About 50 employees of Essentia Health, an upper-Midwest hospital chain, didn't go to work Wednesday. But it wasn't an early start to the. State laws mandating influenza immunization for people who work in health care increase their vaccination rates, according to new research. Mandated vaccination may damage workplace relationships and alienate There is a legal precedent for mandating vaccination in public health crises with.
Man dating vaccines in the workplace - HEALTH CARE WORKERS AND THE SPREAD OF DISEASE
Key points Most North American health care workers who have responded to recent surveys are in favour of condition-of-service influenza vaccination policies. In most Canadian legal cases, arbitrators have weighed the individual rights of employees against the consequences of nonimmunization on patients and have decided in favour of patient safety. To comply with the Canadian Charter of Rights and Freedoms, employers will need to carefully consider the details of any condition-of-service policy.
No other competing interests were declared. This article has been peer reviewed. Allison McGeer and Vanessa Gruben conceived the idea for this commentary. Reed Siemieniuk conducted the literature reviews. All authors contributed to the drafting and revising of the manuscript, and approved the final version submitted for publication.
National Advisory Committee on Immunization. Statement on seasonal influenza vaccine for — Can Commun Dis Rep ; Prevention and control of influenza with vaccines: Health care workers must protect patients from influenza by taking the annual vaccine. Gardam M, Lemieux C. First we need a better vaccine. Ontario Respiratory Virus Bulletin. Public Health Ontario; Alberta respiratory virus surveillance report: Alberta Health Services; AMMI Canada position paper: Influenza vaccination honor roll.
Vaccinating health care workers against influenza: Am J Public Health ; Influenza vaccination for health care workers: Health Law J ; Voluntary reporting of health care personnel seasonal influenza vaccination rates and the impact of universal policies in Illinois hospitals. Increasing influenza vaccination rates among hospital employees without a mandatory policy. Infect Control Hosp Epidemiol ; Unvaccinated health care workers must wear masks during flu season-a possibility to improve influenza vaccination rates?
Developing a program to increase seasonal influenza vaccination of healthcare workers: J Healthc Qual ; An alternate approach to improving healthcare worker influenza vaccination rates. Improving influenza vaccination of healthcare workers by means of quality improvement tools. Increases in vaccination coverage of healthcare personnel following institutional requirements for influenza vaccination: Voluntary reporting of employee influenza vaccination rates by acute care hospitals in Iowa: Mandatory influenza vaccination of health care workers: Clin Infect Dis ; Three year experience with mandatory seasonal influenza immunization for all personnel in a university medical center [poster].
Mandatory influenza vaccination of healthcare workers: Championing patient safety through mandatory influenza vaccination for all healthcare personnel and affiliated physicians. Mandatory influenza vaccine for health care workers: Implementation of a mandatory influenza vaccination program in an academic medical center [presentation]. Mandatory employee vaccination policy with termination for non-compliance increases vaccine coverage in a large, not-for-profit health system [poster].
An 11th hour mandatory influenza healthcare worker vaccination vs. The successful implementation of mandatory seasonal influenza vaccination for health care workers at an academic medical center. Am J Infect Control Currie D, Malow J. The goal of all these measures is to make vaccination as convenient—and avoidance of vaccination as inconvenient—as possible.
Limited exceptions are permitted for individuals known to be at heightened risk for side effects, such as allergies to vaccines, and for those with clear religious objections. New York State was the first in the nation to try to mandate vaccination as a matter of law, but the effort proved to be short-lived.
The Department of Health issued a rule last August that would have barred workers who declined either seasonal or H1N1 influenza vaccination from assignments involving patient contact in any hospital, outpatient clinic or home-care program. Subsequently, the Department, citing vaccine shortages, withdrew the proposal. For the most part, unions representing nurses have been vocal in opposing vaccine mandates. They point out that all vaccines can pose risks.
Even for people without allergies, hazards may lurk in additives, such as thimerosal, a mercury-based preservative used in some vaccines. Moreover, an injection that produces no immediate harm may still pose longer-term risks. Mandate opponents also frame the issue as one of rights.
Should health care workers have less freedom than others to decide what health risks they choose to accept? Should entering the nursing profession turn a person into a second-class citizen? In the end, mandates may have the unfortunate effect of driving some people away from working in health care. In the landmark case of Jacobson v. Massachusetts, the Court upheld an ordinance in Cambridge, Massachusetts, that required all adult citizens to be vaccinated against smallpox in the wake of an epidemic.
Moreover, most states recognize the doctrine of employment-at-will, under which employers can terminate a worker for any reason as long as a prohibited motivation, such as race or disability status, is not involved.
In the absence of a proscribed rationale, vaccination can be used as a condition of continued employment. In , the Washington State Nurses Association sued Virginia Mason Hospital in Seattle, which sought to require nurses to receive seasonal flu vaccine.
The union claimed that a collective bargaining agreement prohibited new workplace rules without its consent. Studies have shown higher patient death rates in hospitals with a smaller percentage of vaccinated employees. The goal of public health is to safeguard the population at large, and this is where priorities must lie.
Mandate advocates also see the risk of vaccines as minimal. The most significant concern is with people who are allergic to eggs, because vaccine production has traditionally required their use to incubate virus stains. However, susceptible people can easily be screened out; in addition, new cell-based manufacturing techniques are obviating the need for eggs. Some batches of H1N1 vaccine have been manufactured using this approach. Thimerosal is used in H1N1 vaccines that are injected but not in vaccines administered nasally.
However, even though mercury is associated with severe health effects, this vaccine preservative has never been linked to adverse outcomes. A guarantee of complete vaccine safety is never possible, but protection of public health often involves a balancing of risks.
Seasonal flu causes an estimated 36, deaths in the U. This hazard is considered to far outweigh the much smaller risk of adverse vaccine effects. Professionals who care for patients accept an overriding ethical imperative embodied in the Hippocratic Oath that new physicians take—first, do no harm.
Health care workers, mandatory influenza vaccination policies and the law
Vaccination is a minor medical procedure that reduces or eliminates the risk of contracting a targeted disease. In most Canadian legal cases, arbitrators have weighed the individual rights of employees against the consequences of nonimmunization on patients and have decided in favour of patient safety. First we need a better vaccine. They point out that all vaccines can pose risks.