The annual vaccination against influenza was proposed for healthcare workers in 1984. Later, the Society for Healthcare Epidemiology (SHEA) stated that unless the workers have contradictions to the vaccine, they are to receive it. Finally, in 2010, SHEA claimed that flu immunization was an obligatory condition for employment for the personnel involved in patient care (Thomas et al., 2010, p. 989). Despite its undeniable contribution to disease resistance, mandatory vaccination violates the human right to choose the appropriate treatment measures. In this paper, the unethical nature of compulsory immunization against influenza will be considered.
Overwhelmed with concern for the patients’ health, hospitals required their employees to get the flu shot annually. The vaccination was aimed to prevent virus transmission among the clinicians and patients, and secure a steady workflow. Nurses, physicians, assistants, or other medical workers delivering patient care might jeopardize the recovery process, let alone their health. Moreover, clinicians who become ill with influenza usually use more sick days (Nurse Journal, 2020, para. 4). The medical organizations proposed that vaccination be made obligatory for those working in healthcare to prevent these deplorable consequences of the virus from spreading.
The patient’s safety remains the highest priority for each medical institution. Specialists in the field state that health care workers have a moral obligation to protect their patients and themselves from influenza. The virus, “spread by droplets made when people with flu sneeze, cough, or talk, can land in the mouths or noses of people who are up to about 6 feet away” (CDC, Influenza Vaccination Information, 2020). About 35,000 deaths from influenza are registered annually, and its mortality rate equals rates of breast cancer (Holliman, 2015, para. 5). With this in mind, it is essential to remember that the workers who are at work while being ill might be a threat to the patients, as well as to their loved ones at home. According to Edmond (2019, para. 5), presenteeism – working while ill – is 47% for nurses and 63% for physicians. This point of view, therefore, undermines the notion of ethics.
However, mandatory vaccination against influenza remains a highly controversial and unethical issue. First, the flu shot might cause side effects such as a high risk of Guillain–Barré syndrome, paralysis, and convulsions (Nurse Journal, 2020, para. 6). The right to refuse medical treatment, in this case, is ruthlessly violated and may come with grave consequences for the receiver. Despite its controversial nature, in 2018-2019, the flu vaccination coverage was highest among physicians (96.7%), nurses (98.1%), pharmacists (91.5%), and nurse practitioners and physician assistants (91.0%) (CDC, Influenza Vaccination Information, 2020). The doctors forced to receive immunization are either subjected to threaten their health or become unemployed, which is far from ethical practice.
The mandate provokes the risk of unemployment for all the employees that refuse to be vaccinated. Currently, to avoid an administrative leave of one week, the clinicians who do not consent to be vaccinated should have an appropriate religious, philosophical, or other exemption. Then, if the demand remains when the leave is over, the employee will be forced to resign voluntarily. Even if an employee has an exemption, they are obliged to wear a mask.
Apart from the person’s right violation and unemployment, the vaccine is modestly effective. Over the recent influenza seasons back in 2004-2005, the flu immunization was proved to have 41% effectiveness. In contrast, many other vaccines in clinical practice exceed 90% (Edmond, 2019, para. 8). If the common immunization is intended to be for “the greater good” for everybody, both patients and medical workers, it contradicts itself by imposing a physical impact on one’s body.
The doctors and nurses have the right to decide for themselves how to treat their health. There are diverse alternatives for the influenza prevention measures they can choose from. Some of them are rather simple, effective, and, most importantly, available daily (Nurse Journal, 2020, para. 10). First, handwashing keeps one’s hands clean and, thus, keeps infections from spreading (CDC, Hand Hygiene, 2020). Second, in healthcare institutions, wearing a mask can prevent the spread of diseases, including flu. Third, it may be of use to keep patients sick with flu isolated from others. All the measures mentioned above contribute to the reduction of virus transmission while maintaining the workers’ health. It would be more effective to encourage, not impose, vaccination, and reduce presenteeism to lessen the transmission of viruses in the healthcare realm.
Any ethical practice implies a respectful attitude towards the people involved. Forcing the medical workers to the flu vaccination may cause irreparable damage to their health. Every person has the right to choose the treatment and, if necessary, refuse one. Although the need to reduce the risk of the virus spreading between the clinicians ill with flu and the patients is present, it should not cause any other harm. If the right violation has been committed, no one can be sure when the next episode comes. However, at the moment, the patient’s right to choose the appropriate treatment measures is ruthlessly violated with the mandate and causes unemployment for those who do not consent to be vaccinated. A practice can hardly be ethical if it provokes disrespect and harm for any human being.
References
Centers for Disease Control and Prevention (CDC). (2020) Influenza Vaccination Information for Health Care Workers. Web.
Centers for Disease Control and Prevention (CDC). (2020) Hand Hygiene is the #1way to prevent the spread of infections. Web.
Edmond, M. B. (2019) ‘Mandatory flu vaccine for healthcare workers: Not worthwhile’, Open Forum Infectious Disease, 6(4), pp: 1-5.
Holliman, K. (2015) ‘Mandatory flu vaccines work but can raise issues for workers’, ACP Hospitalist.
Thomas R. T. et al. (2010) ‘Revised SHEA Position Paper: Influenza Vaccination of Healthcare Personnel’, Infection Control & Hospital Epidemiology, 31(10), pp. 987-995.
Should Nurses Be Forced to Get Flu Shots? (2020) Nurse Journal.