Will NY flu shot mandate drive nurses from field?
No provisions for religion, culture
A New York mandate that health care workers receive seasonal flu shots may drive nurses from the profession even as that state faces a nursing shortage, said Eileen Avery, MS, RN, associate 
director of the New York State Nurses Association (NYSNA).
"We are concerned that nurses would be exempted from the proposed mandate only if the influenza immunization is medically contraindicated," she said at a July 23 hearing. "The proposed regulations have no provision for religious or cultural preferences regarding immunization, effectively blocking individuals who have these beliefs from earning their livelihood. It's possible that nurses will leave the profession or choose another career because of this onerous mandate — a serious threat at a time when the shortage of nurses in New York State is expected to reach 20,000 within a decade."
Nevertheless, state health officials proceeded with the emergency regulation. It was uncertain at press time whether the NYSNA will abandon its strong opposition and cooperate with hospitals implementing the order. Speaking on behalf of 37,000 registered nurse members of the NYSNA, Avery noted numerous areas of concern for health care workers. Highlights of her testimony include:
• Public benefit may not be realized: "[N]urses will have to submit to vaccinations every year for the remainder of their careers . . . [W]ill this really ensure patient safety or prevent the spread of a flu virus? The seasonal flu vaccine is not 100% effective and sometimes is highly ineffective, as it was in 2005 and again in 2007. There is no guarantee that in any given year, the public will benefit from mandatory immunization of health care providers."
• Evidence-based voluntary programs have not been utilized. "The nurses association encourages nurses to voluntarily get flu shots. We question whether the [state] department of health and health care facilities have devoted sufficient time and resources to promoting voluntary immunization. Successful programs include educational components that target specific objections, offer the vaccine at no cost at a time and place convenient for workers, and employ other strategies that have been proven to work. In June 2009, The Joint Commission issued a monograph with 28 examples of hospitals that have improved their immunization rates."
• Other infection control measures have not been taken: "Immunizations are only part of an overall strategy to prevent the spread of influenza virus. When novel H1N1 influenza appeared this spring, nurses were concerned about taking the proper infection control measures when caring for suspected H1N1 cases. When the nurses association evaluated the readiness of hospitals to deal with a possible public health emergency, we were shocked to discover that many facilities were unprepared. . . . In New York State, some hospitals did not have enough N-95 respirators available and had not performed the necessary fit testing. Some had not performed the OSHA-required risk assessment process.
A New York mandate that health care workers receive seasonal flu shots may drive nurses from the profession even as that state faces a nursing shortage, said Eileen Avery, MS, RN, associate director of the New York State Nurses Association (NYSNA).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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