- The Washington Times - Tuesday, September 29, 2009

Health care institutions, concerned that less than half their workers got flu shots in previous years, are moving for the first time to make the shots mandatory in the face of an expected swine flu pandemic.

Centers for Disease Control and Prevention figures for the 2007-08 flu season, the most recent available, show that just 45.4 percent of U.S. health care workers ages 19 to 64 were immunized against seasonal flu that year. Three British surveys released in recent weeks suggest the same pattern with the novel H1N1 virus, commonly known as the “swine flu” virus.

But Dr. Tom Talbot, a professor at Vanderbilt University School of Medicine, said “there has been a big wave this year” of mandatory vaccination rules, ranging from small doctors’ offices to large medical care and hospital systems.

“A lot of people are leaning [toward mandatory vaccinations], pointing to it as a safety issue, akin to a surgeon refusing to do a scrub before surgery,” he said.

“I think H1N1 has prompted it,” he said, adding that rules for seasonal flu are in place and likely will be for H1N1 when the vaccine becomes available. He said that voluntary systems need resources to exhort workers into complying, making a mandatory policy cheaper and quicker.

The New York State Health Department, in what is thought to be the first statewide ruling of its kind, now requires all hospital, hospice and home health care workers to get both a seasonal and H1N1 flu shot. Those who defy the requirement without a religious or medical reason put their jobs at risk.

Policies for H1N1 are generally still being formulated, spokesmen at several hospitals, health care systems and professional groups nationwide told The Washington Times.

“Our policy is to strongly urge all [registered nurses] directly involved in patient care to get seasonal protection annually. We are taking a look at the situation regarding novel H1N1,” said Mary McNamara of the American Nurses Association.

But with seasonal flu, policies are already in full force. As of Aug. 27, the 26,000 personnel in the Washington-Baltimore region MedStar Health system must get seasonal flu shots. For the first time, failure to comply without a documented reason is grounds for dismissal.

Virginia Mason Medical Center in Seattle has had a similar policy in place for five years for the seasonal flu shot and has had a 99.5 percent compliance rate. Center spokeswoman Alisha Mark said at least nine other U.S. health groups are following suit for the first time.

“A handful” of people who chose not to get a shot in the first season were dismissed, she said.

“You can get a religious or medical accommodation, say if you have a proven allergy [to eggs, the basis of the vaccine], but you still have to abide by our infection control policy,” she said, meaning that such a worker would “have to wear a mask during all of flu season everywhere in the medical center except in the cafeteria while you are eating. It’s really important for patient safety.”

Jan Rodolfo, national outreach coordinator for the 86,000-member California Nurses Association, said she is skeptical of health care workers’ reception the H1N1 vaccine but that they retain their personal right to make decisions.

“If you have a perfectly safe vaccine to prevent swine flu, presumably you would say [a shot] is for the greater good,” she said. “In reality, there are a lot of questions about flu vaccines in general and this one in particular because of having to speed up the process of getting it approved.”

Ms. Garcia speculated that some of the reasons for the reluctance among health workers include: “They get busy. They think they don’t need it.” She said will have her entire office staff of 25 vaccinated against seasonal flu by Oct. 1.

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