Mandatory flu shots: It’s about patient safety

By: March 30th, 2010 Email This Post Print This Post

The issue of mandatory flu shots for healthcare workers was a lightening rod for comments, both pro and con, during the H1N1 influenza pandemic (Click here and here to see for yourself).

Now in the calmer aftermath of the H1N1 case spike, a recent HealthLeaders article reports on how the Hospital Corporation of America (HCA) was able to substantially increase vaccination rates with workers among its 163-hospitals. Here are some highlights from a teleconference with Jonathan Perlin, MD, HCA’s president of clinical services and chief medical officer:

  • The 2009 H1N1 pandemic was a good reminder that, historically, inadequate healthcare worker vaccination is an often overlooked patient safety issue.
  • Having healthcare workers stay home when they feel sick is not sufficient to protect patients as studies have shown that infected workers may have few or no flu symptoms or that individuals can still transmit the flu 24 hours before showing symptoms.
  • The HCA influenza prevention strategy policy required that employees who could infect—or become infected—by a patient receive the seasonal influenza vaccine, wear a surgical mask in patient care areas, or be reassigned to non-patient contact roles.
  • A group representing HCA emergency preparedness, infection prevention, human resources, legal, pharmacy, communications, and supply was formed to implement non-vaccine strategies, such as cough etiquette, hand hygiene, cleaning techniques, and the “hazards of presenteeism.”
  • Out of the 140,599 employees offered influenza vaccination, 96% accepted.
  • Reason for declining immunizations were: allergy (12%), contraindicated (7%), fear (4%), pregnant (1%), religion (3%), and no reason given (73%).
  • “The response from our employees was overwhelmingly positive. Our employees have embraced it as a patient safety issue,” Perlin said.

For more details, read Hospitals Make Employee Flu Vaccinations a Patient Safety Issue.


What about the fact that the information about the vaccine says it doesn’t necessarily prevent the flu, but reduces the severity? When I looked for prevention rates for the vaccine I couldn’t find them. There are also those people who can’t be vaccinated because of allergy to the vaccine, etc. Does this mean you restrict their work as well? I have a worker who can’t take the vaccine who hasn’t had an URI in years, probably because of stringent hand washing and pulmonary hygiene. It’s hard to make the case for restricting that person from work or asking them to wear a respirator for months.

By David LaHoda on March 30th, 2010 at 10:34 am

The article does reference some of HCA’s non-vaccine strategies (see above). Also, the HCA policy called for non-vaccinated patient care providers to wear a surgical mask not a respirator. The purpose was to protect patients with the mask. A respirator would be for worker protection.

By David LaHoda on March 31st, 2010 at 9:33 am

In my opinion, you are arguing from a point of convenience, and safety points trump convenience points.

I defer to what lab safety expert Terry Jo Gile, MT(ASCP), MA Ed., says in her The Complete Guide to Laboratory Safety on the subject:

“Store personal property in lockers or closets away from the technical area where contamination could occur. This rule includes, but is not limited to, coats, boots, purses, coffee mugs, sweaters, prepackaged foods, and medications.”


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