Alaska executives, employers wrestle with whether to mandate, incentivize or encourage COVID-19 shots

As seen from above, people sit in chairs spaced six feet apart
After receiving their COVID-19 vaccination, residents sit in a waiting area to be monitored for adverse reactions on Sunday, Jan. 17, 2021, in Juneau. (Rashah McChesney/KTOO)

For Emily Palenske, who works with residents and staff at two nursing and rehabilitation homes owned by a company called Maple Springs in the Mat-Su, the COVID-19 vaccine offered a way out of a year of pandemic anxiety and fear.

Four months after the shots first arrived in Alaska, most of the nursing homes’ 100 residents have chosen to receive the vaccine. But vaccination rates remain far lower among the 250 employees: 45% at Maple Springs’ Wasilla facility, and roughly one-third in Palmer, said Palenske, an infection preventionist.

Many are concerned about possible long-term effects from the vaccine: For example, some young nursing assistants have misplaced fears about the shots affecting their fertility.

Maple Springs, whose facilities are located in one of Alaska’s most vaccine-hesitant regions, has considered offering rewards to employees who get the vaccine. But workers say incentives would do little to change their minds, Palenske said, and the company is unlikely to mandate the vaccine, since it doesn’t require flu shots, either.

“I feel like we are at a plateau point,” Palenske said. “It’s not a matter of rolling it out or making it available or anything like that. It’s a matter of choice — and until people make those choices, I don’t see our numbers changing a whole lot.”

RELATED: As Mat-Su vaccine appointments go unfilled, fears grow about misinformation and hesitancy

Companies take carrot” or “stick” approaches

The vaccine dilemma facing Palenske and her company is playing out across Alaska, where employers are grappling with the balance between ensuring safe workplaces and workers’ rights to make their own medical decisions.

Many executives are using the “carrot” approach, encouraging workers to get the shots by offering incentives as large as $500 or a week of paid time off. Others are hoping structural incentives — such as avoiding quarantine and COVID-19 testing nasal swabs — will boost employee enthusiasm.

Then there are a small number of companies that have required their workers to get the shots, like the Indigenous-owned Bering Straits Native Corp. It said its decision was informed by the traumatic experience of shareholders’ ancestors during the 1918 pandemic flu.

The Wilderness Adventurer, an Uncruise Adventures boat, tied up in Juneau on July 31, 2020.
The Wilderness Adventurer, an Uncruise Adventures boat, tied up in Juneau last year. (Jennifer Pemberton / KTOO)

Uncruise Adventures, a Seattle-based small-boat cruise line, is mandating vaccination for crew and passengers on this summer’s trips to Southeast Alaska. Outside of some nasty comments on social media, it has encountered very little resistance so far, said Dan Blanchard, the company’s chief executive.

RELATED: One small cruise line’s vaccine requirement means passengers can visit Southeast Alaska businesses

About 40 of Uncruise’s 4,000 customers postponed trips to 2022, and only four of 300 crew declined to work this summer based on the vaccine requirement alone, Blanchard said.

“I literally had crew members popping into my office in tears saying, ‘Thank you so much for doing this — I was afraid I wasn’t going to be able to work because I just couldn’t bring myself to be in an unvaccinated situation,’” Blanchard said. He added: “My clientele base and my crew are very much of the mindset that the vaccine is the best thing we can do for our fellow man.”

No “black and white” legal rules for employers

Before adopting the mandate, Uncruise consulted with its attorneys, who said they thought the company was on solid legal ground.

But Gregory Fisher, an Anchorage employment attorney, said COVID-19 vaccine mandates are a big legal gray area — especially since the shots are only authorized on an emergency basis, not fully approved.

RELATED: You’re vaccinated for COVID-19. Now what can you do?

“Be careful,” he and another attorney warned in a written outline accompanying a presentation to Alaska Bar Association employment lawyers last week.

One federal agency, the Equal Employment Opportunity Commission, has suggested companies can require vaccines without breaking disability and nondiscrimination laws. But as of last week, the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration hadn’t weighed in.

