Donna Renee Williams, RN, MBA, CDONA/LTC

The Healthy People 2020 goal is for 90% of America’s health care personnel to be immunized annually against the flu.  According to the CDC (2012), during the 2010-11 influenza season, only 63.5 percent of health care personnel received the vaccine.

On October 5, 2012, in a highly controversial ruling, Rhode Island became the first state to mandate the influenza vaccination for health-care workers (Stokowski-Bisanti, 2012).  On August 28, 2012, the Health Officer of the County of Sacramento issued an order mandating that all health care facilities in Sacramento County require their health care workers to receive an annual influenza vaccination, or if they decline, to wear a mask during the influenza season.  According to the Health Officer, the goal is to increase the rate of influenza vaccination of health-care workers (HCWs), reduce employee absenteeism during influenza season, and reduce HCW transmission of influenza (Memorandum, O.Kasirye, MD, MS).

Considering the goal, ideally and theoretically, all employees in the health care facility would be compliant with the recommendation and receive the vaccination.  “This should be mandated and it should have been done earlier,” said Helen Darling, president and CEO of the National Business Group on Health.  The nonprofit organization, which represents more than 300 large employers, including 68 of the Fortune 100 companies supports the requirement for health care workers (Kane, 2012).  Moreover, Amy Garcia, chief nursing officer for the American Nurses Association states on a more individual level, its an “ethical responsibility.”  Part of nursing’s code of ethics is that the patient comes first. So we believe if there is a chance that a nurse could expose a patient, it is the ethical responsibility of the nurse to be protected by vaccinations (Kane, 2012).  After all, it is safe and effective in reducing the likelihood that one would either transmit or acquire influenza.  Yet that is not the case.  With less than two weeks before the mandate becomes effective, “renegades” and procrastinators render my inoculation rates at less than 60%, to date.  Realizing that 100% compliance is unlikely, administration must now develop policies and procedures which address those that exercise their “right to refuse.”

Perplexed by the number of refusals, I sought to interview some of the staff and inquire about their reasons for refusing.  Along with a kind-hearted indirect “you can’t make me” attitude, I ascertained that the primary reason for refusal was either, “I don’t want to put that in my body! Or, I have never taken it before and I didn’t get sick.”  Appeals to the “conscience” of the healthcare worker were unsuccessful.  Appeals towards their “compassion” and “social responsibility” were equally as ineffective.  Therefore, in the end, I must be resigned to fact that it is a personal choice. 

References: 
Centers for Disease Control and Prevention (2012)  Health Care Personnel Flu Vaccination. Retrieved from http://www.cdc.gov/flu/professionals/vaccination/health-care-personnel.htm

Stokowski-Bisanti, J. (2012, October 7) Rhode Island health-care workers and ACLU object forced vaccine mandate. The Examiner. Retrieved from http://www.examiner.com

Kane, Jason (2012, February 6) Next Health Care Mandate: Flu Shots for Medical Workers. PBS Newshour. Retrieved from http://www.pbs.org