Editorial: Mandate flu shots for health workers

  • Updated: September 19, 2010 - 5:23 PM

Ill-informed objections shouldn't trump patient safety.

Imagine your reaction if you watched a loved one wheeled into surgery, then saw staff preparing to operate without masks, sterile gowns and gloves.

No one questions these basic protections against infection. Nor do individual staffers get to decide if they want to suit up for patient safety. If employees don't feel like wearing a mask, they don't get past the operating room door.

And yet when it comes to another critical patient-safety measure -- influenza vaccines for health care workers -- medical centers in Minnesota and across the nation are shockingly hesitant to mandate the protection of those cared for within their walls. Despite years of efforts to educate and entice employees, the rate of flu vaccination for health care workers hovers nationally at an unacceptable 50 percent. It's time for health care administrators to put patient safety above all other concerns and require employees to get the shot or the nasal spray vaccine.

Leaving this life-and-death decision up to individual staffers makes as little sense as letting them decide to wear street clothes into an operating suite. Different strains of the influenza virus arrive each year with the winter winds. The thousands who die annually from flu complications are those likeliest to need medical care: the elderly, the very young and those with weakened immune systems. Patients and their families have a right to expect that those who care for them have done everything possible to protect them. Unless there's a valid medical reason for a health care worker not to get a flu shot, it is simply one of their moral and professional obligations.

The reasons given for not getting a flu shot and for objecting to a mandatory policy vary, but they boil down to a selfish "don't tread on my rights" attitude and to misinformation about the shot's benefits or risks. The flu vaccine is safe, and it remains the most effective weapon against a killer virus. Bottom line: None of these concerns comes close to trumping patient safety.

A growing number of influential medical organizations are calling for mandatory shots for workers -- including the American Academy of Pediatrics, the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America and the National Patient Safety Foundation. Leading hospitals, including the Virginia Mason Medical Center in Seattle and the Hospital of the University of Pennsylvania, have begun to mandate the shots, and the U.S. Department of Defense requires them for direct-care civilian workers in its facilities.

Despite this, institutions that should know better remain skittish about a mandate. Few if any Minnesota medical centers mandate flu shots for personnel, although data on this is sketchy. The American Nurses Association backs away from enforcement of a mandatory policy. Nursing unions including the Minnesota Nurses Association typically oppose mandates, and that influence is a key reason why they aren't widespread. Medical centers and organizations should place patient safety above fears of pushback from unions and a small number of employees.

Hospitals in Minnesota and elsewhere require some vaccinations, such as the shot protecting against measles, mumps and rubella. In addition, many health care workers are tested for tuberculosis. Requiring the flu shot is a necessary and sensible step whose time has come.


    "I believe that in the near future we will look back and, as medical and nursing professionals, be severely criticized for not having adopted such measures much earlier given our cultural and professional mandate to protect our patients, fellow [health care workers] and communities from harm.''

    DR. GREGORY POLAND of the Mayo Clinic, in an editorial appearing in the Vaccine medical journal.

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