Mandatory Flu Shots Urged for Health Workers


All health care workers should be vaccinated annually against influenza, and doing so should be a condition of new or continued employment, according to a position paper from the Society for Healthcare Epidemiology of America.

This is the first time the organization has recommended mandatory vaccination of all health care workers; and its position was also endorsed by the Infectious Diseases Society of America.

“I am very hopeful that this guideline will encourage the adoption of more mandatory policies at all health care institutions,” said Dr. Neil Fishman, president of SHEA and director of health care epidemiology and infection control for the University of Pennsylvania Health System, Philadelphia.

A variety of vaccinations already are required at health care facilities, including measles, mumps and rubella, and some facilities also require vaccination against chickenpox, pertussis, and hepatitis B. “So there are precedents for having vaccines as a condition of employment,” Dr. Fishman said.

The hope is that SHEA's new recommendation – published Aug. 31 in the journal Infection Control and Healthcare Epidemiology – will improve the current influenza vaccination rates for health care workers, which now hover in the 30%-40% range, Dr. Fishman said. The recommendation applies to all workers, students, and volunteers in all health care facilities, regardless of whether they have direct patient contact.

Under the SHEA position paper, the only exceptions to the mandatory vaccination policy would be for medical reasons, such as a severe allergy to eggs, Dr. Fishman said.

The Centers for Disease Control and Prevention currently recommends that all health care professionals get an annual influenza vaccine and that health care facilities provide the vaccine to its workers with a goal of vaccinating 100% of staff.

Researchers at the Virginia Mason Medical Center, Seattle – believed to be the first in the country to institute mandatory influenza vaccination for its health care workers in 2005 – recently studied their institution's efforts to improve influenza vaccination rates.

They found that in the first year after the mandatory influenza requirement was put in place, 97.6% of the facility's 4,703 health care workers were vaccinated, followed by adherence rates of more than 98% in the following 4 years. Less than 0.7% of the center's workers were exempted from vaccination for medical or religious reasons, and less than 0.2% refused to be vaccinated or left employment at the center (Infect. Control Hosp. Epidemiol. 2010;31:881–8).

Dr. Fishman reported no conflicts of interest. The authors of SHEA's position paper reported having served as consultants for or having received honoraria from various companies that make vaccines, influenza diagnostics, and pharmaceuticals.

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