# 4961
One of the most contentious subjects among Health Care Workers (HCWs) today is the growing move towards making annual seasonal influenza vaccinations a requirement for employment.
Over the past two years several infection control and medical professional organizations have come forth in support of the idea, including APIC, SHEA, IDSA, and most recently the AAP (American Academy of Pediatrics).
A few of my recent blogs on the subject include:
AAP: Recommends Mandatory Flu Vaccinations For HCWs
SHEA: Mandatory Vaccination Of Health Care Workers
IDSA Urges Mandatory Flu Vaccinations For Healthcare Workers
Despite this recent push towards mandatory vaccination for HCWs, only a handful of large hospitals have managed to implement mandatory flu vaccinations, including Seattle’s Virginia Mason Medical Center and BJC Healthcare of St. Louis, Missouri which I blogged about here.
Details on how Virginia Mason Medical Center implemented mandatory HCW vaccinations can be read in the following PDF.
Earlier this week CIDRAP reported on several Health Care Facilities in and around Chattanooga that are now requiring annual vaccinations.
More health facilities require flu immunization for staff
Two health systems and a hospital near Chattanooga, Tenn., are now requiring flu vaccination for healthcare workers, the Chattanooga Times Free Press reported today.
While strongly advocating HCW influenza vaccination, the CDC has stopped short of mandating them. I blogged on this back on June 23rd in CDC: Proposed Influenza Infection Control Guidance.
Similarly, a UK Department of Health report issued in June called Learning The Lessons From the H1N1 Vaccination Campaign For Healthcare Workers – while not mandating vaccination – stresses the `professional duty’ of all HCWs to get the vaccine.
New York State attempted to require vaccination as a requirement to work as a HCW in 2009, but legal challenges and vaccine shortages forced them to abandon – at least temporarily – that mandate (see New York Rescinds Mandatory Flu Shots For HCWs).
Although viewed as an important patient safety, infection control, and liability issue by management, many HCWs see this as an infringement upon their rights to decide what they will have injected into their bodies.
I’ve covered HCW’s objections to forced flu shots in the past, including:
All of which brings us to today’s report on a survey of Infection Control professionals working in Health Care Facilities across the country on their views on requiring mandatory flu vaccinations for HCWs.
Infect Control Hosp Epidemiol 2010;31:1063–1065
© 2010 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2010/3110-0012$15.00
DOI: 10.1086/656382
Results of a National Survey of Infectious Diseases Specialists regarding Influenza Vaccination Programs for Healthcare Workers
Philip M. Polgreen, MD, MPH; Edward Septimus, MD; Thomas R. Talbot, MD, MPH; Susan E. Beekmann, RN, MPH; Charles Helms, MD, PhD
A minority of infectious diseases consultants currently work in healthcare institutions requiring influenza vaccination for healthcare workers, and in approximately half of these institutions, the healthcare workers who refuse vaccination do not face substantial consequences for their refusal.
Although true mandatory policies are not common, a majority of infectious diseases consultants support such policies.
The IDSA sent a 14 question survey to 1326 members of their Emerging Infections Network in December of 2009, followed by a couple of email reminders.
Roughly half of the members responded.
Among the respondents, 80% agreed or strongly agreed that HCWs should be required to get a yearly flu vaccination and that HCWs refusing vaccination should be required to sign a declination statement.
The survey showed that 74% agreed or strongly agreed that influenza vaccination rates should be reported publicly as a measure of patient safety.
Only 37% reported that their healthcare institutions currently required influenza vaccination of HCWs. Of the remaining 63% that did not require vaccination, roughly half (51%) stated they were considering implementing a mandatory vaccination policy.
Among those hospitals requiring vaccination, most (91%) allowed exceptions including medical contraindication [84%], religious beliefs [47%], and personal beliefs [37%].
While mandatory, serious consequences for refusing vaccination were rarely reported. The survey indicated that 54% of respondents reported no consequences while 22% were unsure that consequences existed.
Only 3% required that unvaccinated HCWs wear masks during patient care; and 2% reported that job evaluations were affected. Termination or suspension was reported by only 9% of respondents.
The authors point out that this survey, from a scientific viewpoint, has some limitations; it was not a population-based survey and the response rate may have been higher among those whose facilities have instituted mandatory vaccination programs.
Still this gives us a pretty good sense of the mood among infection control physicians across the country, and the growing move towards `mandatory’ vaccination for health care workers.
Despite the early success of a few mandatory vaccination policies across the country, the ultimate goal of achieving near-universal vaccination of HCWs in America and reducing the burden of influenza in health care facilities remains elusive.
The authors sum up the situation with this closing paragraph:
. . . given that the meaning of “mandatory” appears to have different interpretations in different institutions, the success of mandatory influenza vaccination programs may depend largely on the enforcement mechanisms implemented and the consequences for HCWs refusing influenza vaccination.
Whether accidental or intentional, I was surprised (and delighted) to find that a link to the entire PDF comes up at the top of a Google search on the study’s title. [PDF] Results of a National Survey of Infectious Diseases Specialists ...
