How vaccine hesitancy is quietly reshaping workers' compensation exposure for employers and carriers.
A new KFF Tracking Poll on Health Information and Trust, released in 2026, confirms what claims professionals are beginning to see in their files: vaccine misinformation reaches a large share of the public, and while few Americans firmly embrace the myths, a substantial "mixed middle" remains uncertain. That uncertainty, playing out across hospitals, schools, and public-facing workplaces, is steadily changing the shape of workers' compensation exposure.
For employers, insurers, and the attorneys who advise them, the poll is not merely a public-health data point. It is a preview of the next wave of occupational disease and vaccine-reaction claims, and a reminder that how an employer handles immunization can determine whether a resulting injury lands inside or outside the compensation system. That question is answered differently across jurisdictions, and, as shown below, New Jersey has its own statute, its own seminal case, and a first-responder presumption that sharpen the analysis.
What the KFF Poll Actually Found
KFF reports that roughly a third of adults (36%) have heard the claim that mRNA vaccines can alter a person's DNA, and most remain uncertain whether it is true or false. Across four common vaccine myths tested, far more respondents called each claim "definitely false" than "definitely true," yet at least half of the public expressed some uncertainty on each. Only about 8% were consistent or leaning myth believers, while roughly 55% were consistent or leaning deniers, and about 31% fell into a "mixed middle" that supplied a range of true and false answers.
KFF also found that people without a trusted health care provider, and those who rely on social media or AI chatbots for health information, were more likely to endorse vaccine myths, a relationship that held even after controlling for age, education, and partisanship. Parents who reported skipping or delaying childhood vaccines were at least 25 percentage points more likely to believe the myths tested.
Why This Matters for Workers' Compensation Claims
Vaccine hesitancy does not stay in the household. It follows workers into the workplace, and it drives claims in two opposite directions that both increase employer exposure.
First, lower immunization rates fuel occupational-disease exposure. As community vaccination coverage falls, vaccine-preventable illnesses such as measles resurge, and workers with daily public contact absorb the risk. OSHA recognizes that susceptible health care workers are among those at highest risk for contracting measles, with the danger amplified during community outbreaks. Nurses, teachers, child-care staff, first responders, and correctional and transit workers who contract a resurgent disease on the job present classic occupational-disease claims, and every unvaccinated coworker enlarges the pool of workplace transmission.
Second, employer efforts to counter hesitancy generate vaccine-reaction claims. When an employer mandates, administers, or strongly urges immunization to keep its workforce operational, an adverse reaction to that shot can itself be compensable. The more the employer directs or benefits from the vaccination, the more likely the resulting injury is found to arise out of and in the course of employment.
The result is a squeeze: hesitancy raises disease-exposure claims, and the countermeasures raise reaction claims. The decisive legal question in the second category is almost always the degree of employer involvement.
The Governing Case Law
Courts have long treated employer-directed immunization as employment-connected. The controlling authorities remain instructive for every COVID-era and post-COVID vaccine dispute:
Maher v. Workers' Compensation Appeals Board, 33 Cal. 3d 729 (Cal. 1983). The California Supreme Court held that where an employee submits to an inoculation or vaccination at the direction of the employer and for the employer's benefit, any injury from an adverse reaction is compensable, even if employment is only a contributing cause. Read the full opinion: Justia | full text (LSU Law repository).
Hicks's Case, 62 Mass. App. Ct. 755 (2005). A flu-vaccine side effect was compensable because the hospital employer strongly urged its patient-care employees to receive the shot and administered it on premises, tying the vaccination to the employment.
Colagreco v. Workers' Compensation Appeal Board (Vanguard Group Inc.), 232 A.3d 971 (Pa. Cmwlth. 2020). Post-vaccination shoulder injury following a flu shot administered in the employer's on-site clinic, described as part of the employer's health package, was treated as a work-related condition requiring extensive medical care. The full opinion is not posted on a free-access site; for the holding and record, and the opinion is applied in M.L. Boulin v. Brandywine (CourtListener).
The counterweight is equally important. Where a vaccine is genuinely voluntary and the employer neither mandates, urges, nor benefits from it, courts have denied compensability, as a 2025 Massachusetts reviewing-board decision reaffirmed in denying a crane mechanic's claim for Guillain-Barre syndrome after a COVID-19 shot he could not show his employer required. The dividing line is employer involvement, not the vaccine itself.
The New Jersey Framework
New Jersey follows the same core principle but through its own statute and a distinctive body of authority. The threshold requirement appears in N.J.S.A. 34:15-7, which makes compensable a personal injury or death "by accident arising out of and in the course of employment." Read the statute text: N.J.S.A. 34:15-7 (Justia) | official consolidated Act (NJ DOL). For occupational exposure claims, the disease must be characteristic of or peculiar to the work, not a risk shared equally by the general public, which historically has made ordinary community infection difficult to compensate.
