American Academy of Pediatrics Backs Mandatory Flu Shots For Health Workers

Flu vaccination should be required for all doctors, nurses, and other health workers, the nation's largest pediatricians' group says, calling it a long overdue step to protect patients.

The American Academy of Pediatrics says voluntary vaccination programs just haven't worked. Too many health workers still shun annual flu vaccinations, and evidence shows some have passed flu along to patients. The academy says it should be up to hospitals to devise mandatory programs and enforce them.

"Employees of health care institutions have both ethical and professional obligations to act in the best interests of the health of their patients," and that includes annual flu vaccinations, the new policy says.

Vaccination rates of at least 80 percent offer the best protection against transmitting the flu in medical settings, it says, but only about 40 percent of health workers are vaccinated each year.

Another medical group, the Society for Healthcare Epidemiology of America, last week issued a similar policy and said flu shots should be a condition of employment for health workers. Exemptions should only be allowed for medical conditions and noncompliance "should not be tolerated," that group said.

The pediatrics group's policy says medical and religious exemptions should be allowed.

Other mainstream medical groups, including the American Medical Association and the American Nurses Association, encourage doctors and nurses to be vaccinated but have stopped short of saying it should be required. The nurses group's board on Wednesday adopted a revised policy urging improved infection control polices and education at hospitals to curb flu spread. Nancy Hughes, director of the group's center for occupational and environmental health, said vaccination shouldn't be the only focus, shouldn't be mandatory, and nurses who oppose vaccination shouldn't be penalized.

The pediatrics academy's policy applies to all health workers, even hospital cafeteria and laundry workers who don't always have direct contact with patients, because their germs could reach patients and other workers, said Dr. Henry Bernstein, an author of the policy and a pediatrics professor at Dartmouth Medical School.

Mandatory vaccination is not a new concept. Bernstein noted state laws require vaccinations for children to enter school; many hospitals require certain vaccinations for their workers. However, health workers in New York sued when that state last year ordered them to get flu shots during the H1N1 flu pandemic. The state's health commissioner withdrew the policy when federal officials lowered estimates on available vaccine, although the issue is still under review.

Bernstein, who also takes care of patients, says he's always had an annual flu shot. Colleagues who don't give the same reasons many other people cite: They worry about vaccine safety and effectiveness or don't believe they're at risk for the flu; some are even afraid of needles, he said. He said the H1N1 pandemic, which disproportionately affected children and young adults, highlighted why flu vaccinations are especially important for pediatricians.

"There's no question that we as health care personnel should be front and center and role models for the community in getting our annual influenza vaccinations," he said.

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