Mandatory flu vaccinations

Now that flu season is upon us, it’s particularly important for hospital staff and bedside clinicians to remain ‘flu free’ and prevent the possibility of spreading the virus to patients and family members.

In 2017, the Centers for Disease Control and Prevention (CDC) reported that 80,000 people died as result of the flu, making it the highest death toll in over 4 decades. (Typical flu-related fatalities range from 12,000 to 56,000 per year.)

Unlike patients who have a choice about getting the flu shot, most health care workers don't have a say. Many hospitals across the country have policies requiring employees to get vaccinated.

The flu shot debate

Though the government recommends that health care facilities increase the number of workers who get vaccinated, nurses and other workers in some communities have put their jobs on the line by refusing due to medical/religious reasons. Many employers feel otherwise, in that bedside caregivers have a responsibility to protect the well-being of vulnerable patients and co-workers who need to stay healthy.

Some patients cannot get the flu shot because they are undergoing cancer treatment, for example, and have compromised immune systems.

Although the CDC recommends that everyone age 6 months and older get a flu shot, annual statistics show that approximately 63% of all health care workers are vaccinated compared with 40% of the general public. The CDC also reports findings that vaccines among the health care work force helps reduce patient fatalities, and aims to have 90% compliance for health care workers by 2020.

The American Nurses Association (ANA) and National Nurses United (NNU), which represent about 300,000 of the nation's nurses, have not tracked how many workers have been suspended or fired for refusing to get a shot. Both groups recommend the vaccination for nurses, but agree  that it shouldn't be mandated and workers shouldn't be fired. In most states, individual hospitals set their own policies.

The argument for mandatory flu shots

There are three main arguments hospitals set forth as justification for requiring employees to get flu shots:

• Patient safety is the hospital’s primary motivation for requiring flu shots. Hospitals don’t want their patients to contract the flu from the nurses and doctors who treat them.
• Effectiveness of the vaccine is about 70%, a significant reduction in risk from a single shot.
• Employee health and wellness is also a consideration. Health care professionals are at increased risk for contracting the flu since they are around sick people all day. Hospitals want to reduce the occurrence of flu among their employees not just to protect patients, but also to protect their employees from getting sick and missing work.

The argument for allowing staff to decide for themselves

Some argue the case against mandatory vaccination:

• Some vaccine recipients have reported side effects. The flu vaccine has been linked to increased risk of seizures, for example, and Guillain-Barré syndrome.
• It sets a precedent. If it’s okay to mandate doctors and nurses to be vaccinated, will they require the rest of the population next? Patients still have a right to refuse medical treatments they don’t agree with.
• Many believe the flu shot is unnecessary because when they contract the flu they don't experience any adverse effects and are left with a natural immunity to the virus that made them ill.