142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Vaccination Mandates for Healthcare Professionals - An Evaluation of How Ethical Concerns Impact Implementation

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 4:45 PM - 5:00 PM

Arthur Caplan, PhD , Department of Population Health, NYU Langone Medical Center, New York, NY
Esther Chernak, MD, MPH , Center for Public Health Readiness & Communication, Drexel University School of Public Health, Philadelphia, PA
Evelyn Arana, MS , Community Health and Prevention, Drexel University School of Public Health, Philadelphia, PA
Nina Blank , Weill Cornell Medical College, New York, NY
Robert Field, JD, MPH, PhD , Department of Health Management and Policy, Drexel University School of Public Health, Philadelphia, PA
Michael Yudell, PhD, MPH , Department of Community Health and Prevention, Drexel University School of Public Health, PA
Influenza immunization rates for healthcare personnel (HCP) remain far below the Healthy People 2020 goal of 90%. Vaccination of HCP contributes to patient safety, protects against occupational hazards, and ensures healthcare facilities maintain a critical workforce. Our research examines precedents from historical and existing vaccine mandates to highlight ethical challenges. Our analysis shows mandating vaccination among HCP is consistent with professional ethics based on the following principles: 1) professional duty to prioritize patients’ interests above all else; 2) obligation to ‘do no harm’; 3) requirement to protect those who cannot protect themselves; and, 4) obligation to set a good example for the public. We also make the following recommendations/observations based on these principles: 1) that occupational health programs provide educational programs for HCP that address vaccination as a condition of employment; 2) that because of the burden placed on HCP autonomy, influenza vaccination should be provided free of charge; 3) there is no evidence that mandating flu vaccine diverts attention and resources away from other hospital based flu control measures, all of which are critical for preventing transmission of other respiratory viruses for which there are no vaccines; 4) that penalties for vaccine refusal are ethically justifiable in the context of public health ethics, which seeks to ensure the health and safety of populations; and 5) health care facilities have an ethical duty to provide data assessing effectiveness of vaccine mandates. Discussing and analyzing these ethical issues is important for health administrators and policy makers when mandates may be considered.

Learning Areas:

Ethics, professional and legal requirements
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Identify and discuss the ethical issues surrounding influenza vaccine mandates for health care personnel. Formulate a strong language for policy makers that outlines when mandates may be considered.

Keyword(s): Patient-Centered Care, Occupational Health and Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a second year Doctoral Student who has been an integral part of this research. I conducted an extensive literature review on the ethics of vaccine mandates, have facilitated a class discussion on vaccination mandates and have helped draft the development of this paper. I will be an author on all upcoming published papers as a result of my research. Among my interests are the ethics behind policies that limit autonomy for other individuals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.