Publication date: May 22, 2025

Objectives. To measure the associations between access to paid sick leave (PSL) and COVID-19 vaccination status in the United States, both overall and stratified by occupation and industry of employment. Methods. We extracted data on employed adults aged 18 to 64 years from the 2021 and 2022 US Medical Expenditure Panel Survey. We assessed associations between PSL and COVID-19 vaccination status using logistic regression. We used marginal effects analyses to estimate associations within occupation and industry groups. Results. Our analytic sample (n = 15 089) represented more than 114 million employed US adults. Access to PSL was significantly associated with receipt of a COVID-19 vaccination (adjusted odds ratio = 1. 33; 95% confidence interval = 1. 14, 1. 55). Marginal effects analyses indicated that this association was significant within most occupation and industry groups. Conclusions. These findings suggest PSL is associated with higher COVID-19 vaccination rates among US workers. PSL remains an important tool for improving preventive health care access and reducing rates of infectious disease in the United States. (Am J Public Health. Published online ahead of print May 22, 2025:e1-e4. https://doi. org/10. 2105/AJPH. 2025. 308095).

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Original Article