Posted On: January 31, 2013 by Patrick A. Malone

Required: A Flu Shot for Every Hospital Worker

If the staff of any particular work site should be required to get a flu shot, it’s the people working in a hospital. Guarding against the flu in the hospital isn’t just a matter of personal protection; it’s a matter of patient protection and safety.

So why do so many doctors, nurses, technicians, service workers and clerks go unvaccinated?

It’s a question Dr. Bob Wachter addresses on his blog, Wachter’s World. He’s professor and associate chairman of the department of medicine at the University of California, San Francisco, and a renowned hospitalist. That medical specialty is dedicated to the delivery of comprehensive medical care to hospitalized patients.

Wachter believes getting a flu shot shouldn’t be optional for hospital workers. Hospital patients are more vulnerable to infection because they’re already sick, because many are older (which is an added risk factor) and because they’re at higher risk for contracting other infections, so they need to be protected from the introduction of any additional microbes.

As Wachter writes, “[I]nfluenza can be an unpleasant inconvenience for a healthy person, but, for older and immunosuppressed patients, it can be a killer. … While one would hope that the professionalism of clinicians would drive them to vaccinate on behalf of their patients’ welfare (and most do – CDC data shows that about two-thirds of hospital workers get the vaccine), it’s not enough.

“Sorry folks, but this one should not be a choice. It should be a mandate.”

At his hospital, clinicians who refuse the vaccine must wear masks during the flu season. More than 9 in 10 people there are vaccinated, and as a result, he reports, there have been no recent cases of clinician-to-patient (or vice versa) transmission, unlike in the days before the vaccine (or mask) was required.

Wachter refers to a Centers of Disease Control and Prevention (CDC) survey from 2011 that found that more than 400 U.S. hospitals (about 1 in 10) now require flu vaccine for employees; 29 of them fire unvaccinated employees.

The Joint Commission, an independent, nonprofit organization that accredits and certifies health-care organizations, now requires accredited hospitals to have a program for promoting staff vaccinations.

Still, Wachter says, some health-care personnel object to the vaccines because they are worried about side effects (which are rare) or about how well they work (this year’s vaccine is 62 percent protective). These objections are surprisingly strong among a population of people who should know better. A recent article refutes them in the Journal of the American Medical Association.

But some people object to being forced to get the shot purely as a breach of their rights. “One nurse in Indiana who was fired for refusing the vaccine,” Wachter reports, “spoke of ‘the injustice of being forced to put something in my body.’”

OK, then don’t be a health-care worker. It’s that simple. Your rights shouldn’t override those of patients who are in no position to protect themselves from you.

As Wachter says, “The average hospitalized patient … will see up to 50 different healthcare workers each day. Any one of them with the flu can put their patients at risk, and not all of them will have full-blown symptoms to warn them to stay away. Patients giving their trust to healthcare professionals have a right to know that we have done everything within reason not to compromise their health further.”

For Wachter, it’s not just a single practice for patient safety; it’s a matter of changing a paternalistic culture. “[L]et’s require flu shots, not just to prevent flu but also to begin to shift our culture to one in which we actually require people to do things when they are the unambiguously right things to do.”

It’s a little late—although not too late—to improve the odds for this season that hospital workers won’t give you the flu along with your treatment. You should advocate for vaccination.

Ask your caretakers if they’ve been vaccinated, and if not, request that they wear masks when treating you. Ask the hospital’s patient advocate what is the facility’s flu vaccination policy. Make sure that person knows of your concern. And let your health insurer know if unvaccinated staffers are treating you or your loved ones.

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