Building a Strong Business Case for Employee Vaccinations 

An Evidence-Led Case For Employer-Funded Flu And COVID Vaccination At Work

Respiratory infections are estimated to cost UK businesses around £44 billion each year in lost productivity (Office of Health Economics, 2024). A substantial share of that burden sits in presenteeism, the productivity loss that occurs when employees work while unwell and operate below their usual capacity (Pfizer, 2025a). Because presenteeism is less visible than recorded sickness absence, it is often under-measured and underweighted in senior funding decisions (CIPD, 2025a).

Workplace flu vaccination programmes are familiar because influenza follows a more predictable winter pattern, which supports clearer planning and justification (UKHSA, 2025a). COVID does not always follow the same seasonal rhythm and protection reduces over time, so disruption can occur outside the core flu window (UKHSA, 2025a; UKHSA, 2025b). When an employer vaccinates for flu only, they reduce one component of the respiratory burden but leave a meaningful share of productivity loss uncovered (Office of Health Economics, 2024).

This article sets out an evidence-led business case for offering flu and COVID vaccination together, using cost and workforce impact estimates and independent evidence that employees who repeatedly work while unwell are more likely to have future sickness absence and report worse overall health over time (Skagen and Collins, 2016).

More than half of the productivity cost sits in presenteeism. If you only measure absence, you can understate the true business burden.

Table of Contents

1. Why This Topic Matters Now
2. ROI Toolkit For Employer Decision Makers
   1. 2.1 Repeatable Calculation
   2. 2.2 Productivity Impact Calculator
   3. 2.3 How Senior Leaders Should Interpret The Result
   4. 2.4 Worked Examples Using Standard Inputs
3. Defining The Terms
4. The Operational Cost Of Working While Unwell
5. The Real Cost Of Respiratory Infections For Employers
6. Why Presenteeism Is The Hidden Cost
7. Flu Vaccination Is A Strong Foundation, Adding COVID Makes It Stronger
8. Why Employers Often Combine Flu And COVID Clinics
9. Vaccination As A Workplace Intervention
10. Co-Administration And Operational Efficiency
11. Demand And Uptake
12. Delivery Models That Make Programmes Work
13. How Employers Can Apply These Findings With Doctorcall
14. Evidence And Sources
15. Reference List

Why This Topic Matters Now

Most organisations track sickness absence and use those figures in risk and budget discussions. Reduced performance while employees work through illness is measured far less consistently, including the growing pattern of working from home while unwell (CIPD, 2025a). This can lead to an underestimation of total productivity loss and an undervaluation of prevention measures.

In parallel, UKHSA surveillance continues to monitor influenza, COVID and other respiratory viruses across the year, drawing on community, primary care, secondary care and mortality data. For HR, occupational health and healthcare leaders, this ongoing surveillance supports a more realistic planning assumption that respiratory disruption is not confined to one narrow winter peak (UKHSA, 2025a).

When organisations measure absence but not at-work impairment, the case for prevention can look weaker on paper even when the operational impact is significant (CIPD, 2025a).

How Senior Leaders Should Interpret The Result

The key insight is the split. A significant share of the burden is not sick leave. It is reduced performance when employees continue working while unwell. This is why absence figures alone can understate the true productivity impact of respiratory illness.

In practical terms, flu-only vaccination reduces risk linked to influenza. Adding COVID vaccination broadens coverage to a wider share of respiratory-related productivity loss, particularly where disruption occurs outside the main flu period and where protection reduces over time (UKHSA, 2025a; UKHSA, 2025b).

Defining The Terms

Clear definitions matter because they shape what gets recorded, what gets reported and what receives investment. Absence is visible and routinely tracked. Sickness presenteeism is less visible, but it can account for a substantial share of the total productivity burden from respiratory infections (Office of Health Economics, 2024).

