Mandatory flu vaccinations cause healthcare workers to quit–a myth

Bones fluOne of the many myths of the vaccine denialism movement is that healthcare workers will quit if there is a mandatory vaccination, usually the flu. Many of the healthcare worker vaccine deniers base their opposition to vaccines based on thoroughly debunked lies about vaccinations. Their invented opposition to vaccines is in direction contradiction to their obligation to protect the health of patients. However, more and more healthcare systems are mandating the flu vaccine for their employees.

A four-year analysis of mandatory influenza (flu) vaccinations, which are a condition of employment at Loyola University Health System in Chicago, IL, showed no statistical increase in voluntary terminations of employees. In the first year of Loyola’s mandatory policy (2009-10 flu season), 99.2% of employees received the vaccine, 0.7% (yes, 0.7%) were exempted for religious/medical reasons, and 0.1% refused vaccination and chose to terminate employment with Loyola. In 2012, the last year of the study, the vaccination uptake rate at Loyola remained steady: 98.7% were vaccinated, 1.2% were exempted and 0.06% refused vaccination.

According to Dr. Jorge Parada, study author and professor of medicine at Loyola University Chicago Stritch School of Medicine, reported that “in reality our numbers were even better than that, of the 5 persons who refused vaccination in the mandatory period, 3 were unpaid volunteers, who later reconsidered, received vaccine and returned to Loyola. The two other persons were part-time staff, each with only 10% time commitment at Loyola…truly reflecting a 0.002 vaccine refusal rate” reports Parada. The study showed that, over the course of four years, less than 15 staff, including volunteers, out of approximately 8,000 healthcare workers in the system, chose termination over vaccination. Loyola has sustained a 99 percent compliance average since adopting the mandatory flu vaccination protocol four years ago.

Dr. Parada also explained the principles that led to Loyola to implement the policy. “First do no harm is our mandate as health care workers. We have a fiduciary responsibility to perform hand hygiene and adhere to contact precautions, and flu vaccines should be considered in the same vein – meaning we should do all we can to not pass along illness to our patients.” He also provided a proper metaphor about a healthcare worker’s obligation to receive a flu vaccination, by stating that “just as construction workers must wear steel-toed boots and hard hats on job sites as a condition of employment, we believe that healthcare workers should get a flu shot to work in a hospital.”

The US Centers for Disease Control and Prevention also recommends that all U.S. health care workers get vaccinated annually against influenza, because flu infections result in approximately 150,000 hospital admissions and 24,000 deaths annually. The CDC states that the current scientific consensus about vaccinating healthcare works show that:

  • Health care workers who get vaccinated help to reduce: transmission of influenza, staff illness and absenteeism, and influenza-related illness and death, especially among people at increased risk for severe influenza illness
  • Higher vaccination levels among staff have been associated with a lower risk of nosocomial (hospital-acquired) influenza cases.
  • Influenza outbreaks in hospitals and long-term care facilities have been attributed to low influenza vaccination coverage among health care workers in those facilities.
  • Higher influenza vaccination levels among health care workers can reduce influenza-related illness, and even deaths, in settings like nursing homes.

In fact, there are many who consider healthcare works who refuse flu vaccinations as “irresponsible”. In a Scientific American opinion piece, Katherine Harmon stated that:

If an office worker gets sick, he or she might spread germs to co-workers who sit nearby. But if doctors or nurses get the flu, they can pass it to the dozens of patients they come into contact with each day—many of whom have other conditions that render them more susceptible to infection. The flu still kills thousands of people each year in the U.S., most frequently those with underlying conditions, who also have more frequent contact with medical personnel than the healthy.

And as tough as they can be, the immune systems of doctors and nurses are not impervious to influenza. Unvaccinated health care staffers are second only to unvaccinated adults living with kids in their likelihood of coming down with the flu. About 18.7 percent of unvaccinated health workers versus 24 percent of unvaccinated adults with children in the home get the flu each year, according to Allison McGeer, a microbiologist and infectious disease consultant at Mount Sinai Hospital in Toronto. That means “health care workers are at higher risk of influenza than other working adults,” who have an annual infection rate of just 5.4 percent, she said at the ESWI meeting. And her analysis suggests that health workers tend to have a higher rate of asymptomatic infections, which “may say something about the risk of influenza transmission to patients.”

Arnold Monto, a professor of epidemiology at the University of Michigan School of Public Health, calls the decision to pass up the vaccine—whether you are a health worker or not—”stupid behavior,” noting that the demonstrated benefits to yourself and those around you far outweigh any slight risks of adverse reactions.

Dr. Mark Crislip, an infectious disease expert, wrote a humorous and fairly pointed take on healthcare workers who refuse the flu vaccination:

I wonder if you are one of those Dumb Asses who do not get the flu shot each year? Yes. Dumb Ass. Big D, big A. You may be allergic to the vaccine (most are not when tested), you may have had Guillain-Barre, in which case I will cut you some slack. But if you don’t have those conditions and you work in healthcare and you don’t get a vaccine…, you are a Dumb Ass. (Full monologue.)

It’s clear that healthcare workers have a moral and ethical obligation to do no harm to their patients, which is embedded in codes of most healthcare professions. Stopping the spread of disease by vaccination, which has substantial science based medicine supporting its safety and effectiveness, should not be subverted by personal feelings on the matter. If a doctor or nurse or laboratory worker does not want to get a vaccine, they have other choices in profession that doesn’t require them to protect their patients from vaccine-preventable diseases. Loyola made it mandatory, and just a handful of people quit, and a tiny percentage had either a medical or religious exemption.

Good for Loyola, because vaccines save lives.


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The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!