Flu season can create workplace challenges for employers, from employee absences and productivity concerns to sick leave, pay and policy enforcement. To help U.S. and Canadian employers prepare, here are answers to eight common questions about managing the flu at work.

1. Why should employers care about the flu at work?

Flu outbreaks can increase absences, reduce productivity and strain staffing—especially when multiple employees are sick at the same time. Flu-related absences can also raise questions about sick leave, paid leave, workplace safety and consistent application of health-related policies.

2. What can employers do now to prepare for flu season?

Employers can take several practical steps to reduce flu-related disruption and help limit the spread of illness at work:

• Provide flu-prevention information. Share information about vaccination safety, the benefits of getting vaccinated, prevention steps and related workplace policies.
• Offer flu shots. Employers can provide free or discounted vaccinations through on-site clinics or partnerships with local pharmacies. The International Foundation’s Workplace Wellness and Financial Education Programs: 2025 Survey Report finds:
  • Among U.S. employers overall, 64.4% have a flu shot program (free or discounted flu shots). Of those, 24.9% offer incentives.
  • Among Canadian employers overall, 34.9% offer flu shots. However, none of those programs offer incentives.
• Encourage the use of sick days. Remind employees to stay home when they are ill and use available paid sick leave to help limit the spread of flu. Managers should model the same behavior.
• Implement paid time off policies. Paid time off for short-term illnesses can reduce workplace disruption during flu season. Separate sick leave may be more effective than a combined paid time off (PTO) bank because employees may be less hesitant to use it when they are ill.
• Promote hand washing and cough etiquette. Remind employees to wash their hands with soap and water for at least 20 seconds at key times, including after coughing, sneezing or using the restroom as well as before eating or preparing food. CDC also advises covering coughs and sneezes with a tissue.
• Keep the workplace clean. Make disinfectant wipes, hand sanitizer, automatic soap and paper towel dispensers, and other cleaning supplies readily available.

3. Can employers require employees to get flu shots?

In some circumstances. While employers may require flu shots, mandatory vaccination programs are generally not recommended. Some employers, especially in health care settings, make vaccination mandatory because employees may transmit the virus to patients.

Before implementing a mandatory flu shot program, employers should consider disability and religious accommodation issues under the Americans with Disabilities Act (ADA) and Title VII of the Civil Rights Act in the United States. Canadian employers should consider whether similar issues may arise under the Canadian Human Rights Act. Employers should also review any applicable state, municipal or provincial laws that may cover these issues.

Employers that require flu shots should allow for exceptions when employees cannot receive a vaccine because of a medical condition or sincerely held religious belief. A reasonable accommodation may be required unless it would create an undue hardship.

4. Can employers tell employees to stay home if they have flu-like symptoms?

Generally, yes. Employers may send sick or contagious employees home—or instruct them not to report to work—to help maintain a safe and healthy workplace.

Under the Occupational Safety and Health Act (OSHA) in the U.S. and the various federal, provincial and territorial Occupational Health and Safety Acts (OHSA) in Canada, employers can send a visibly ill employee home. If it is not obvious that the employee is sick, employers may ask whether the employee has flu symptoms, since that is not necessarily a disability-related inquiry.

When available and appropriate, employers may encourage remote work while an employee is contagious or experiencing flu-like symptoms, including as a reasonable accommodation under the ADA or applicable human rights laws. Before going beyond general workplace health guidance, employers should confirm compliance with applicable disability and human rights laws.

5. Can an employee use job-protected leave for the flu?

Sometimes. In the U.S., flu-like illnesses may qualify as a “serious health condition” under the Family and Medical Leave Act (FMLA), but most flu-related absences will fall under state or local leave laws or employer absence policies.

In Canada, job-protected sick leave varies by province. For example, Ontario’s Employment Standards Act provides leave for employees who are sick or need to care for family members. Rules on whether employers may require medical evidence, such as a sick note, also vary by province. McCarthy Tétrault provides a province-by-province overview of sick note requirements in Canada.

6. How do U.S. leave and pay rules apply when an employee is sick?

Employers generally do not have to pay employees for sick time unless a federal, state or local paid sick leave law applies. For nonexempt employees under the Fair Labor Standards Act (FLSA), missed work may be unpaid, but employers may require or allow use of available PTO.

The rules differ for exempt employees. Employers may require exempt employees to use PTO for missed time but generally may not deduct wages from an exempt employee’s salary for sickness or disability absences.

An exception applies in limited circumstances, such as when an exempt employee has exhausted available leave or has not yet accrued PTO, and the deduction is made under a bona fide plan for sickness or disability absences.

7. What should employers do when an employee needs to care for a sick family member?

Employers should first review their policies and any applicable leave laws to determine whether time off or remote work is available. Depending on the jurisdiction, family or medical leave laws, sick leave laws or PTO policies may allow available leave to be used for caregiving. Flexible policies and alternate work schedules can help employees manage family needs while reducing workplace transmission. These options should be applied consistently to avoid claims of unequal treatment.

8. What should employers include in a flu or infectious disease policy?

A clear policy can help employers respond consistently when employees are sick and reduce confusion about workplace expectations, leave and pay.

• Follow applicable public health guidance. Specify when sick employees should stay home and when they may return to work—for example, once symptoms are improving and they have been fever-free for at least 24 hours without medication. Because not all flu cases involve fever, the policy should also address other flu-like symptoms and when employees should be sent home from work.
• Address leave and pay issues. Explain how sick leave, family caregiving leave, PTO and compensation rules apply.
• Clarify reporting and work-from-home expectations. Explain how employees should report flu-like symptoms or absences, whether remote work or flexible scheduling is available, and who employees should contact with questions.
• Protect employee privacy. Remind managers to handle health-related information carefully and share it only when necessary and appropriate.
• Apply policies consistently. Use the same standards for leave, attendance and workplace health issues across similar situations.

Key Takeaway

By communicating early and applying policies consistently, employers can help reduce workplace transmission while supporting employees who are sick or caring for family members.

Learn More About the Flu at Work

Additional flu resources include:

• Flu (influenza): Symptoms and treatment, Government of Canada
• Flu (seasonal influenza): Monitoring, Government of Canada
• Influenza (Flu), Centers for Disease Control and Prevention
• Seasonal Flu, Occupational Safety and Health Administration.

For information on paid sick leave issues that may arise during flu season, visit our paid sick leave pages for the U.S. and Canada.

Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.