Mandate flu shot for health-care workers: Journal



Doctors and nurses should be legally required to get flu shots to protect their patients' lives, the editor of a leading medical journal says.

"No right-thinking physician would ever knowingly harm a patient or fail to do some essential thing that would result in harm to a patient," writes Dr. Ken Flegel, associate editor of the Canadian Medical Association Journal, in an editorial released Monday.

But that's exactly what doctors are doing when they don't get vaccinated, Flegel said.

Pointing to a 2010 study in the same journal that showed between 55% and 65% of Canadian doctors don't get an annual flu shot, Flegel notes those doctors are putting patients with weakened immune systems at risk.

Doctors need flu shots more than anyone, he argued, because they're infected at much higher rates (5-10% of the general population versus 20% of health-care workers).

And research shows flu shots literally save lives in hospitals, he said.

An American Association of Occupational Health Nurses study shows a 5% to 20% reduction on mortality rates for chronic patients in hospitals where 51%-70% of the doctors have had the flue shot, compared to ones where between 3.5% and 32% of doctors have been vaccinated.

"Compulsory vaccination may be regarded as ethically questionable because it violates a person's autonomy. But in the case of influenza vaccination, the autonomy of health-care workers comes into conflict with the best interests of the patient," Flegel wrote. "Patients should come first, and in similar situations they do already. For example, a surgeon infected with HIV or a hepatitis virus is not allowed to operate."

The editorial brings a controversial and once highly discussed issue to the forefront again.

In 2002, the Ontario labour board ruled that mandatory flu shots for health-care workers in Hamilton, Ont., was "a serious invasion of their rights." The ruling stemmed from a CUPE complaint after nine workers were suspended for refusing to get vaccinated.

Despite the Ontario ruling, the B.C. government announced in August it would be making flue shots mandatory for all public health-care workers.

"Influenza causes more deaths annually than all other vaccine-preventable diseases combined, and hospitalized patients are more vulnerable to complications from influenza than the general population," Dr. Perry Kendall, B.C.'s health officer, said at the time. "This policy will protect patients. Putting in place consistent policies to prevent influenza from spreading is the right thing to do from a patient safety perspective."

The B.C. Nurses' Union is against the new rules.

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