Although they were among some of the first groups to qualify for COVID-19 vaccinations in most states, construction workers have been notoriously hesitant to roll up their sleeves and get the shots. Now, as the percentage of Americans yet to receive a first dose remains in the mid 40s — just slightly below the 46% of readers who told Construction Dive in April they had no plans to get the shot — construction companies that want their workers to be vaccinated have their work cut out for them. 

Construction workers’ consistent skepticism about vaccinations is raising alarm bells for public health officials like University of Pittsburgh associate professor of epidemiology Wendy C. King, who sees vaccine hesitancy as a key barrier to ending the pandemic. In late April, King and a team of researchers from the University of Pittsburgh and Carnegie Mellon University also found that 46% of construction workers weren’t planning to get vaccinated. Now the team is trying to understand what’s behind that hesitation so they can help the healthcare community target interventions and address workers’ concerns. 

Workers are telling pollsters that they don’t trust the vaccine (or the government providing it), and misinformation continues to blossom online. People mistakenly believe the process of getting the vaccines to market was accelerated “in a way that makes it unsafe or that corners have been cut,” Amelia Jamison, a faculty research assistant at the Maryland Center for Health Equity, said during a recent webinar sponsored by the Colorado School of Public Health.

In addition, about a third of unvaccinated adults are concerned they might have to pay for the shots (which are free to everyone), a Kaiser Family Foundation poll found.

A political divide

At B&M Roofing in Frederick, Colorado, many field workers are holding off on getting shots because they or someone close to them have already had mild cases of COVID-19 and recovered without incident, said vice president Scott Kawulok. 

“Most of our employees are young, male, relatively healthy — they probably have bad habits like a lot of other construction workers, but for the most part, they’re healthy and active,” he said. “Initially, there was much more fear about the virus until they knew a lot of people who had had it or they experienced it themselves. Their concern for catching the virus is way, way less than it was initially, which is kind of the inverse thing you want to have happen when you want to get a lot of people vaccinated.”

And, of course, the well-documented partisan divide over vaccinations comes into play. A Gallup poll in February found that 91% of Democrats and 51% of Republicans were willing to get the shot, and the Associated Press reported in April that states won by Joe Biden had higher vaccination rates than states that went for Trump. 

“For good or bad, right or wrong, the vaccine has been politicized,” said Reid Ribble, CEO of the National Roofing Contractors Association. “We’re so regionally and politically divided. I would be willing to bet the number of construction and roofing workers being vaccinated lines up pretty closely with how progressive or conservative their states are. In rural, conservative states like Alabama, you’ll have pretty low rates, and in Massachusetts, New York and California, it will be pretty high. Because it’s also cultural, isn’t it? And when you have this blend of culture and politics, it becomes very complicated.”

Education and incentives

Most U.S. companies are encouraging vaccinations because they believe they’re key to getting the economy back on track, but as they attempt to craft vaccination policies, they’re struggling against all these factors as well as confusing, constantly evolving messages from the federal government.

In May, the Equal Employment Opportunity Commission said companies could require workers to get vaccinated (with health and religious exemptions) and offer incentives like paid time off, gift cards and even permission to work without a mask; OSHA did an about-face on its previous policy when it announced that employers didn’t have to record adverse reactions from the vaccines on their OSHA 300 logs; and a tax credit was passed to help companies pay for employee time off to get the vaccination and recover from its side effects. 

Attorney Katherine Suttle Weinert, special counsel for global employment and labor law firm Littler Mendelson, said the majority of the companies she works with are weighing whether they should continue to simply ask workers to get vaccinated or beef up their requests with incentives and mandates. Most of them started out with employee education pushes like lunch-and-learns with local medical providers and are now moving on to offering “a range of carrots” to motivate hesitant workers, she said.

“We’re seeing a bigger move toward incentives, but that education piece is still really critical, along with strong communication from management, often coupled with leadership,” Weinert said. When CEOs and project managers show that they’re willing to get the shot, she added, it provides “that sense of community and motivation.”

Mandates are coming primarily from companies that work in healthcare settings, Weinert said, but more companies might have to start requiring vaccinations if their workers are hesitant. She expects more employees to get the shots, currently being administered under emergency-use authorization, once the FDA has formally approved them. (Pfizer-BioNTech, Moderna and Johnson & Johnson applied for full approval, which will likely take months, in May.)

Positive feedback

At B&M Roofing, Kawulok said, management — concerned about the impact on the company’s culture as well as the potential loss of employees — decided against a mandate early on. “It’s already hard enough to find qualified workers,” he said. “We wanted to leave it up to individuals to choose.” 

As part of San Francisco-based Dome Construction’s “people-first approach,” the company utilized anonymous employee surveys and found that vaccines — everything from their risks and effectiveness to which one to get—were an area of particular importance for team members. In March, Dome and its insurance team hosted a town hall meeting with a medical doctor who answered questions about all aspects of the vaccines. The recorded event was then translated into Spanish and sent out companywide. 

In addition, all Dome employees are eligible for up to 80 hours of supplemental paid sick leave to get the vaccination or recover from side effects, and the company is looking for a partner to provide vaccinations on site. 

“We’re really just trying to let everyone know, we’re here for you and we’re navigating this together,” said Brent Miller, Dome’s director of risk management. 

Dome has measured the results of these efforts only in Santa Clara County, which requires companies to ask employees if they’ve been vaccinated. About 77% — well above the national average — have gotten their shots, said Michelle Austin, Dome’s human resource director. 

“We’re hearing nothing but positive feedback from our teams,” Austin said.