Widespread immunization is key to ending the coronavirus pandemic, but a significant number of Americans are reluctant to get their vaccines because of financial worries — especially people of color.

More than a third of adults are concerned about having to pay out of pocket for the vaccine, despite the fact that it’s free to every American, according to a recent survey from the Kaiser Family Foundation. Additionally, a third are worried about missing work if the side effects make them sick, while 1 in 6 are concerned about having to take time off to get the vaccine.

“If you’re a low-wage worker, you’re far less likely to have access to paid sick days,” Elise Gould, senior economist at the Economic Policy Institute (EPI), told Yahoo Money. “So that simple fact of getting to a vaccine site, spending the time there, doing it again, and then potentially having side effects could make economically fragile families pass.”

“It’s very much of an issue,” she added.

‘Definitely a role for employers to play here’

The addition of Johnson & Johnson’s vaccine is crucial in addressing some of the vaccine hesitancy. Because it’s only one dose, workers don’t have to worry about missing extra days of work.

“The Pfizer and Moderna vaccines were the two that were available first to people in this country and both require two doses,” said Maura Calsyn, acting vice president for health policy at the Center for American Progress. “That’s two days potentially of missing work, two days potentially of having some side effects. With the J&J vaccine being authorized by the FDA, that’s really important because it’s one dose so that halves the concern potentially.”

There are no federal requirements for paid sick leave. However, eight states and the District of Columbia have enacted their own statewide paid family and medical leave laws. Some companies, like Trader Joe’s and Dollar General, have offered their employees paid time off to get their vaccines, but this isn’t the case for every business across the country.

“There’s definitely a role for employers to play here, which is making it clear to their employees that they want them to get vaccinated and having policies at work that say you can take paid time off to get the vaccine but if you get sick from the side effects of the vaccine, you can take time off,” Liz Hamel, vice president at the Kaiser Family Foundation, told Yahoo Money.

This is especially important for hourly workers, who are often low income and lose pay if they take any time off, along with essential workers, Gould said.

“It’s definitely not a negligible hurdle,” Gould said.

Research has found that people of color represent a disproportionate amount of essential workers, and they also account for a large amount of deaths from COVID-19.

And while 34% of those unvaccinated are worried about missing work because of vaccine side effects, that number is even higher among Black and Hispanic adults at 49%. And 45% of them are concerned about having to pay for the vaccine.

“It’s particularly important to address some of those concerns and information needs for those populations if we want to get to a more equitable outcome in terms of who’s getting the vaccine,” Hamel said.

According to Calsyn, the most important factor is vaccine education, specifically ensuring that people understand they don’t have to pay for the vaccine and making sure they understand that side effects should not be a deterrent. But paid sick leave and providing more vaccine locations near people’s work are key, especially for those in communities most vulnerable to the COVID-19.

“It’s emblematic of inequities across the health care system,” Calsyn told Yahoo Money. “I hope that there’s some additional flexibility on when you can get the vaccine, hopefully as supply increases, more appointments available for people, and mobile clinics and the retail pharmacy program.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance.

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