4

 It is true that sometimes side effects will be experienced after getting a flu shot – most commonly redness or swelling at the injection site. Headache, nausea, and muscle aches also are possible. Any person who is allergic to flu shots or their ingredients or who has a history of Guillain-Barre syndrome is advised to consult a doctor.5

Before a flu vaccine is approved, the Food and Drug Administration (FDA) evaluates its safety and effectiveness and ensures compliance with good manufacturing practice regulations. The CDC and FDA also continuously monitor for any adverse effects.6

Employees who question the effectiveness of the flu vaccine may be surprised to learn that the CDC acknowledges flu vaccines have never been 100 percent effective (but are still the single best step for preventing illness). From 2009 through 2018, estimates of the effectiveness of flu vaccines ranged from a low of 19 percent in 2014-2015 to a high of 60 percent in 2010-2011.7 For the 2019-2020 flu season, preliminary estimates indicate vaccine effectiveness for A and B flu viruses varied from 35 percent in the 18-to-49 age group, 42 percent for ages 50 to 64, and 37 percent for people 65 and older.8

Major benefits of the flu shot include avoidance of illness, medical visits, and death. Consider a five-year period from the 2014-2015 flu season to the 2018-2019 flu season.9 The CDC estimates flu shots averted an annual average of:

  • 4.5 million cases of symptomatic flu illness
  • 2.3 million medical visits
  • 66,000 hospitalizations
  • 4,800 deaths

Another point of assurance you can give employees who are concerned about flu vaccine effectiveness is this: Concentra’s preferred supplier is the only US-based vaccine manufacturer using cell-based technology that potentially improves the effectiveness of the vaccine compared to egg-based vaccines. Vaccines produced by growing influenza viruses in eggs can introduce “egg-adapted changes” that interact with an individual’s immune system to produce antibodies that are less effective at preventing disease caused by the specific flu viruses in circulation. The FDA approved cell-based technology to help improve vaccine effectiveness.10  That is a good reason to come to Concentra for your flu vaccination program.

Finally, in this group of beliefs about flu vaccinations, there is a persistent myth, and you may have already guessed what it is: “I think the flu shot will give me the flu.” A flu shot cannot give a person the flu because it does not contain a live virus. A flu shot (depending on the vaccine) contains either an inactivated virus or a particle designed to look like the virus to the immune system. A nasal spray vaccine does contain live virus but it is changed so it cannot give you the flu, the CDC explains.11

Group 3 Beliefs: Barriers in Trust, Support, and Logistics

 People are motivated to act – to get a flu shot – when encouraged by people and organizations they trust. In the absence of encouragement by a spouse, family (or the presence of children in the household), friends, or employer, people are less inclined to get a flu shot, German researchers discovered.12 Even the word of local, state, or national health officials may not be enough this year because public trust has eroded due to widespread confusion and misinformation about the COVID-19 pandemic.13

Kaiser Health News (KHN) is a nonprofit news service that covers health care policy and health issues.14 KHN reported on an effort to track down internet misinformation. It identified 217 websites in Europe and the United States that dispensed “materially false” information about COVID-19.15 As a result, there may be more confusion this year about health information. Advise your employees to rely on scientific research and authorities like the CDC. Enlist an occupational health provider, such as Concentra, that is science-based in its practices and educational outreach. Emphasizing science-based information will serve you well in another way. Public trust in medical scientists and medical research scientists has increased, according to an April 2020 national survey by the Pew Research Center. Public confidence in medical scientists to act in the best interests of the public has increased since the COVID-19 pandemic began; public confidence in medical scientists generally has held steady, perhaps increased slightly, from 2019 to the spring of 2020.16

There may be a tendency to numb ourselves to information about the flu because it occurs every year. This may be especially true when something new and different emerges, such as the COVID-19 pandemic. Take a few minutes during a team meeting to quickly review together the CDC’s influenza information page to raise awareness about the facts.

Logistical barriers – lacking a primary care physician, transportation, and cost – can be addressed by setting up a flu vaccination program with Concentra. Your employees can come into any nearby Concentra center or, if you have an onsite program, flu shots can be provided at your worksite.

Who should NOT get a flu shot

The list of people who should not get a flu shot is small17:

  • Anyone younger than six months of age
  • Anyone with life-threatening allergies to the flu vaccine or its ingredients
  • Anyone with a history of Guillain-Barr syndrome should first consult with their doctor

COVID considerations and time to act

  • Although a flu shot will not protect employees from COVID-19, it has been shown to reduce the need to visit a hospital or other medical facility by 40 to 60 percent18, possibly avoiding exposure to COVID-19-infected people.
  • Flu shots help avoid flu illness and can reduce worsening of chronic heart and lung conditions and diabetes.19
  • It is possible to be infected with both flu and COVID-19. Co-infection may increase the severity of COVID-19.
  • Employees suspected or confirmed with COVID-19 should not get a flu shot until they have met the criteria to discontinue isolation.”

The best news is, you can partner with Concentra for all your flu vaccination program needs and get occupational health expertise backed by more than 40 years of experience.


  1. Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior – a Systematic Review of Influenza Vaccine Hesitancy, 2005-2016. PLoS One. 2017; 12(1): 30170550.
  2. Flu Vaccine Safety Information. Centers for Disease Control and Prevention. Last reviewed: September 17, 2019.
  3. Fahlquist JN. Vaccine hesitancy and trust. Ethical aspects of risk communication. Scandinavian Journal of Public Health. 2018; 46(2): 182-188.
  4. Flu Vaccine Safety Information.
  5. Flu Vaccine Safety Information.
  6. What are the benefits and risks of flu shots?” Medical News Today. Last medically reviewed: March 26, 2020.
  7. CDC Seasonal Flu Vaccine Effectiveness Studies. Centers for Disease Control and Prevention. Last reviewed: July 1, 2020.
  8. US Flu VE Data for 2019-2020. Centers for Disease Control and Prevention. Last reviewed: July 29, 2020.
  9. Past Seasons Estimated Influenza Disease Burden Averted by Vaccination. Centers for Disease Control and Prevention. Last reviewed: January 7, 2020.
  10. Cell-Based Flu Vaccines. Centers for Disease Control and Prevention. Last reviewed: October 11, 2019.
  11. Flu Vaccine Safety Information.
  12. Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy, 2005-2016.
  13. Conflicting COVID Messages Create Cloud of Confusion Around Public Health and Prevention. US News and World Report. June 19, 2020.
  14. Kaiser Health News.
  15. How Mis- And Disinformation Campaigns Online Kneecap Coronavirus Response,” Kaiser Health News. June 29, 2020.
  16. Trust in Medical Scientists Has Grown in the US, but Mainly Among Democrats.” Pew Research Center, May 21, 2020.
  17. Who Should and Who Should NOT get a Flu Vaccine. Centers for Disease Control and Prevention. Last reviewed: October 11, 2019.
  18. What are the benefits of flu vaccination? Centers for Disease Control and Prevention. Last reviewed: December 3, 2019.
  19. What are the benefits of flu vaccination? Centers for Disease Control and Prevention. Last reviewed: December 3, 2019.