COVID VaccinesReturn to WorkMental Health

With a vaccine mandate looming, these apps help businesses check which employees got vaxxed

November 1, 2021, 7:00 PM UTC

With a few exceptions, all of City Winery’s roughly 850 employees spread across seven states are fully vaccinated. But it wasn’t easy getting there, says Michael Dorf, founder and CEO of the chain of restaurants that feature wine and live music. “There’s so much hand-holding and psychological support that we’re doing today that is so far beyond anything we were enjoying before the pandemic,” Dorf says. 

Especially for workers in locations “south of the Mason-Dixon line,” Dorf tells Fortune. In order to get employees onboard with the policy before the company’s Oct. 1 deadline, Dorf said the company provided education, talked with workers one-on-one, and paid for employees to take time off to get the vaccine (and more if they needed to recover from reactions). The company granted a few medical and religious exemptions, allowing a few corporate employees to work remotely. 

But there were only so many accommodations Dorf decided he could give. “We just can’t have someone working in the kitchen who could possibly get the whole kitchen sick—even if the rest of us are vaccinated—since we know there are breakthrough cases,” he said, adding the process was very labor-intensive. 

City Winery requires vaccines of both its employees and guests.
City Winery requires vaccines of both its employees and guests.
Courtesy of City Winery

The direct and indirect costs of the vaccine mandate, however, weren’t as expensive as testing. Prior to the availability of vaccines, Dorf estimates he spent at least $100,000 on $11 rapid tests for the staff, who were testing three times a week. “At this point, in 2020 and 2021 we’ve lost so much money, it’s one of those things that whether it costs us another $50,000, it’s like okay, great, let’s add to the losses for the year. That’s nothing,” Dorf says. “I probably spent six figures on testing.”

Even though his staff is vaccinated, Dorf has been keeping an eye on the forthcoming emergency temporary standard from the Occupational Safety and Health Administration. Directed to formulate new requirements for private employers by President Joe Biden, OSHA is expected to require companies with at least 100 employees to require vaccinations or ensure workers undergo weekly COVID-19 testing. 

“We’ve been extra cautious the whole time, and so I’m optimistic that our programs are safer than what will be ultimately mandated,” Dorf says. One of the sticking points, however, may be vaccine verification. Currently, Dorf says City Winery relies on attestations from employees.

The staff have been under “an honor system in terms of getting vaccinated or not,” Dorf says. Under the new requirements, that may not go far enough.  

Yet City Winery is ahead of the curve. Overall, OSHA’s vaccine and testing mandate presents a huge challenge for businesses, particularly for those on the smaller end of the spectrum, which may need to comply with the requirements but don’t have the size or scale to bring on solutions at a reasonable cost. 

About 40,650 businesses in the U.S. employ between 100 and 150 workers, according to the most recent data from the U.S. Census Bureau. About 5 million workers were employed by those smaller businesses in 2018. 

Nearly one in five adults, or about 16% of Americans, say they will “definitely not” get a COVID-19 vaccine, according to the latest KFF COVID-19 Vaccine Monitor published last week. About 4% report they will get the vaccine only if required, while 5% of Americans are still in “wait and see” mode. 

That means many small businesses will be left to verify not only vaccines but also routine test results. Specialized software to tackle these requirements exists, but many businesses will be left to cobble together less costly solutions. Vaccine verification apps may help. 

Apps could help lower the cost of verification

The cost of specialized software to verify and track employees’ COVID vaccination status can range in price from $1 to $6 per employee per month, says Sandy Goldstein, clinical services leader at Mercer, a firm that provides advice and solutions around corporate health benefits, talent recruitment, risk management strategies, and reopening plans.

ReturnSafe—a company that has helped more than 75 employers including the San Antonio Spurs, the Howard Hughes Medical Institute, and the Federal Home Loan Bank of Chicago implement COVID-19 safety protocols—says it costs $1.50 per employee per month or $18 per employee per year for software to track vaccines and test results at large volumes.

That’s not terribly expensive, but those costs can add up, especially for many small businesses who are struggling to return to normal operations. Free is better. 

That’s exactly what the SMART health cards framework offers—a free, digital credential that proves a worker has been vaccinated. Apps like New York’s Excelsior Pass and Hawaii’s vaccine verification run off the SMART health card network and generate a unique QR code that businesses easily scan. 

Businesses don’t even need to be based in one of these states. ​​There’s a universal SMART Health Card Verifier app that companies can use to quickly validate workers’ vaccine status if they received their vaccine from one of the approximately 250 participating institutions. And several major companies, including Salesforce and ServiceNow, are incorporating the SMART health card system into their internal and customer systems.

“The scalable thing is to scan a SMART health card, which is both verifiable and actually trustworthy—but it’s also simpler to actually process,” says Paul Meyer, CEO of the Commons Project Foundation. The organization is a member of the Vaccine Credential Initiative, a coalition of more than 800 public and private organizations, including the Mayo Clinic, Boston Children’s Hospital, Microsoft, and Mitre, working on the SMART Health Cards specifications.

Verification may prove to be a critical component, especially considering the proliferation of fake vaccine cards. Rather than simply relying on a photo of a vaccine card, the SMART health card network actually pulls the vaccine records from state health agencies and providers. 

“With uploading a picture of a CDC card, you have to be sure it’s not a picture of a cat. You’re going to have to have staff and back office staff somewhere looking at it online. It’s a very expensive, time-consuming process,” Meyer says. 

Where apps stand now

More than 150 million people have access to a SMART health card, with state public heath agencies, pharmacies, and health care providers issuing verifications. 

So far California, New York, Louisiana, Virginia, Hawaii, Utah, New Jersey, and Washington are all issuing SMART cards, and Meyer says a dozen more states are launching in the coming weeks. Several other states have signed onto apps like Docket and MyIR Mobile.

Additionally, four national pharmacies—CVS Health, Rite Aid, Walgreens, and Walmart—are all part of the SMART network, as are hundreds of Epic and Cerner health systems.

Beyond just verifying workers’ vaccination status, New York’s Excelsior Pass Scanner app can also be used to confirm negative COVID test results for PCR and antigen testing. Meyer said that the SMART Health Card Verifier app doesn’t currently verify test results, but that feature is coming soon. 

“It’s not going to be universal because not everybody has access to this yet. Although hopefully that starts to be true soon,” Meyer says.

The expected vaccine mandate may also push adoption forward, especially since many employers will want to make the process as painless as possible. In fact, many businesses worry OSHA’s mandate will make it more difficult to attract and retain employees in an already extremely tight labor market. 

It’s a fear that isn’t necessarily unfounded. “It’s really, really hard to find people, and then we make it even harder on ourselves because there are some people who would work for us who don’t want to be vaccinated, and we’re not hiring them,” Dorf says. City Winery’s current staff level is still down from the 1,370 employees the business employed in February 2020. 

Yet Dorf says that his team is resilient and more tight-knit than before, adding it’s possible to make a vaccine mandate work. “We’ve had to reallocate a lot of financial and bandwidth resources to keep our labor team, our whole employee team happy, safe, and satisfied,” Dorf says. 

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