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Mandatory Flu Shot Not Justified for Health Care WorkersCategory: Public Health News
Article Date: 13 Sep 2005
Mandatory influenza vaccination for health care workers is not justified
says the American College of Occupational and Environmental Medicine (ACOEM)
in a new position statement. The College further opposes the use of declination
statements noting that there is “no evidence to suggest that such programs
will increase compliance.” The statement - Influenza Control Programs for
Healthcare Workers - applies to seasonal influenza and is not necessarily
appropriate during a major antigenic shift in the virus resulting in a
pandemic situation.
Influenza continues to be a major cause of
death and disease, readily spread by respiratory droplets both in the community
and in the hospital environment. While ample reasons exist for employers
to sponsor influenza vaccination programs for their employees and to pursue
strategies to maximize participation, the College noted that mandatory
flu shots are not justified for several reasons - the vaccine itself is
variably effective; vaccination does not preclude the need for other controls;
and a coercive program has the potential to harm the employer-employee
relationship. In addition, the College points out that “given the ubiquitous
nature of influenza in the community, patients will continue to be exposed
to influenza through family members and friends regardless of the vaccination
status of their health care workers, with whom they have much less intimate
contact.”
“Vaccination is only one prong in a multi-faceted approach to infection
control,” said William Buchta, MD, MPH, FACOEM, chair of the College's Medical
Center Occupational Health Section and author of the paper. “Health care
workers must also appropriately use hand washing and personal protective
equipment and they should consider self-removal from work when experiencing
symptoms of a communicable illness.” Dr. Buchta also noted that reliance
on employee vaccinations alone for prevention and control of influenza in
the health care environment offers a false sense of security and ignores
some of the more practical, but also effective means of minimizing nosocomial
transmission.
While ACOEM endorses a multifaceted influenza control program in all health
care facilities and strongly encourages health care organizations to facilitate
participation by providing influenza vaccine and/or prophylactic medication
at no expense to the employee, the College discourages generalized policies
requiring mandatory compliance with employee vaccination or prophylactic
medication, noting that such policies have already been successfully challenged
in Canada. “Making people sign a statement that they have declined to receive
a flu shot not only impacts the employer-employee relationship in a negative
way, but diverts resources from activities known to increase compliance
and devotes them to enforcement of a policy with no proven benefit,” said
Dr. Buchta. “Influenza control can be successful with creative programs
that employ the ‘carrot' rather than the ‘stick' while still respecting
the rights of both patients and employees.”
Influenza Control Programs for Healthcare Workers was approved by the
ACOEM Board of Directors on July 30, 2005. It is available on line at acoem.org/guidelines/article.asp?ID=86. In addition, the paper was published in the July/August issue of ACOEM Report, the College's official newsletter.
Founded in 1916, ACOEM is an international medical society of more than
5,000 occupational and environmental health professionals who provide leadership
to promote optimal health and safety of workers, workplaces, and environments.
The College is headquartered in Elk Grove Village, Ill.
American College of Occupational and Environmental Medicine
http://www.acoem.org
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