The Real Cost Of Respiratory Infections For Employers

The estimates are useful because they translate respiratory illness into board-level measures. They present a national annual cost, a per-employee estimate and a framing in working days affected per employee each year.

Crucially, the same estimates split impact into absenteeism and presenteeism, with presenteeism accounting for 54 to 55 percent of the cost (Office of Health Economics, 2024). This matters because many organisations can quantify absence, but struggle to quantify at-work output loss.

Why Presenteeism Is The Hidden Cost

Presenteeism is often absent from standard reporting systems. Operationally, it can appear as slower throughput, more errors, lower service levels, longer decision cycles, higher pressure on colleagues and higher likelihood of onward transmission (CIPD, 2025a).

Independent evidence also suggests sickness presenteeism is associated with longer-term consequences, including later sickness absence and worse overall health over time (Skagen and Collins, 2016). This strengthens the business case for prevention because it links day-to-day underperformance with future capacity risk.

Flu Vaccination Is A Strong Foundation, Adding COVID Makes It Stronger

Workplace flu vaccination is a proven and practical intervention. Influenza activity in the UK typically peaks in late December, January or February and is not usually significant before mid-November (UKHSA, 2025c). That predictability is helpful for employers. It supports autumn planning and the aim of completing most vaccinations by the end of November, so protection is in place ahead of the winter peak (UKHSA, 2025d).

However, many employers now view flu cover as the baseline rather than the full answer. COVID is monitored alongside influenza in UKHSA surveillance reporting across the season, and disruption can occur outside the core flu window (UKHSA, 2025a). UK guidance also notes that protection wanes over time, particularly against symptomatic disease following boosters, which supports keeping timing and eligibility under review (UKHSA, 2025b).

For decision makers, the advantage is simple. Flu vaccination reduces a major seasonal risk. Adding COVID vaccination builds on that by widening the protection story to cover a broader share of respiratory disruption. It strengthens continuity planning by addressing both the predictable influenza peak and the additional risk that COVID can present outside that peak (UKHSA, 2025a; UKHSA, 2025b).

Why Employers Often Combine Flu And COVID Clinics

UKHSA surveillance reports monitor COVID circulation and other respiratory viruses across the season. The COVID Green Book chapter also notes waning protection over time, particularly for symptomatic disease after boosters, reinforcing the need for programme timing and eligibility to remain under review (UKHSA, 2025b).

For many employers, combining flu and COVID vaccination into a single clinic is also about operational simplicity. It reduces downtime from running multiple vaccination events across the year and makes it easier for employees to attend in one appointment (UKHSA, 2025a; UKHSA, 2025b).

Vaccination As A Workplace Intervention

Respiratory infection control is strongest when interventions reinforce each other. Ventilation, hygiene, staying home when unwell and vaccination each reduce risk through different mechanisms (UKHSA, 2023).

Vaccination supports business continuity because it can reduce infection risk and reduce severity where infection occurs, supporting both lower sickness absence and lower at-work performance loss.

Co-Administration And Operational Efficiency

Co-administration means giving the flu vaccine and the COVID vaccine during the same appointment, usually in different arms. For employers, the value is practical. A single visit reduces the time employees spend away from work, lowers drop-off between doses and avoids the disruption of running separate clinics.

UK guidance supports co-administration where it is operationally expedient (UKHSA, 2021).

Demand And Uptake

The employer materials suggest most employees respond well to vaccination when it is provided through work. In the survey findings, 66 percent viewed employer-funded vaccination positively. Among those, 80 percent said they would be likely to take it up (Pfizer, 2025a).

In practice, uptake is influenced by a small number of practical factors.

Delivery Models That Make Programmes Work

On-site clinics

Best for concentrated workforces with predictable attendance patterns and visible leadership support.

Pharmacy vouchers

Best for distributed workforces, shift patterns, higher turnover and hybrid working where attendance is less predictable.

Hybrid models

Best where organisations have multiple sites or mixed patterns and need to maximise coverage without unnecessary complexity.