Increases In COVID-19 Vaccination Among NYC Municipal Employees After Implementation Of Vaccination Requirements

Abstract

In July 2021 New York City (NYC) instituted a requirement for all municipal employees to be vaccinated against COVID-19 or undergo weekly testing. The city eliminated the testing option November 1 of that year. We used general linear regression to compare changes in weekly primary vaccination series completion among NYC municipal employees ages 18-64 living in the city and a comparison group of all other NYC residents in this age group during May-December 2021. The rate of change in vaccination prevalence among NYC municipal employees was greater than that of the comparison group only after the testing option was eliminated (employee slope = 12.0; comparison slope = 5.3). Among racial and ethnic groups, the rate of change in vaccination prevalence among municipal employees was higher than the comparison group for Black and White people. The requirements were associated with narrowing the gap in vaccination prevalence between municipal employees and the comparison group overall and between Black municipal employees and employees from other racial and ethnic groups. Workplace requirements are a promising strategy for increasing vaccination among adults and reducing racial and ethnic disparities in vaccination uptake.

Exhibit 2

COVID-19 vaccination prevalence among New York City (NYC) municipal employees and a comparison group, May–December 2021 SOURCES NYC Citywide Immunization Registry (2021); NYC Department of Citywide Administrative Services (2021); and NYC Department of Health and Mental Hygiene, using modified data from Census Bureau estimates (2019). NOTES The study period was classified in three phases: phase 0, from May 28 to July 22, 2021 (weeks 1–8), before any vaccination policies for NYC municipal employees were announced; phase 1, from July 23 to October 11, 2021 (weeks 9–20), including the week of the July 26 announcement of the vaccinate-or-test policy and the following weeks; and phase 2, from October 12 to December 30, 2021 (weeks 21–31), including the October 20 announcement that the testing option would be eliminated and encompassing the period during which unvaccinated NYC municipal employees could be placed on unpaid leave and terminated. Data points shown represent vaccination prevalence at the end of each week of the study period. Differences in vaccination prevalence between NYC municipal employees and the comparison group (NYC residents who met the age criteria and were not municipal employees) were calculated using Yuen’s test on the trimmed mean difference and were significant (p < 0.05), except at week 28 (p = 0.069); differences in vaccination slopes were calculated using analysis of variance tests and were significant (p < 0.05), except during phase 1 (p = 0.374). The study was restricted to people ages 18–64. Population counts for the comparison group are described in the exhibit 1 notes. Vaccination prevalence for municipal employees was adjusted to account for vaccinations that were self-reported to NYC agencies as part of the workplace vaccination requirement policies.