Flu shots not needed for health care workers?
Flu shots not needed for health care workers?
Two national health care organizations have come out with competing positions on whether mandatory influenza vaccination for health care workers is justified.
In a new position statement, the American College of Occupational and Environmental Medicine (ACOEM), based in Elk Grove Village, IL, asserts that mandatory influenza vaccinations are not necessary. It also opposes the use of declination statements, stating 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.
The Society for Healthcare Epidemiology of America, based in Alexandria, VA, however, 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 at: www.shea-online.org.
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 argues 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, ACOEM 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."
Declination statements
However, SHEA argues, 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 ACOEM's Medical Center Occupational Health Section and author of its paper, does note that "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."
He adds, however, 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 diverts resources from activities known to increase compliance and devotes them to enforcement of a policy with no proven benefit."
Influenza Control Programs for Healthcare Workers is available on line at www.acoem.org/guidelines/article.asp?ID=86.
Two national health care organizations have come out with competing positions on whether mandatory influenza vaccination for health care workers is justified.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.