Commentary
Healer, heal thyself: Health care workers and the influenza vaccination

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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

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References (40)

  • R.A. Martinello et al.

    Correlation between healthcare workers' knowledge of influenza vaccine and vaccine receipt

    Infect Control Hosp Epidemiol

    (2003)
  • D.M. Morens et al.

    Lessons from a nursing home outbreak of influenza A

    Infect Control Hosp Epidemiol

    (1995)
  • Centres for Disease Control and Prevention

    Outbreak of influenza A in a nursing home—New York, December 1991-January 1992

    Morb Mortal Wkly Rep

    (1992)
  • J.A. Wilde et al.

    Effectiveness of influenza vaccine in health care professionals: a randomised trial

    JAMA

    (1999)
  • R.T. Lester et al.

    Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff

    Infect Control Hosp Epidemiol

    (2003)
  • F.M. LaForce et al.

    Influenza: virology, epidemiology, disease, and prevention

    Am J Prev Med

    (1994)
  • C. Bridges et al.

    Transmission of influenza: implication for control in health care settings

    Clin Infect Dis

    (2003)
  • H. Foy et al.

    Influenza B in households: virus shedding without symptoms or antibody response

    Am J Epidemiol

    (1987)
  • C. Bridges et al.

    Effectiveness and cost-benefit of influenza vaccination of healthy working adults: a randomised controlled trial

    JAMA

    (2000)
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