Do hospital workers need flu shots? Groups disagree
Two national health care organizations have come out with contradictory positions on whether mandatory influenza vaccination for health care workers is justified.
The Elk Grove Village, IL-based American College of Occupational and Environmental Medicine (ACOEM), in a new position statement, asserts that such vaccinations are not necessary and further opposes the use of declination statements (signed statements indicating the worker has opted not to have a vaccination) 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.
However, The Society for Healthcare Epidemiology of America in Alexandria, VA, has come out with a position paper of its own that recommends health care workers who decline flu immunization must sign a declination statement. Slated for publication in the November 2005 issue of Infection Control and Hospital Epidemiology, the paper is available on the SHEA web site. In a nutshell, SHEA recommends that all health care workers be immunized for flu annually unless they have a contraindication to the vaccine or actively decline vaccination.
ACOEM says 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."
However, argues SHEA, the health care worker’s flu infection may be flying below the symptomatic radar. It cites one study that found 28% of health care workers with serologically confirmed flu infections did not recall having a respiratory infection during the period. The patient receiving care may not be so lucky, the organization argues.
William Buchta, MD, MPH, FACOEM, chair of the ACOEM’s Medical Center Occupational Health Section and author of its paper, indicated in the paper that health care workers also must appropriately use hand washing and personal protective equipment. Buchta also said they should consider self-removal from work when experiencing symptoms of a communicable illness.
He further noted that 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 also diverts resources from activities known to increase compliance and devotes them to enforcement of a policy with no proven benefit.
A free copy of Influenza Control Programs for Healthcare Workers is available on-line at www.acoem.org/guidelines/article.asp?ID=86.
Resource
For a free copy of The Society for Healthcare Epidemiology of America’s paper on mandatory vaccinations, go to www.shea-online.org. Under "SHEA News," click on "Position Paper: Influenza Vaccination of Healthcare Workers."
Two national health care organizations have come out with contradictory positions on whether mandatory influenza vaccination for health care workers is justified.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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