CommentaryHealer, heal thyself: Health care workers and the influenza vaccination
Section snippets
Influenza and influenza vaccine: the facts
Influenza is a highly contagious, acute viral infection of the respiratory tract, causing significant morbidity and mortality on an annual basis worldwide.1 However, influenza affects different groups differently, being particularly dangerous for many of the patients in health care facilities, especially the elderly population, the immunocompromised, the critically ill, and young children.2, 3, 4, 5 In such people, influenza can result in severe, prolonged, devastating illness and death.3, 6
Ethical considerations
Standard discussions of the ethical principles applicable to the health care setting since 1979 have included autonomy, nonmaleficence, beneficence, and justice.34 Some would add trust to the list to highlight the fiduciary nature of the HCW-patient relationship.
Conclusion
Quite apart from any other requirements that might be placed on HCWs, the ethical argument seems compelling. We have an obligation to prevent, in so far as we can, harm to our patients and to honor their trust of us to be professionals fit to care for them. Among other things, this obligation requires us to take all reasonable steps to be fit for the task of clinical care. Often, this is interpreted solely in terms of competence, but the possibility of nosocomial infection of patients by HCWs
References (40)
- et al.
Influenza in the acute hospital setting
Lancet Infect Dis
(2002) - et al.
Barriers to influenza vaccine acceptance: a survey of physicians and nurses
Am J Infect Control
(1989) - et al.
Requiring influenza vaccination for health care workers: seven truths we must accept
Vaccine
(2005) - et al.
Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial
Lancet
(2000) - World Health Organization. Influenza fact sheet. 2003; N211. Available at:...
- et al.
Mortality associated with influenza and respiratory syncytial virus in the United States
JAMA
(2003) - et al.
Nosocomial transmission of influenza
Occup Med (London)
(2002) - et al.
Prevention and control of influenza: recommendations of the Advisory Committee on Immunisation Practices
Morb Mortal Wkly Rep
(2004) - et al.
APIC position paper: improving health care worker influenza immunization rates
Am J Infect Control
(2004) Counterpoint: in favour of mandatory influenza vaccine for all health care workers
Clin Infect Dis
(2006)
Correlation between healthcare workers' knowledge of influenza vaccine and vaccine receipt
Infect Control Hosp Epidemiol
Lessons from a nursing home outbreak of influenza A
Infect Control Hosp Epidemiol
Outbreak of influenza A in a nursing home—New York, December 1991-January 1992
Morb Mortal Wkly Rep
Effectiveness of influenza vaccine in health care professionals: a randomised trial
JAMA
Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff
Infect Control Hosp Epidemiol
Influenza: virology, epidemiology, disease, and prevention
Am J Prev Med
Transmission of influenza: implication for control in health care settings
Clin Infect Dis
Influenza B in households: virus shedding without symptoms or antibody response
Am J Epidemiol
Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomised controlled trial
JAMA
Cited by (29)
Should nurses take a COVID-19 vaccine?
2021, Nursing OutlookCitation Excerpt :A similar point to Anikeeva et al. (2009) could be made about receiving a COVID-19 vaccine that it could afford a nurse the opportunity to continue to deliver care to patients in the context of high level of virus circulating. Although the obligation to increase the benefit or welfare for someone is not unrestrictive, health care professionals do have specific obligations of beneficence towards their patients; taking a vaccine for a vaccine-preventable infection has been considered to be part of this (McLennan et al., 2008; Beauchamp & Childress, 2019). A similar proposition could be made about taking a COVID-19 vaccine.
Perception and attitudes of health professionals from a health area regarding influenza vaccination
2016, Revista de Calidad AsistencialEmployee designation and health care worker support of an influenza vaccine mandate at a large pediatric tertiary care hospital
2011, VaccineCitation Excerpt :This raises important ethical implications of a policy that overrides individual choice and can result in loss of employment. Proponents of vaccination mandates cite the importance of patient safety, professional ethical responsibility and public health considerations and cost-effectiveness [18,33–35]. On the other hand, mandatory programs do challenge autonomy and can also be seen as infringing upon privacy which may affect morale or acceptance of future mandatory initiatives [13,15,20,36,37].
Reflections on the influenza vaccination of healthcare workers
2010, VaccineCitation Excerpt :This approach generally involves the annual influenza vaccination being made the required default position for all HCWs, but a declination form being included as part of the process so that those who choose not to be vaccinated, who wish to ‘op-out’, are required to think through and professionally acknowledge and document why they are making their decision. The approach is seen as a useful means for people who are honestly opposed to vaccination, and to distinguish those people from those who are simply too lazy or indifferent to get vaccinated [51]. Since 2005, for example, the CDC has recommended the use of signed declination forms for HCWs who refuse vaccination [53].
Seasonal Influenza Vaccination Coverage Among Local Health Department Personnel in North Carolina, 2007-2008
2010, American Journal of Preventive MedicineCitation Excerpt :Influenza is responsible for 75 million days of missed work and 22 million healthcare visits annually.2,3 The Advisory Committee on Immunization Practices recommends healthcare workers receive vaccination annually,2–4 but worker vaccination coverage is lower than the estimated proportion vaccinated for the general population.2,5–9 Vaccination of healthcare workers is associated with lower work absenteeism10,11 and reduced mortality in nursing home residents12,13 and elderly patients in hospitals.14