Wednesday, September 09, 2009

HCWs: Refusing To Bare Arms



# 3710


Despite the almost universal plea each year by by public health officials, only about 40% of American Health Care Workers (HCWs) are inclined to get an annual flu shot.


This year, with both seasonal and pandemic flu to worry about, some online polls are showing that doctors and nurses are not exactly quick to embrace the pandemic vaccine as well.


Online polls are not considered `scientific’, because they generally attract people who have strong feelings one-way or the other on an issue, instead of being a random sampling.


Still, they can be a valuable gauge of public  opinion.


Last month the Nursing Times in the UK released a poll where 1/3rd of frontline nurses said they wouldn’t take the shot, roughly 1/3rd said they would get the shot, and 1/3rd were undecided (see HCWs: Developing a Different Kind Of Resistance).


Today, Medscape – a web resource for doctors and other healthcare professionals- is running a poll where they ask their members:


Several recent studies have shown that healthcare workers may choose not to get the H1N1 flu vaccine when it becomes available because of skepticism about the vaccine's effectiveness and possible adverse effects. How likely are you to get the H1N1 vaccine when it is available?


This poll runs for a week, but in the first 24 hours it has roughly 2,700 responses (we’ll check back next week when it’s finished). Thus far, the feedback is less than encouraging.

Overall only 40% are very likely to take the shot, and just over half are either very likely or somewhat likely.



As of 0800 hrs, 9/9/09 – poll ongoing


Of those who identify themselves as physicians, only 43% are very likely to get the shot. 



Over at we are watching an ongoing poll with a similar question being posed.  The number of respondents is fewer, but this poll has the advantage of having comments attached, where you can read the rationale of many of those who took part.




In the past few years a small number of hospitals have moved toward making the seasonal flu shot a mandatory condition of employment, which is a move that was endorsed by APIC (Association for Professionals in Infection Control and Epidemiology) last fall. 


APIC released a statement on October 9th of last year, recommending that "influenza vaccine be required annually for all healthcare personnel with direct patient care."

Recently New York State has moved to make the flu shot mandatory for many in the medical field, which has inspired the ire of a number of HCWs.



State Requires Flu Vaccination for Caregivers

Published: August 18, 2009

The State Health Department is requiring tens of thousands of health care workers across the state to be vaccinated for flu, amid fears that swine flu will return in the fall.

The new regulation, quietly adopted as an emergency on Thursday, affects workers at hospitals, in home health care agencies and in hospice care, but, because of a technicality in state law, not in nursing homes.



There seems little doubt that the refusal of HCWs to bare their arms for the yearly flu shot puts patients in their care at greater risk of infection.   Hospitals, ever mindful of liability concerns, are taking a hard look at mandating vaccination.



We find ourselves at an impasse between the individual’s right to choose what they wish to be injected into their bodies, the moral obligation of HCWs to `do no harm’, and growing concerns of hospitals over liability. 


A lot of eyes will be on New York State to see how well this mandate goes over, and what court challenges it inspires. If New York is successful, I’ve no doubt other states will follow suit in the years to come.


A few previous blogs I’ve written on this controversy include:


BJC: Mandatory Flu Shots For HCWs

UK: Unvaccinated Health Care Workers Spread Flu

Ongoing Debate: Mandatory Flu Shots For Health Care Workers?

APIC Seeking Mandatory Flu Shot For HCWs

1 comment:

Peter Christian Hall said...

Good piece, clear thinking, as usual! The question of liability trumps choice.
Best, Peter