Mandatory Vaccination of Healthcare Workers: Ethical Considerations and Professional Obligations

As the eradication of smallpox and the near-eradication of polio demonstrate, vaccination is one of the most effective approaches for controlling the spread of infectious disease. This approach is so effective that mandatory vaccination for public health purposes is the norm even in a libertarian society like the United States. For example, all 50 states require parents to vaccinate children against various communicable diseases like measles as a prerequisite for public school entry. During a emergency, public health officials also have broad authority to mandate vaccination of first responders, healthcare workers, and even the general population. Mandatory vaccination in the absence of such an emergency, however, is a hotly debated topic. In late 2009, the New York State Department of Health passed (but quickly rescinded) a controversial regulation that would require annual influenza vaccination for all healthcare workers in New York as a condition of continued employment. This paper will discuss the ethical and legal considerations of mandatory vaccination of healthcare workers, arguing that such mandates are not only appropriate from a public health perspective but fit with the professional duty of all healthcare workers to provide care even in the face of great personal risk.