Should health care workers be immunized against influenza?

Physician vaccinate thyself: why influenza vaccination rates are higher among clinicians than among nonclinicians

BACKGROUND

National vaccination guidelines recommend influenza vaccination for clinical employees with patient contact. For many other healthy working adults, influenza vaccination is optional.

PURPOSE

We examined acceptance of a free influenza vaccine among clinical university employees who had patient contact and nonclinical university employees who did not have patient contact. We asked whether and why job role had an influence on the decision to be vaccinated.

METHOD

Clinical (n = 103) and nonclinical (n = 339) employees of two universities completed a mailed questionnaire.

RESULTS

Vaccination rates were higher among clinical employees (62%) than among their nonclinical counterparts (47%). This effect of job role on vaccine acceptance was statistically mediated by perceived riskiness of getting vaccinated, knowledge about the vaccine, easy access to the vaccine, pro-Western medicine beliefs, and social influence. It was not vaccinated by perceived likelihood of getting infected or concern about infecting others.

CONCLUSION

Clinical employees have higher vaccination rates than nonclinical employees, but not for the reasons that form the basis of national vaccination guidelines.

Chapter 4: Can Mandatory Vaccination of Health Care Professionals during an Influenza Pandemic ever be Justified?

Objectives: To discuss whether, during an influenza pandemic, public health authorities could be ethically justified in implementing a mandatory vaccination program directed at health care professionals.

Methods: Ethical analysis is carried out by examining arguments that can be made in favor or against such a mandatory measure and by seeking a reasonably balanced position between them. Arguments under consideration are based on the duties of health professionals and public health authorities, the consequences of their actions and on other ethical principles. The importance of relevant empirical data is stressed without any attempt to review or analyze them systematically.

Results: Mandatory vaccination of some health care professionals during a serious pandemic of influenza can be justified, but only under certain limited conditions.

Conclusions: In the throes of an influenza pandemic, health care professionals (and to a variable degree, other health care workers) have an ethical obligation to accept influenza vaccination if it is reasonably safe and effective. The ethical responsibility of public health authorities is to limit the impact of a pandemic on the population by all reasonable means, which clearly includes the appropriate use of vaccine. Consequently, the vaccination of health care staff can be made mandatory under certain conditions. However, a critical objection to this conclusion, which upholds that a voluntary vaccination program (an ethically much less problematic intervention) is just as effective, needs to be addressed.