Protection, Professionalism, and Power: Examining the Pros and Cons of Healthcare Worker Immunization Programs

Vaccinations against infectious illnesses are one of the most effective, and cost-effective, health interventions, conferring typically a decade or more of protection for vaccinated individuals and providing a tremendous boon to public health through herd immunity effects that benefit both immunized and unimmunized individuals. All of these benefits are achieved, moreover, with quite limited risks of adverse events.

Recently, programs to vaccinate healthcare workers (HCW) against seasonal influenza (flu) have become more prominent and assertive, arguing that achieving high levels of HCW flu vaccination rates will protect patients from acquiring nosocomial flu, and that protecting patients' safety is a professional duty. Whereas healthcare organizations have historically reported rates of HCW flu vaccination that have been below 50%, several organizations that have mandated flu vaccination as a condition of employment have reported essentially complete compliance.

In this presentation, as a staunch advocate for flu vaccination, I will examine the arguments and evidence used to justify mandated vaccination. Specifically, we will first review the yearly efficacy of flu immunization; the data that HCW flu vaccination reduces rates of nosocomial flu; and costs associated with HCW flu vaccination programs. We will then consider the implications stemming from the fact that mandated vaccination policies dodge the question of why volunteer vaccination programs have such low rates, usurp the individual HCWs professional duty, may fuel anti-vaccination movements, and pose pressing questions about the use of state or organizational power over individuals for the public good.