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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

OSHA position on mandatory flu shots: OK with a key caveat

In the continuing hue and cry over mandatory flu shots for health care workers, questions have arisen about the regulatory position of the U.S. Occupational Safety and Health Administration (OSHA).

Can hospitals mandate that health care works be immunized without running afoul of OSHA? The answer is “yes,” with a key caveat, according to an OSHA position established in 2009.

In a “letter of interpretation” in response to a question about the increasingly popular but controversial policy, OSHA ruled that employers may mandate the vaccination as long as they don’t retaliate against employees who have “a reasonable belief” that they would have a serious medical reaction to the vaccine. There’s no mention of philosophical or religious beliefs, but if the worker claims to be at risk, for example, of “a serious reaction” to the flu vaccine, OSHA says they may be protected under “whistleblower” statutes.

The position was established during emergence of the H1N1 influenza A pandemic strain. The agency states:

“OSHA does expect facilities providing healthcare services to perform a risk assessment of their workplace and encourages healthcare employers to offer both the seasonal and H1N1 vaccines. It is important to note that employees need to be properly informed of the benefits of the vaccinations. However, although OSHA does not specifically require employees to take the vaccines, an employer may do so. In that case, an employee who refuses vaccination because of a reasonable belief that he or she has a medical condition that creates a real danger of serious illness or death (such as serious reaction to the vaccine) may be protected under Section 11(c) of the Occupational Safety and Health Act of 1970 pertaining to whistle blower rights.”