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The benefits and costs of U.S. employer COVID-19 vaccine mandates
Authors:Maddalena Ferranna  Lisa A Robinson  Daniel Cadarette  Michael R Eber  David E Bloom
Institution:1. Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, California, USA;2. Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA;3. Independent Researcher, Cambridge, Massachusetts, USA;4. Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA

Harvard Graduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts, USA

Abstract:In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and contractors and for some healthcare and private sector workers. These mandates have been challenged in court; some have been halted or delayed. However, their costs and benefits have not been rigorously appraised. This study helps fill that gap. We estimate the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, we find that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. The associated net benefits depend on the subsequent evolution of the pandemic—information unavailable ex ante to analysts or policymakers. In scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, the estimated net benefits are potentially large. They reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates’ benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic. However, we do not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.
Keywords:benefit-cost analysis  COVID-19  regulation  vaccination  value per statistical life (VSL)  willingness to pay (WTP)
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