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One of the most contentious pandemic issues to arise during the past six months has been the notion that HCW’s (Health Care Workers) should be required to get vaccinated against pandemic and seasonal influenza.
New York State attempted to require vaccination as a requirement to work as a HCW, but legal challenges and vaccine shortages forced them to abandon – at least temporarily – that mandate (see New York Rescinds Mandatory Flu Shots For HCWs).
While New York was the only state to try to mandate flu vaccination for HCWs, the suspension of that ruling doesn’t mean the issue has gone away.
- Some hospitals around the nation have adopted mandatory vaccination – or require the wearing of masks by unvaccinated workers during flu season.
- APIC (Association for Professionals in Infection Control and Epidemiology) has been promoting the idea of mandatory flu shots for HCWs for over a year (see APIC Seeking Mandatory Flu Shot For HCWs)
- And the New York State Health Department indicates that they will pursue mandatory vaccination again in 2010, assuming adequate vaccine supplies are available.
I strongly support the idea that HCWs should get vaccinated, but I fell short of wanting to see that mandated with this year’s vaccine. (See Public Support For Mandatory HCW Vaccination).
Forcing vaccinations during a time when a sizable portion of Health Care workers perceived the vaccine to be `untested and unsafe’ (it isn’t) seemed to me to be terrible timing and almost certain to backfire.
Better to implement this sort of thing during a non-pandemic year, I should think, when the release of a `new’ vaccine isn’t clouding the issue.
I do believe the day is coming when most states will require yearly flu vaccines for HCWs, and I am generally supportive of the idea.
But before that can happen, better education of the workforce needs to be implemented, and steps must be taken to make getting the shot easy, free, and convenient.
Despite the vocal outcry in New York State against mandatory flu shots, at least one poll – highlighted in this month’s issue of Archives of Pediatrics & Adolescent Medicine - indicates broad support (70%) for compulsory vaccination of HCWs.
This report from Medscape, followed by the study’s abstract.
Most Healthcare Workers Support Compulsory Influenza Vaccinations
Nancy Fowler Larson
January 5, 2010 — Most healthcare workers (HCWs) approve of mandatory influenza vaccines for hospital employees, and their numbers could be further boosted by giving opponents more information, according to a study released yesterday in the January 2010 issue of the Archives of Pediatrics & Adolescent Medicine.
"Influenza is responsible for an estimated 36,000 deaths and 226,000 hospitalizations every year in the United States," write John D. Lantos, MD, from Children's Mercy Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri, and colleagues. "The Centers for Disease Control and Prevention recommend that all [HCWs] receive an annual influenza immunization to protect themselves and their patients. Nevertheless, only 40% of HCWs in the United States get immunized every year."
At greatest risk for influenza infection are children and the elderly. Although vaccination rates are greater at pediatric hospitals, some continue to have low rates even in high-risk units. With the eventual goal of protecting pediatric and other populations in hospital settings, the study sought to determine the level of support for mandated vaccinations among HCWs and to pinpoint differences in the beliefs and behavior of supporters vs opponents.
Excerpts from the abstract which appears in this month’s Archives of Pediatrics & Adolescent Medicine.
Health Care Worker Knowledge, Attitudes, and Beliefs Regarding Mandatory Influenza Vaccination
Lauren E. Douville, BS; Angela Myers, MD, MPH; Mary Anne Jackson, MD; John D. Lantos, MDArch Pediatr Adolesc Med. 2010;164(1):33-37.
Objective To determine the attitudes, beliefs, and knowledge of children's hospital health care workers toward mandatory influenza vaccination.
<SNIP>
Results Many employees (70%) thought influenza vaccination should be mandatory for health care workers who did not have a medical contraindication. Nearly everyone, 363 of 391 (94%), who favored mandatory immunization had been immunized themselves. Of those who opposed mandatory immunization, 45 of 81 (55.6%) had been immunized (P < .001). Individuals who supported mandatory policies were more likely to believe that the vaccine is safe for both children and adults.
There was no significant difference between the percentages of promandate and antimandate employees who believed influenza was dangerous for the patients where they work (66.5% and 62%, respectively, P = .07). Only 29% of antimandate employees believed they were at high risk of contracting influenza, compared with 51% of promandate employees (P < .001).
Conclusions Approval of mandatory influenza vaccine policies was high; however, attitudes about the dangers of influenza for patients were not associated with acceptance of mandatory vaccination policies for health care workers. Educational efforts targeting health care workers' fears and misconceptions about influenza vaccines might help to decrease the reservoir of unimmunized health care workers.
A few blogs from the past year on this subject include:
Public Support For Mandatory HCW Vaccination
HCWs: Refusing To Bare Arms
HCWs: Developing a Different Kind Of Resistance
BJC: Mandatory Flu Shots For HCWs
