Flu shots for health care workers – updated

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Mandatory swine flu vaccination for health care workers: I change my mind

[Via Effect Measure]

In an earlier post I said I opposed mandatory vaccination for adults (but not for children), the one exception being for health care workers because they come in contact with people at high risk. My view then was that if you work in a health care institution and won’t get vaccinated against flu, then you shouldn’t come to work. Now I am re-evaluating my position as a result of some cogent and pragmatic comments from lawyer-bioethicist George Annas, professor of health law, bioethics and human rights at Boston University School of Public Health, and author of “The Rights of Patients.” I know Annas to be pro-vaccination and unambiguous about mandatory vaccination for children. His (and my attitudes) about adults is that there is a primacy to the principle of autonomy, as bioethicists frame it, and that no one who is competent to decide for themselves should be legally forced to be vaccinated. But we differed on the matter of health care workers because I felt that while they might be able to decide for themselves, they had no right to put their patients at risk. But Annas has argued — I think persuasively — that legally requiring vaccination for health care workers would backfire:


I can understand the emotional belief that coercing hospital staff to get vaccinated displays a distrust. Many said they would have gotten the vaccination anyway but hate being told they have to. Perhaps at the end of the day, mandating would not be as successful as simply employing more ‘social engineering’ approaches.

Maybe. Of the arguments for simply asking nicely, the one that holds the most weight with me is that the backfire could result in mass numbers of health care workers simply refusing. The hospitals could not just fire them all. Mass action might be a result that is completely wrong for both sides but would be a linear consequence of the lack of trust being displayed.

Two major pools for the spread of a disease like the flu are schools, where lots of children congregate, and hospitals, where the sick are found. Any ethical person who works in either location should make sure steps are taken to protect themselves and others from the spread of this disease. Acting as a vector for the spread of the disease puts everyone at greater risk.

This includes getting vaccinated, whether it is seasonal flu, pandemic flu or any other infectious disease being spread. That is what ehthical  people should do.

[Updated– of course, if the health care workers do not get vaccinated and come down with the flu, then they either keep working, putting everyone at risk or they stay at home, resulting in increased burdens for others at the hospital, such as understaffing, etc. That is why an ethical person working at such a facility should get vaccinated.

Not getting one indicates a selfishness that I, for one, would not like to see in those people potentially dealing with my health.]

2 thoughts on “Flu shots for health care workers – updated

  1. Iagree that taking the seasonal flu shot is a choice not to be forced. Taking the seasonal flu shot does not guarante that your will not be exposed, because their are different strains of these viruses. My organization has given us the opportunity to be exempt based on one’s religious belief. I submitted a religious exempt letter and was denied because my religious affliation did not meet thier standards. When asked to elaborate on the issue, the Human Resource Director was unable to explain nor was the person willing to forward me a detailed standard of code for a religious exemption. How can you discriminate me against my religious beliefs and practices. Why are my rights be violated.

    1. What is your religious basis for refusing a flu vaccine? Does it extend to other vaccines? Does your work involve direct interaction with sick patients? If so, why would you want to take the chance of spreading the disease in a sector full of ill people?

      It seems to me that if you are going to work with sick people, taking all precautions, including vaccinations, in order to prevent them from becoming sicker would be the ethical choice.

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