Many might recall that early in the outbreak, pandemic denialists — who continue to this day — frequently said COVID-19 was no worse than seasonal influenza. More than 600,000 Americans would beg to differ, if they could speak.

As part of an argument for healthcare workers to take the vaccine, a physician noted in a recently published paper the mortality rate for influenza is estimated to be 1 in 1,000, whereas for SARS-CoV-2 is closer to 1 in 100 to 250.1

“We need merely review the large bump in national death rates and decrease in life expectancy last year compared to prior years to appreciate that SARS-CoV-2 is more deadly than influenza,” says Michael Klompas, MD, a professor of population medicine at Harvard Medical School.

Trying to keep it simple, Klompas and authors listed eight reasons healthcare workers should be mandated to receive a COVID-19 vaccine as a condition of employment. The rapidly spreading delta variant was not one of them, but Klompas says such mutations make the other reasons for mandates that much more compelling.

“Variants sharpen all the issues associated with COVID and the rationale in favor of vaccination because they increase the likelihood that one will get infected and then pass on infection to patients and colleagues,” Klompas says. “The vaccines, fortunately, appear to be protective against infection with variants and highly protective against severe disease.”

Klompas and colleagues noted “up to two-thirds of cases of SARS-CoV-2 infection are attributable to asymptomatic and presymptomatic transmissions.”1

“The high fraction of transmissions that are attributable to people without symptoms at the time means that you cannot rely on symptom screening to identify the patients or colleagues who might be infectious,” Klompas says. “Vaccine provides protection against infection during all interactions, regardless of people’s symptoms. Same applies to the healthcare worker as a potential source of infection. Just because I’m feeling fine, it doesn’t mean that I may not be contagious and at risk of infecting my patients or colleagues. Vaccination helps diminish this risk.”

Another reason healthcare workers should be required to take the vaccine is medical workers are critical for healthcare delivery, and the vaccines are safe and effective.

“Despite the enormous number of people who have now received SARS-CoV-2 vaccines, serious side effects have been exceedingly rare,” Klompas and colleagues concluded. “We acknowledge that some life-threating adverse effects and deaths have occurred, but the incidence of these complications is vanishingly small, is substantially lower than the risk for complications of COVID-19, and is far outweighed, in our opinion, by the likelihood of benefit to both healthcare workers and their patients.”


  1. Klompas M, Pearson M, Morris C. Ideas and Opinion. The case for mandating COVID-19 vaccines for health care workers. Ann Intern Med 2021 Jul 13;M21-2366. doi: 10.7326/M21-2366. [Online ahead of print].