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States, Institutions Requiring
Flu Shots For Healthcare
Workers On The Rise

By Emma Hitt, PhD
Due to state and institutional mandates, healthcare workers across the country are increasingly being required to undergo vaccination, both for seasonal and potentially for H1N1 influenza virus when the vaccine becomes available.
Last month, the Health Department of New York State took the mandates to a new level by adopting a regulation requiring tens of thousands of healthcare workers to be vaccinated against both the seasonal and H1N1 strains of influenza. According to a New York Times report, the regulation was strongly protested by New York's largest healthcare union, 1199 S.E.I.U. United Healthcare Workers East, whose president, George Gresham, said that the policy was "completely unprecedented" and could become punitive if the religious or cultural beliefs of workers prevented them from being vaccinated.
Traditionally, fewer than half of healthcare workers seek out influenza vaccination on their own each year, according to a Centers for Disease Control and Prevention survey on the topic.
In addition, a nonscientific online poll of healthcare professionals conducted by Medscape this month has found that of nearly 9000 respondents, 42% said they are "very likely" to get vaccinated, and 13% are "somewhat likely" - together representing more than half the respondents.
The informal poll also indicated that an equal number of nurses and physicians (44%) were "very likely" to get vaccinated. In contrast, nearly one fourth of respondents to this poll (24%) indicated that they were "not at all likely" to get the vaccine.
State and Institutional Mandates
Other states in addition to New York with mandatory vaccination laws include Alabama, Arkansas, California, and Kentucky. However, in these states, the laws include exemptions through which healthcare workers can abstain from vaccination due to religious or medical reasons (eg, Alabama and Kentucky); in California, healthcare workers can decline for any reason if the refusal is made in writing. The New York requirement is, to date, the most stringent among the states.
In addition to state mandates, several institutions require that their employees get vaccinated. Examples include the Barnes Jewish Corporation HealthCare in Missouri, the University of Iowa Hospitals, and Grady, a large hospital in Atlanta, Georgia. According to Grady officials, similar mandates could follow for healthcare workers to take the H1N1 influenza vaccine when it becomes available in mid-October.
"While we were well above the national average for immunization of healthcare workers, we can do even more to protect our patients and each other from the flu," notes Clay Dunagan, MD, Barnes Jewish Corporation HealthCare vice president of quality and director of the Center for Health Care Quality and Effectiveness in a written release. "This is a very simple step we can take to reduce the transmission of influenza within our hospitals and workplaces," he added.
Professional Viewpoints
In general, professional medical societies support the concept of influenza vaccination for healthcare professionals provided that healthcare workers are allowed to decline on the basis of medical or professional reasons.
The Infectious Diseases Society of America recommends that healthcare workers should be required to get annual influenza vaccination or decline in writing.
The American Nurses Association has not been supportive of mandated influenza shots, but it recommends flu vaccination and supports the use of a signed declination form.
The American Medical Association also does not support mandatory vaccinations, but "we strongly encourage all healthcare professionals to protect their patients, their families, and themselves from the harmful effects of the flu by getting vaccinated," Rebecca J. Patchin, MD, a member of the Board of Trustees of the American Medical Association, told Medscape Infectious Diseases.
"We don't think forcing people to get vaccinated is the right approach. Rather, we need to educate people about the benefits of vaccination and make it easy for them to get it," she said.
Gayle Eversole, DHom, PhD, MH, NP, ND
Founder and Director, Creating Health Institute and The Oake Centre for natural health education
Creator of ADVENTURX, the original xtreme sports supplement
visit us at Natural Health News, Natural Notes and BlogTalkRadio/herbalYODA-Says
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