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Mandate Flu Vaccination for Healthcare Workers, Say Infectious Disease
Experts
August 31, 2010 Healthcare professionals should be required to get
vaccinated against seasonal influenza or else lose their jobs and professional
privileges, the Society for Healthcare Epidemiology of America (SHEA) says in
a position paper released today.
The paper, endorsed by the Infectious Diseases Society of America, argues that
allowing healthcare workers to go unvaccinated except for recognized medical
contraindications is just as unacceptable as allowing physicians and nurses to
forgo scrubbing before a surgical procedure.
"SHEA views influenza vaccination of HCP [healthcare personnel] as a co re
patient and HCP safety practice with which non-compliance sho uld not be
tolerated," according to the position paper, published in this month'sInfection
Control and Healthcare Epidemiology. "SHEA endorses a policy in which
annual influenza vaccination is a condition of both initial and continued HCP
employment and/or professional privileges."
The goal of HCP vaccination is not only preventing virus transmission to
patients, but also reducing the risk for infection of HCPs, which in turn
preserves an adequate healthcare workforce, the position paper notes. At the
same time, HCPs who get vaccinated contribute to "herd immunity" and set a
good example.
The position paper, which updates a SHEA statement issu ed in 2005,
recommends mandatory vaccination of all HCP wo rking in all healthcare
settings, regardless of whether they come into contact w ith patients and
whether they are directly employed by the facility. The recommendation
extends to students, volunteers, and con tract workers.
Mandated Vaccination Has Met Resistance
The recommendations from SHEA come on the verge of the 2010-2011
influenza season and follow a previous season in wh ich seasonal influenza
vaccination among HCP reached an all-time high of 62% as of mid-January
2010, according to the US Centers for Disease Control and Prevention.
Physicians, physician' assistants, nurse practitioners, and dentists poste d the
highest immunization rate as a group amon g HCP 77%. In co ntrast, the
immunization rate among all HCP against the H 1N1 influenza virus stood at
37%.
SHEA believes a voluntary approach will not dramatically increase HCP
immunization rates. Its position paper points to several healthcare
organizations such as Virginia Mason Medical Center (VMMC ) in Seattle,
Washington, and BJC Healthcare in St. Louis, Missouri, that have achieved
immunizations rates surpassing 98% by mandating vaccination of HCPs .
The success of institutions like VMMC and BJC notwithstanding, some HCP
have not taken kindly to vaccine mandates.
During the H1N1 influenza pandemic of 2009-2010, for example, the state of
New York ordered its healthcare workers to get vaccinated against both
seasonal and pandemic influenza only to rescind the requirementseveral
months later. At the time, New Yo rk Gov. David Patterson said the mandate
turned out to be impractical in light of a s hortage of pandemic influenza
vaccine, but the state also had encountered several lawsuits and o pposition
from a large healthcare union.
Noting the possibility of continued resistance by labor unions to vaccine
mandates, the SHEA position paper states that requiring HCPs to get
immunized is just as reasonable as requiring them to wear appropriate attire
in the operating room or to care for patients "regardless of un derlying di
even when they have disease that might place the HCP at some risk."
"One hopes that, in the interests of protecting both patients and their
members, these organizations will not oppose ma ndatory programs that
developed in collaboration with employees," the position paper states.
One author reports that he is a consultant for Joint Commission Resources.
and some other authors report various financial relationships with Avianax
Diagnostics, Care Fusions, CSL, Cubist, EMD Serono, Emergent BioSolutions
GlaxoSmithKline, Human Genome Sciences, Liquidia Technologies, MedImm
Merck, Novartis Vaccines and Therapeutics, Novavax, OrthoMcNeil, PaxVax
Pfizer, Rymed Technology, Sage, Sanofi Pasteur, Theraclone Sciences (form
Spaltudaq Corporation), Vaxxinate, and/or Wyeth. All other authors have
disclosed no relevant financial relationships.
August 31, 2010 Healthcare professionals should be re quired to get
vaccinated against seasonal influenza or else lose their jobs and professio
privileges, the Society for Healthcare Epidemiology of America (SHEA) sa
a position paper released today.
The paper, endorsed by the Infectious Diseases Society of America, argue
allowing healthcare workers to go unvaccinated except for recognized m
contraindications is just as unacceptable as allowing physicians and nurs
forgo scrubbing before a surgical procedure.