The legality of vaccine mandates likely won’t be resolved until and unless they’re challenged in court. Even then, Fisher said, results will likely depend on industry circumstances: For example, it’s probably easier for a hospital to make the case unvaccinated employees pose a threat than a remotely working graphic design firm.

a nurse administers a vaccine to a patient
An Anchorage Health Department public health nurse prepares to administer the Covid-19 vaccine during a community vaccine clinic in February. (Jeff Chen/Alaska Public Media)

He also cautioned employers could run into legal trouble if vaccine-related perks are too large, since EEOC and other guidelines bar them from “coercive” incentives.

The legal considerations around vaccines and the workplace are complicated enough that they caused “tremendous confusion” even for the dozens of Alaska employment attorneys who attended Fisher’s presentation last week, he said.

But for now, he added, many of the conflicts that might have been expected around workplace vaccinations don’t seem to be cropping up. In part, that’s because most people are motivated to get the vaccine, Fisher said, but also because companies have gotten much better at accommodating remote workers over the course of the pandemic.

“We crave black and white rules. But there are no black and white rules here,” Fisher said. “And so, you really have to be careful. It’s really driven by the facts and the context. And you have to confer with your attorney about exactly the problem that you’re facing.”

BSNC, the Native-owned corporation, is one of the largest Alaska employers so far to mandate vaccinations, though it’s making what a spokeswoman called “reasonable accommodations” for workers with “valid documented medical reasons or religious objections.”

RELATED: Bering Straits Native Corporation Uses History to Inform Vaccine Mandate

The company and its subsidiaries have just under 2,000 employees, and BSNC announced the decision by its board last month.

No mandates yet at Anchorage hospitals, major public employers

Other major Alaska employers are taking a more conservative approach, including Anchorage’s three large hospitals.

The Alaska Native Tribal Health Consortium, which runs Anchorage’s Native hospital in partnership with another tribal provider, hasn’t required the vaccine for workers so far, spokeswoman Shirley Young said, though it does require flu shots for employees working in patient care.

“We are carefully researching and considering the implementation of mandatory vaccinations for our employees,” Young said by email. “Having a healthy workforce and doing our part to protect our patients and the communities we serve remains a top priority.”

Anchorage’s other hospitals, Providence Alaska Medical Center and Alaska Regional Hospital, aren’t requiring workers to get COVID-19 vaccines either. At Alaska Regional, flu shots aren’t required, though employees who decline them must wear masks whether they work with patients or not, spokeswoman Kjerstin Lastufka said in an email.

a person wearing a face shield and mask administers a shot to someone wearing scrubs and a mask
An Alaska Native Tribal Health Consortium nurse administers the COVID-19 vaccine during a December clinic. (Jeff Chen/Alaska Public Media)

When it comes to the COVID-19 vaccine, she added, “we will review any new guidelines and recommendations to make that decision based off the evidence when we get to that point.”

“We know we are not there yet, so will continue universal masking and look at any changes at a time when community transmission levels are lower,” Lastufka said.

RELATED: You’re vaccinated for COVID-19. Now what can you do?

Asked if any kind of vaccine requirement was under consideration for state workers, a spokesman for Republican Gov. Mike Dunleavy, Jeff Turner, said the governor will not mandate vaccines for anyone. Employees can use personal leave time to get their shots, but no incentives are offered, and the state is not tracking the share of its workforce that’s vaccinated, officials said.

Anchorage’s city government isn’t considering a vaccine mandate either, said Katie Scovic, spokeswoman for Acting Mayor Austin Quinn-Davidson. But all city employees are eligible for two hours of vaccine leave per shot, with the exception of police and firefighters, who were vaccinated on the job.

The city is “generally encouraging vaccination,” Scovic added, including by sharing and following municipal guidance allowing vaccinated workers to go unmasked when they’re not around the public or unvaccinated co-workers.

At Maple Springs, the Mat-Su company, substantial vaccine hesitancy is lingering among its 250 workers, said Palenske, the infection prevention specialist.

The company has made significant efforts to promote the vaccines’ safety and effectiveness, even bringing in state doctors for educational Zoom presentations. Those have helped convince some workers, Palenske said.

But many others remain skeptical, and don’t don’t seem to be motivated by extra time off or cash payments, she added. So for now, Palenske is waiting to see if forces outside her control — such as vaccine passports or travel restrictions — end up changing people’s minds.

“I’ve come around to the fact that I can’t force anybody into this right now,” Palenske said. “All I can do is educate them the very best that I can.”