Mandatory Healthcare Employee Vaccination: A Public Health Initiative

Despite decades of concerted efforts to increase voluntary flu vaccination rates in health care providers, healthcare institutions have failed to achieve sustained high-level annual vaccination rates. As a result, nosocomial seasonal flu transmission remains an immediate threat to public health. Studies show that a majority of healthcare employees continue to provide patient care even after showing symptoms or other evidence of infection. This high risk behavior can lead to wide spread outbreaks, compromised patient care environments, and increased patient mortality. It is clear that nosocomial transmission of influenza is a major safety problem that not only negatively affects the quality of care for patients, but also negatively affects the health and safety of health care workers. This paper will argue that healthcare institutions have an obligation to achieve adequate vaccination rates based on established scientific evidence and principles in public and biomedical ethics. Discussion will focus on how public health standards relate to the ethical and social obligations of licensed healthcare providers. Additionally, the role of healthcare institutions in meeting this challenge will be addressed by examining the identity of healthcare institutions and re-asking the question of what it means to be a trusted provider including broader questions of: From where does a healthcare institution derive their moral authority? How is an “ethical organization” defined? What obligations does a healthcare institution have to its employees? The paper will conclude by offering policy solutions and recommendations on how we can implement ethical, efficient and cost-effective mandatory healthcare employee vaccination programs.