The swine-flu scare of 2009 turned a spotlight on a controversial issue: Should healthcare workers be required to have an annual flu vaccine? Most studies suggest that healthcare workers should be vaccinated to help stop the spread of flu. But surveys show a sizable portion of people who work in hospitals, clinics and doctor’s offices don’t want to get an annual flu shot. According to a Rand Corp. survey issued last year, 39% of healthcare professionals said they would not get a flu vaccine, even with the threat of pandemic flu.

A policy paper published Tuesday says healthcare workers are ethically obligated to get a flu vaccine. The paper was written by representatives of the Society for Healthcare Epidemiology and is endorsed by the Infectious Diseases Society of America.

Agreeing to an annual flu shot should be a condition of initial and continued employment in healthcare facilities, the authors said. Exceptions should be permitted only in cases where a flu vaccine is not recommended for medical reasons.

The reasons for the heavy-handed approach are multiple, the authors state. Voluntary vaccination has not worked to increase the proportion of workers who are immunized. Moreover, studies show the spread of flu is reduced when all of the workers in a health facility are vaccinated. Death rates from complications of flu also decrease. Finally, mandatory vaccination will mean that a sufficient number of healthy workers will be available during disease outbreaks.

Although some workers have called mandatory policies coercive, there is legal precedent for the mandatory vaccination, the authors state. Already, healthcare workers are required to have regular tuberculosis skin tests and to show proof of having had other vaccinations.

“Because the likelihood of a serious adverse reaction to influenza vaccine is extremely low, the duty to protect vulnerable patients and to put their interest above the personal interest of the healthcare worker does not demand undue sacrifice,” the authors wrote. The paper is published in the journal Infection Control and Hospital Epidemiology.

The move toward mandatory flu vaccination for healthcare personnel already has begun. During last year’s swine-flu outbreak, several hospitals implemented a mandatory policy. One hospital chain has adopted mandatory vaccination. And the State of New York Department of Health is writing a permanent regulation for yearly flu vaccination of healthcare personnel.

-- Shari Roan / Los Angeles Times

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