- Due to state and institutional mandates, healthcare workers
across the country are increasingly being required to undergo vaccination,
both for seasonal and potentially for H1N1 influenza virus when the vaccine
- Last month, the Health Department of New York State took
the mandates to a new level by adopting a regulation requiring tens of
thousands of healthcare workers to be vaccinated against both the seasonal
and H1N1 strains of influenza. According to a New York Times report,
the regulation was strongly protested by New York's largest healthcare
union, 1199 S.E.I.U. United Healthcare Workers East, whose president, George
Gresham, said that the policy was "completely unprecedented"
and could become punitive if the religious or cultural beliefs of workers
prevented them from being vaccinated.
- Traditionally, fewer than half of healthcare workers
seek out influenza vaccination on their own each year, according to a Centers
for Disease Control and Prevention survey on the topic.
- In addition, a nonscientific online
poll of healthcare professionals conducted by Medscape this month
has found that of nearly 9000 respondents, 42% said they are "very
likely" to get vaccinated, and 13% are "somewhat likely"
- together representing more than half the respondents.
- The informal poll also indicated that an equal number
of nurses and physicians (44%) were "very likely" to get vaccinated.
In contrast, nearly one fourth of respondents to this poll (24%) indicated
that they were "not at all likely" to get the vaccine.
- State and Institutional Mandates
- Other states in addition to New York with mandatory vaccination
laws include Alabama, Arkansas, California, and Kentucky. However, in these
states, the laws include exemptions through which healthcare workers can
abstain from vaccination due to religious or medical reasons (eg, Alabama
and Kentucky); in California, healthcare workers can decline for any reason
if the refusal is made in writing. The New York requirement is, to date,
the most stringent among the states.
- In addition to state mandates, several institutions require
that their employees get vaccinated. Examples include the Barnes Jewish
Corporation HealthCare in Missouri, the University of Iowa Hospitals, and
Grady, a large hospital in Atlanta, Georgia. According to Grady officials,
similar mandates could follow for healthcare workers to take the H1N1 influenza
vaccine when it becomes available in mid-October.
- "While we were well above the national average for
immunization of healthcare workers, we can do even more to protect our
patients and each other from the flu," notes Clay Dunagan, MD, Barnes
Jewish Corporation HealthCare vice president of quality and director of
the Center for Health Care Quality and Effectiveness in a written release.
"This is a very simple step we can take to reduce the transmission
of influenza within our hospitals and workplaces," he added.
- Professional Viewpoints
- In general, professional medical societies support the
concept of influenza vaccination for healthcare professionals provided
that healthcare workers are allowed to decline on the basis of medical
or professional reasons.
- The Infectious Diseases Society of America recommends
that healthcare workers should be required to get annual influenza vaccination
or decline in writing.
- The American Nurses Association has not been supportive
of mandated influenza shots, but it recommends flu vaccination and supports
the use of a signed declination form.
- The American Medical Association also does not support
mandatory vaccinations, but "we strongly encourage all healthcare
professionals to protect their patients, their families, and themselves
from the harmful effects of the flu by getting vaccinated," Rebecca
J. Patchin, MD, a member of the Board of Trustees of the American Medical
Association, told Medscape Infectious Diseases.
- "We don't think forcing people to get vaccinated
is the right approach. Rather, we need to educate people about the benefits
of vaccination and make it easy for them to get it," she said.
- Gayle Eversole, DHom, PhD, MH, NP, ND
- Founder and Director, Creating Health Institute and The
Oake Centre for natural health education
- Creator of ADVENTURX, the original xtreme sports supplement
- visit us at Natural Health News, Natural Notes and
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