"SHEA views influenza vaccination of HCP [healthcare personnel] as a co
patient and HCP safety practice with which non-compliance sho uld not b
tolerated," according to the position paper, published in this month'sInfe
Control and Healthcare Epidemiology. "SHEA endorses a policy in which
annual influenza vaccination is a condition of both initial and continued H
employment and/or professional privileges."
The goal of HCP vaccination is not only preventing virus transmission to
patients, but also reducing the risk for infection of HCPs, which in turn
preserves an adequate healthcare workforce, the position paper notes. A
same time, HCPs who get vaccinated contribute to "herd immunity" and s
good example.
The position paper, which updates a SHEA statement issu ed in 2005,
recommends mandatory vaccination of all HCP w orking in all healthcare
settings, regardless of whether they come into contact w ith patients and
whether they are directly employed by the facility. The recommendation
extends to students, volunteers, and contract workers.
Mandated Vaccination Has Met Resistance
The recommendations from SHEA come on the verge of the 2010-2011
influenza season and follow a previous season in wh ich seasonal influenz
vaccination among HCP reached an all-time high of 62% as of mid-Januar
2010, according to the US Centers for Disease Control and Prevention.
Physicians, physician' assistants, nurse practitioners, and dentists posted
highest immunization rate as a group amo ng HCP 77%. In co ntrast, th
immunization rate among all HCP against t he H1N1 influenza virus stood
37%.
SHEA believes a voluntary approach will not dramatically increase HCP
immunization rates. Its position paper points to several healthcare
organizations such as Virginia Mason Medical Center (VMMC ) in Seattle,
Washington, and BJC Healthcare in St. Louis, Missouri, that have achieved
immunizations rates surpassing 98% by mandating vaccination of HCPs .
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8/8/2019 Nursing Readings
2/29
The success of institutions like VMMC and BJC notwithstanding, some HCP
have not taken kindly to vaccine mandates.
During the H1N1 influenza pandemic of 2009-2010, for example, the state of
New York ordered its healthcare workers to get vaccinated against both
seasonal and pandemic influenza only to rescind the requirementseveral
months later. At the time, New Yo rk Gov. David Patterson said the mandate
turned out to be impractical in light of a s hortage of pandemic influenza
vaccine, but the state also had encountered several lawsuits and o pposition
from a large healthcare union.
Noting the possibility of continued resistance by labor unions to vaccine
mandates, the SHEA position paper states that requiring HCPs to get
immunized is just as reasonable as requiring them to wear appropriate attire
in the operating room or to care for patients "regardless of underlying disease,
even when they have disease that might place the HCP at some risk."
"One hopes that, in the interests of protecting both patients and their
members, these organizations will not oppose ma ndatory programs that are
developed in collaboration with employees," the position paper states.
One author reports that he is a consultant for Joint Commission Resources. He
and some other authors report various financial relationships with Avianax, BD
Diagnostics, Care Fusions, CSL, Cubist, EMD Serono, Emergent BioSolutions,
GlaxoSmithKline, Human Genome Sciences, Liquidia Technologies, MedImmune,
Merck, Novartis Vaccines and Therapeutics, Novavax, OrthoMcNeil, PaxVax,
Pfizer, Rymed Technology, Sage, Sanofi Pasteur, Theraclone Sciences (formally
Spaltudaq Corporation), Vaxxinate, and/or Wyeth. All other authors have
disclosed no relevant financial relationships.
August 19, 2010 Teenagers who get little exercise, are overweight, or who
smoke are more likely to have frequent headaches o r migraines, report
researchers.
"There was a significant trend for stronger associations between the number
of negative lifestyle factors that were present and the different headache
diagnoses and headache frequency," point out the investigators led by Jo hn-Anker Zwart, MD, from Oslo University in Norway. "We believe that the
associations observed and the additive effect of these negative lifestyle factors
on the prevalence of recurrent headache strongly indicates that these lifestyle
factors are possible targets for headache preventive measures."
The new study appears in the August 18 issue ofNeurology. As part of the
cross-sectional study, researchers interviewed more than 5 500 students
about headache complaints. The adolescents also com pleted a questionnaire
and underwent a clinical examination with height and weight measureme nts.
Investigators classified adolescents who were very physically fit and who
were not current smokers as having a goo d lifestyle. Negative lifestyle factors
were surprisingly common with low p hysical activity in 31%, smoking in 19%,and overweight in 16% of these teens.
In adjusted multivariate analyses, recurrent headache was associated with
overweight (odds ratio [OR], 1.4; 95% c onfidence interval [CI], 1.2 1.6; P
