Photo Credit – CDC PHIL
# 5709
A perspective appears today in The Lancet by Arthur Caplan, Ph.D., who is director of the Center for Bioethics at the University of Pennsylvania, on the ethics of mandating yearly influenza vaccination for Health Care Workers (HCWs).
Arthur Caplan is the author and/or editor of nearly 25 books, and more than 500 journal articles. He writes a regular column on bioethics for MSNBC.com, and is a frequent guest commentator on NPR, CNN, MSNBC, and for major newspaper outlets, including the New York Times and Washington Post.
In 2008, Discover Magazine named him one of the 10 most influential people in science.
Not known for mincing words (see Arthur Caplan On `Flunking The Swine Flu Test’ for an earlier example), Caplan states that: “Vaccination is a duty that one assumes in becoming a health-care provider.”
He argues that the evidence overwhelmingly shows that vaccinating HCWs helps to protect patients from infection (and possible death), and that the influenza vaccine is both safe and effective.
Citing language common to all oaths sworn by health care professionals (Doctors, Nurses, Techs, etc.), he points out the universal concept that the interests of the patient must come first, and that all HCWs must honor the core medical principal of, “First, do no harm.”
Both tenets, he argues, are violated when HCWs fail to accept a yearly flu vaccination.
Yet every year, despite awareness campaigns and the endorsement by many medical organizations, less than half of all healthcare providers in the United States and the UK voluntarily agree to take the vaccine.
You can read the entire piece at the link below, after which I’ll return with more.
The Lancet, Volume 378, Issue 9788, Pages 310 - 311, 23 July 2011
doi:10.1016/S0140-6736(11)61156-2
Time to mandate influenza vaccination in health-care workers
While strongly advocating HCW influenza vaccination, the CDC has stopped short of mandating them. I blogged on this back on June 23rd, 2010 in CDC: Proposed Influenza Infection Control Guidance.
Numerous professional medical organizations have adopted policies calling for mandatory vaccination of HCWs, however. A few earlier blogs on that include:
APIC Calls For Mandatory Flu Vaccination For HCWs
AAP: Recommends Mandatory Flu Vaccinations For HCWs
SHEA: Mandatory Vaccination Of Health Care Workers
IDSA Urges Mandatory Flu Vaccinations For Healthcare Workers
While many infection control experts see this as a long overdue step in patient and co-worker protection, this is a hugely divisive issue, with many HCWs believing that it is an infringement of their rights to decide what will be injected into their bodies.
I’ve covered HCW’s objections to forced flu shots in the past, including:
HCWs: Developing a Different Kind Of Resistance
Given that hospitalized patients are often at increased risk of serious illness or death from influenza, reasonable measures that can reduce the spread of the virus – such as improved vaccination rates and better infection control measures - are vital areas that many healthcare facilities need to review and improve.
In recent years an increasing number of hospitals have managed to implement mandatory flu vaccinations, including Seattle’s Virginia Mason Medical Center and BJC Heathcare of St. Louis, Missouri (see here and here).
The Immunization Action Coalition (IAC) maintains a terrific website with extensive information on vaccines, and includes a growing `Honor Roll’ of organizations and practices that have adopted a mandatory flu shot policy (some exemptions may apply).
As we saw last month in SHEA: Improving HCW Flu Vaccine Uptake, some facilities are offering employees an alternative to taking the vaccine. This from a recent edition of Infection Control and Hospital Epidemiology.
An Alternate Approach To Improving Healthcare Worker Influenza Vaccination Rates
Lisa M. Esolen, Kimberly Kilheeney, Richard E. Merkle
Essentially, this approach allows HCWs with medical or ethical objections to flu vaccination to opt out and elect to wear a surgical facemask during flu season when in close contact with patients.
Increasingly, hospitals are looking at this as both a liability and an economic issue, on top of their concerns over patient welfare.
Of course, legal challenges still lie ahead.
But love the idea, or hate it, the momentum appears to be moving in the direction of mandatory influenza vaccinations for Health Care Workers.
