Should health care workers be required to be immunized against influenza? A case for mandatory vaccination is made

0 Comments | Family Practice News, Oct 1, 2009 | by Christine J. Nutty

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices provides annual recommendations for prevention of influenza by vaccination. ACIP currently recommends vaccination against both seasonal influenza and pandemic influenza A(H1N1) when vaccines become available. Because of their close proximity to sick people, health care workers are among the priority groups to receive both vaccines.

Despite years of education, publicity, begging, and pleading, the average rate of flu vaccination among health care personnel remains about 40%.

Because influenza is a highly contagious disease that can be spread 24 hours before symptoms appear, health care workers can transmit the virus to high-risk patients and coworkers before realizing they are sick. Until vaccines are mandated for all health care providers, every patient will be placed at risk, many will develop influenza, and thousands will die.

Some facilities have achieved great improvements in their rates of health care worker flu vaccination through voluntary efforts, but have had to spend many hours promoting the vaccine--hours that could have been better spent on measures to prevent the spread of other deadly infections such as methicillin-resistant Staphylococcus aureus or Clostridium difficile.

Multiple studies have shown that changes brought about by education programs are short lived, and that these programs require much effort each time improvement is sought.

When facilities such as Barnes-Jewish Hospital in St. Louis report their 98% vaccination rate with a mandatory program, it is no wonder other institutions consider following suit. When consumers learn that flu vaccination of health care workers can be required as a condition of employment, it is only a matter of time before hospital boards start asking administrators why mandatory efforts have not been instituted.

Several organizations, including my own--the Association for Professionals in Infection Control and Epidemiology--have called for such mandatory policies. We are confident that facilities that require flu shots will save lives, reduce sick hours, and realize financial savings.

Most health care providers agree that prevention is crucial to saving patients from infections. When health care workers are required to be vaccinated against influenza, it sends a message that their employer is determined to prevent infections. If the employer decides not to mandate flu vaccines, that also sends a message--that infection prevention is not a priority at that facility.

BY CHRISTINE J. NUTTY, R.N.

Ms. NUTTY is president of the Association for Professionals in Infection Control and Epidemiology.