The National Vaccine Advisory Committee (NVAC), which advises the US Department of Health and Human Services (HHS), adopted a position this month that physician practices, hospitals, and other healthcare employers should "strongly consider" mandating that their employees receive influenza vaccinations if they fall short of a 90% immunization rate on a voluntary basis. It also said healthcare employers should be free to exempt employees from a vaccination requirement based on their medical condition or religious convictions.
It falls short of an outright call to mandate influenza vaccination for healthcare workers, which is advocated by a number of healthcare organizations. The Healthy People 2020 initiative of HHS set a target of 90% of healthcare personnel getting immunized. While the actual rate has been rising in recent years, it still is a long way off from the HHS goal. During the 2010-2011 influenza season, for example, just 63.5% of healthcare workers received the seasonal vaccine, according to the US Centers for Disease Control and Prevention.
Some hospitals have achieved immunization rates topping 98% after ordering employees to get vaccinated. However, mandatory vaccination has not always gone over well.
The American Health Care Association agrees that influenza vaccine should be offered to all healthcare workers but it stops short of endorsing the recommendation. Commenting to McKnights, Greg Crist, vice president of public affairs said:"We agree that employees in long term and post-acute care facilities should be offered the influenza vaccination. [But] it's difficult to support mandatory vaccinations at the present. One reason is costs and what type of financial burdens might exist. On a personal level, some staff may have objections for religious or cultural beliefs. Finally, we're concerned about the impact on an already difficult workforce situation."
The American Hospital Association approved a policy calling for, among other things, employees to be vaccinated against the flu or otherwise wear a facemask while around patients during the flu season. So some people are on board.
Citing costs in this day and age can be a legitimate argument for nursing home and other aging services providers. And NVAC has addressed the personal reasons cited so that is less of an argument. However, a nursing home worker getting the flu can pose more serious risk and financial hardship as well. Sick time incurred, productivity loss, exposure to residents are just some of the consequences. And if you weigh the cost of immunization versus the consequences of getting the flu, it may balance itself out. And that is before you weigh in on the issue of hospital readmissions as the topic of the day.
I personally don't like mandates but a flu vaccine does make sense. In the absence of that organizations need to take other precautions.
- Screening visitors and staff who leave and then return to the facility.
- Isolating symptomatic residents.
- Placing restrictions on visitors.
- Modifying work schedules.
- Use precautions to reduce their risk of infection, like washing hands and using protective masks.
The advisory vaccine panel also recommended that HHS standardize the way it measures healthcare worker vaccination rates, establish comprehensive flu prevention programs and integrate them with infection prevention efforts.
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