Mandatory influenza vaccination for healthcare personnel needed

Vaccination should be requirement for continued employment for health-care personnel, epidemiologists and infectious disease physicians say

Influenza vaccination of healthcare personnel is a professional and ethical responsibility and non-compliance with healthcare facility policies regarding vaccination should not be tolerated, according to a position paper released today by the Society for Healthcare Epidemiology of America (SHEA). The paper, published in this month's Infection Control and Healthcare Epidemiology journal and endorsed by the Infectious Diseases Society of America (IDSA), stresses influenza vaccination of healthcare personnel as a core patient safety practice that should be a condition of both initial and continued employment in healthcare facilities.

According to SHEA, their recommendations apply to all healthcare professionals in all healthcare settings, regardless of whether the professional has direct patient contact or whether he or she is directly employed by the facility. The policy also applies to students, volunteers, and contract workers. The only exemptions, say the epidemiologists and infectious disease physicians, should be in cases of medical contraindications.

"The transmission of influenza in healthcare settings is a substantial safety concern for both patients and healthcare personnel and deserves our attention and action," said Neil Fishman, MD, president of SHEA. "Healthcare providers are ethically obligated to take measures proven to keep patients from acquiring influenza in healthcare settings. Mandatory vaccination is the cornerstone to a comprehensive program designed to prevent the spread of influenza which also includes identification and isolation of infected patients, adherence to hand hygiene and cough etiquette, the appropriate use of protective equipment, and restriction of ill healthcare personnel and visitors in the facility."

The position paper, an update of an original statement issued in 2005, comes as healthcare personnel and facilities prepare for the upcoming 2010 flu season, and on the heels of one of the worst flu seasons in our nation's history, the result of the H1N1 strain. Last year's flu season highlighted the necessity for stronger policies for healthcare personnel influenza vaccination, especially in light of the low vaccination rates in many voluntary influenza vaccination programs.

"Given the debate that surrounded mandatory healthcare personnel vaccination during the last influenza season, we support and applaud SHEA for issuing a strong and unequivocal statement about the critical importance of healthcare personnel vaccination," said Richard Whitley, MD, president of IDSA.

According to a 2009 RAND Corporation survey, 39 percent of healthcare professionals stated they had no intention of getting vaccinated despite the heightened concern surrounding influenza with the H1N1 pandemic.

"The scientific evidence shows significant reductions in the risk of influenza in both acute and long-term care settings as a result of strong immunization policies and programs," Dr. Whitley said. "Vaccination of healthcare personnel saves patients' lives and reduces illness. It also protects the individual worker from falling ill during influenza outbreaks and from missing work, which further impacts patient care." IDSA also supports SHEA's recommendation that a mandatory vaccination program be part of a multi-faceted, comprehensive infection control program.

Fishman added that he believes that this position paper, coupled with full and visible support of mandatory influenza vaccination by healthcare facility leadership, will dramatically improve the rates of vaccination.