The seminal New Jersey vaccine-reaction decision is Saintsing v. Steinbach Co., 1 N.J. Super. 259 (App. Div.), aff'd, 2 N.J. 304 (1949). An employer circulated a notice strongly urging employees to receive a free, voluntary smallpox inoculation. The employee had an adverse reaction, and the Appellate Division held the injury compensable, resting on two pillars: the employer's strong urging and the mutual-benefit doctrine, concluding the activity was mutually beneficial and the risk reasonably incident to the employment. Read the full opinion: full text (LSU Law repository).
Two cautions apply for practitioners relying on Saintsing today. It is a 1949 decision, and the New Jersey Workers' Compensation Act was comprehensively revised in 1979, after which the mutual-benefit doctrine faded from the case law; some commentators argue a voluntary-program reaction may no longer be compensable on that theory. Saintsing has not been analyzed by a published New Jersey opinion since, so its continued force in a purely voluntary program is genuinely uncertain, a point worth candor with any client.
The one modern New Jersey statute that speaks directly to vaccine injuries is the Thomas P. Canzanella Twenty-First Century First Responders Protection Act (P.L. 2019, c. 156; eff. July 8, 2019). For public safety workers, its provisions, including N.J.S.A. 34:15-31.6, create a rebuttable presumption that an adverse reaction to a vaccine administered to guard against a serious communicable or epidemic-related disease arises out of and in the course of employment. The presumption also covers exposure to serious communicable diseases and the cost of testing and monitoring, even where the worker is ultimately found not to have contracted the disease. Read the statute text: N.J.S.A. 34:15-31.6 (Justia) | official consolidated Act (NJ DOL).
The practical New Jersey takeaway: for first responders and public safety workers, hesitancy-driven exposures and employer-directed immunizations sit inside a claimant-friendly presumption. For everyone else, compensability turns on the Saintsing factors, employer direction, urging, and mutual benefit, with the added uncertainty that the pre-1979 doctrine may not survive a modern challenge. Documentation of exactly how a vaccine was offered will often decide the New Jersey claim.
Practical Impact on Claims Handling
The hesitancy trend translates into concrete adjusting and defense considerations:
• Compensability turns on employer conduct. Document whether a vaccine was mandated, urged, incentivized, or purely optional, and whether it was administered on premises. A "de facto mandatory" program, one heavily incentivized or penalizing non-participation, can be treated as compulsory.
• Exclusive remedy cuts both ways. When a reaction is compensable, the exclusive-remedy rule generally bars a tort suit against the employer, capping exposure to comp benefits, an outcome that can favor employers over civil liability.
• Occupational-disease claims will rise with outbreaks. Falling community immunity increases the odds that public-facing workers contract resurgent diseases at work, sharpening causation and course-of-employment disputes.
• Experience rating and premiums. In some jurisdictions, communicable-disease and vaccine-related claims now flow into experience-rating and retrospective-adjustment calculations, affecting future premiums and claim-free discounts.
• Medical severity can be substantial. As Colagreco illustrates, a single reaction claim may involve multiple surgeries, nerve blocks, and long-term treatment, not a nominal exposure.
• Jurisdiction drives the analysis. In New Jersey, a first responder enjoys the Canzanella presumption, while a private-sector employee must fit the aging Saintsing framework; identify the controlling state rule before valuing any vaccine claim.
The Takeaway
Vaccine hesitancy is no longer only a clinical or political story. It is a workers' compensation cost driver. The KFF data shows a public that is uncertain rather than fixed, which means employer policy, and the messaging, mandates, and on-site programs that flow from it, will increasingly decide whether the next vaccine-related injury is compensable. Employers and carriers who track the KFF findings, document their immunization practices carefully, and understand the Maher line of authority will be far better positioned for the claims already on the horizon.
Sources
1. KFF, New KFF Poll Examines Patterns of Belief Across Common Vaccine Myths — The Monitor (2026).
2. KFF, KFF Tracking Poll on Health Information and Trust: Update on Common Vaccine Myths (2026).
3. KFF, People Without a Trusted Health Care Provider Are More Likely to Endorse Vaccine Myths (2026).
4. Maher v. Workers' Comp. Appeals Bd., 33 Cal. 3d 729 (Cal. 1983).
5. Hicks's Case, 62 Mass. App. Ct. 755 (2005).
6. Saintsing v. Steinbach Co., 1 N.J. Super. 259 (App. Div.), aff'd, 2 N.J. 304 (1949) (full text).
7. N.J.S.A. 34:15-7, New Jersey Workers' Compensation Act (arising out of and in the course of employment).
8. Thomas P. Canzanella Twenty-First Century First Responders Protection Act, N.J.S.A. 34:15-31.6 (P.L. 2019, c. 156; first-responder vaccine presumption).
Jon L. Gelman of Wayne, NJ, is the author of NJ Workers' Compensation Law (West-Thomson-Reuters) and co-author of the national treatise Modern Workers' Compensation Law (West-Thomson-Reuters).
Blog: Workers' Compensation
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© 2026 Jon L Gelman. All rights reserved.
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