Photo Credit – CDC PHIL
# 7620
Four years ago (2009), with the specter of the H1N1 pandemic looming, the state of New York attempted to mandate that all health care workers (HCWs) receive a yearly flu shot.
But due to a shortage of pandemic H1N1 vaccine that fall, and vigorous protests (and threats of legal action) by employees, in October of 2009 we saw New York Rescind Mandatory Flu Shots For HCWs.
Since that time, the debate over mandatory flu vaccinations for HCWs has raged. While the CDC only recommends the flu shot, many professional medical organizations have adopted policies calling for mandatory vaccination of health care workers.
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, some HCWs see this as an infringement of their rights to decide what will be injected into their bodies (see HCWs: Refusing To Bare Arms & HCWs: Developing a Different Kind Of Resistance).
In July of this year, the CDC reported – after seeing increases in the update of flu vaccines by HCWs over the past few years – that last year (2012-13) saw little improvement over the previous year (see CDC: Uptake Of Flu Vaccine By HCWs).
In recent years a growing number of medical facilities have implemented mandatory flu vaccination as a condition of employment, including Seattle’s Virginia Mason Medical Center and BJC Healthcare of St. Louis, Missouri (see here and here).
Some states have begun to consider laws requiring HCW immunization, including last October when Rhode Island Adopts New Flu Vaccination Requirements For HCPs.
Earlier this month, New York state quietly passed a regulation that would require – once flu season begins – for all health care workers either to be vaccinated against influenza, or `wear a surgical or procedure mask while in areas where patients or residents may be present’.
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.
The entire regulation may be read at this link.
Critics point out that we really don’t know just how effective masks are in preventing the transmission of influenza to patients. The assumption is, by helping to contain respiratory secretions, they would help reduce transmission.
But by how much? No one knows.
Of course, flu vaccines aren’t close to being 100% effective either.
Most years (see CIDRAP: The Need For `Game Changing’ Flu Vaccines), protection from the flu shot runs under 60% for healthy adults, and probably even less for those over 65 or with weakened immune systems.
While admittedly imperfect solutions - given the increased risk to patients of serious illness or death from influenza - reasonable measures that can reduce the spread of the flu in the healthcare environment are increasingly being considered.
Love the idea or hate it – short of an overturn in the courts – the requirement for annual flu vaccinations in HCWs appears to be gaining traction across the country.
