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SARS-C0V-2 vaccination in the context of employment: the legal framework in Hungary

Abstract Background Deployment of SARS-CoV-2 vaccines has sparked the debate on action that employers can lawfully take to promote vaccination uptake among employees. Absenteeism reduction, liability concerns, occupational health and safety, protecting the health and safety of clients and service recipients might prompt such action. This raises questions about employees' freedom of choice and right to (refuse) consent. The research examined the related policy and regulatory framework in Hungary. Methods Legal and policy analysis was conducted on Hungary's immunization policy as well as its legal and regulatory framework for SARS-CoV-2 vaccines deployment. The focus was on health law and labour law to explore whether and how SARS-CoV-2 vaccination could be turned into a workplace safety requirement. Results In Hungary, SARS-CoV-2 vaccination is currently voluntary. However, the Hungarian Healthcare Act and Labour Code allow for making it mandatory by ministerial decree prescribing a vaccination obligation as an employment condition for certain jobs. The National Public Health Center determines on a yearly basis the list of jobs concerned. Individuals may only be exempted if their (current or foreseeable) underlying health conditions so require. Further to the Labour Code, if employers use negative incentives (e.g., sanctions) and positive incentives (e.g., bonuses) to enforce vaccination, they must satisfy the conditions of necessity, proportionality and non-discrimination. Conclusions Although SARS-CoV-2 vaccination is currently voluntary in Hungary, the legal framework for mandatory vaccination at work is put in place. When it comes to enforcing the vaccination obligation, sanctions imposed by employers and related application of the necessity and proportionality standards have not yet been tested in Hungarian courts. Key messages Regulation shall ensure protection of employees’ rights as part of SARS-CoV-2 vaccination policies. Measures promoting vaccination must respect the legal requirements of proportionality, necessity and non-discrimination.

Workplaces are high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. Included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-three studies from international healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for 280,000 employees.

Background:
Deployment of SARS-CoV-2 vaccines has sparked the debate on action that employers can lawfully take to promote vaccination uptake among employees. Absenteeism reduction, liability concerns, occupational health and safety, protecting the health and safety of clients and service recipients might prompt such action. This raises questions about employees' freedom of choice and right to (refuse) consent. The research examined the related policy and regulatory framework in Hungary.

Methods:
Legal and policy analysis was conducted on Hungary's immunization policy as well as its legal and regulatory framework for SARS-CoV-2 vaccines deployment. The focus was on health law and labour law to explore whether and how SARS-CoV-2 vaccination could be turned into a workplace safety requirement.

Results:
In Hungary, SARS-CoV-2 vaccination is currently voluntary. However, the Hungarian Healthcare Act and Labour Code allow for making it mandatory by ministerial decree prescribing a vaccination obligation as an employment condition for certain jobs. The National Public Health Center determines on a yearly basis the list of jobs concerned. Individuals may only be exempted if their (current or foreseeable) underlying health conditions so require. Further to the Labour Code, if employers use negative incentives (e.g., sanctions) and positive incentives (e.g., bonuses) to enforce vaccination, they must satisfy the conditions of necessity, proportionality and nondiscrimination.

Conclusions:
Although SARS-CoV-2 vaccination is currently voluntary in Hungary, the legal framework for mandatory vaccination at work is put in place. When it comes to enforcing the vaccination obligation, sanctions imposed by employers and related application of the necessity and proportionality standards have not yet been tested in Hungarian courts. Key messages: Regulation shall ensure protection of employees' rights as part of SARS-CoV-2 vaccination policies.
14th European Public Health Conference 2021 Measures promoting vaccination must respect the legal requirements of proportionality, necessity and nondiscrimination.
Trends in associations between sickness absence, disability pension and paid work after age 65 Prior sickness absence was associated with paid work and sickness absence after age 65, while disability pension before age 65 was associated with less sickness absence after 65.

Anne van der Put
A van der Put 1 , L Ellwardt 2 1 Department of Sociology, Utrecht University, Utrecht, Netherlands 2 Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany Contact: a.c.vanderput@uu.nl Exercising and eating healthy are not just an individual choice, but influenced by the social environment. Family members, friends or neighbors influence (un)healthy choices individuals make, yet little is known about other important contacts: colleagues. Many people spend at least 8 hours a day at work, mostly surrounded by the same colleagues. As a third of daily calories are consumed in the workplace and a lot of time is spent sitting there, colleagues could be important in shaping the (un)healthy choices employees make. We study to what extent colleagues influence each other's eating and exercise behavior. We focus on two pathways: colleagues can encourage a healthy lifestyle or act as role models whose behavior can be observed and copied. We use the European Sustainable Workforce Survey, with data on 4345 employees in 402 teams in 113 organizations. We measured healthy eating as how often employees eat fruit and vegetables. We measured exercise by the number of days in the past week employees did sports/physical activity for more than 30 minutes. Colleague encouragement was assessed by the extent to which employees said their colleagues encourage them to eat healthy food or exercise frequently. We computed colleague behavior by taking the average fruit and vegetable consumption, and exercise, of all colleagues in a team. We fitted multilevel models with employees nested in teams and controlled for gender, age, education, working hours, job physical demands, self-rated health, sector and country. Climate change is the biggest threat to public health. Any increase in global warming leads to negative impacts on human health and well-being. Due to the complexity of climate change, it is essential that future generations of public health professionals have the knowledge to address the uncertainties faced currently. Yet, schools and institutes in public health are taking insufficient action in preparing the current and future public health workforce. This workshop focuses on climate and health education inside and outside the public health field. Research from Krasna et al. (2020) shows that public health employees need professionals with the knowledge and skills set in climate and health. There has been a clear trend in which job postings for public health professionals are increasingly mentioning ''climate change''