by Heather Mayer
, DOTmed News Reporter | August 31, 2010
Influenza vaccination should be mandatory for all health care workers, the Society for Healthcare Epidemiology of America argued in a paper released today in Infection Control and Healthcare Epidemiology.
The group calls influenza vaccination of health care personnel a core patient safety practice.
"Health care providers are ethically obligated to take measures proven to keep patients from acquiring influenza in health care settings, said Dr. Neil Fishman, president of SHEA, in prepared remarks. "Mandatory vaccination is the cornerstone to a comprehensive program designed to prevent the spread of influenza."
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The paper was based on existing evidence that showed vaccinating health care workers, especially those in nursing homes, can significantly decrease death rates for elderly patients and residents, explained Dr. Andrew Pavia, chief of pediatric infectious disease at the University of Utah and chair of the Pandemic Influenza Task Force of the Infectious Disease Society of America (IDSA), which endorsed the paper.
"You can't achieve [the same results] by vaccinating residents," Pavia told DOTmed News. "The effect is less dramatic, but [mandatory vaccination] plays out the same way in a hospital."
The influenza vaccine is less effective in those who are more vulnerable to the disease - the elderly, young children and those with compromised immune systems. Stopping or lessening the infection with the caregiver would have huge effects in reducing transmission.
"The vaccine provides mediocre protection for them," Pavia said of vulnerable populations. "The best way to protect them is to provide a ring around them."
Despite the evidence that has been around for decades, health care worker vaccination uptake has been "abysmally low," said Pavia.
According to a 2009 RAND Corporation study, only 59 percent of health care workers are vaccinated. And 39 percent said they had no intention of getting vaccinated.
"Voluntary programs, in spite of good efforts, don't get you there," said Pavia. "It's really not an optional item. To get those high rates, [vaccination] should be a requirement."
Not only will mandatory vaccination protect the vulnerable patients, argued Pavia, health care workers will also be protected and they will set a good example to all patients.
Currently, some large health care organizations do require their staff to be vaccinated, and there is a mandate in the state of New York for health care professionals to be vaccinated, which was protested last year. Pavia doesn't predict it will become a federal law, although the Department of Defense and the National Institutes of Health require vaccination for their staff.
"It probably won't come down as Congressional law, but there are other things that the federal government can do," he said, including making staff vaccination rates part of a facility's quality indicator.