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In recent years, public administration scholars investigated the relationship between employee turnover and public sector performance in settings where tasks are routine and frequently executed. This article builds on that foundation by investigating the contribution of organizational memory to the execution of infrequent and extraordinary tasks, theoretically distinguishing it from routine and ordinary tasks. Using a panel of administrative state employee payroll data from 45 states, this article tests the relationship between state health department employee turnover, retention, and performance in response to an emergency: the COVID vaccination campaign of 2021. Results show that recent health department turnover rates are a more substantive predictor than retention of employees with long-term experience. It is estimated that a one percentage point reduction in turnover would cost about $1.6 billion in additional compensation to state health departments and would produce reduced mortality benefits of $2.4 billion.
