Compulsory flu shot for health-care professionals?

A perennially controversial topic that continually divides the medical community is the discussion on mandatory flu vaccination for healthcare providers, and there’s no international consensus right now.

In Canada, less than 50 per cent of healthcare workers get the flu shot. Conversely, at U.S. medical centres like Virginia Mason in Seattle, Washington where it’s required, vaccination rates are 98 per cent. There’s no national standard in Europe, and even in countries with mandatory policies these aren’t always implemented.

Dr. Michael Gardam, director of infection prevention and control at Toronto’s University Health Network, gets the shot. However, in a 2013 commentary published in the Canadian Medical Association Journal (CMAJ), he argues that it may be premature to make it compulsory for healthcare providers because the vaccine is imperfect.

The shot is only about 60 per cent effective when it matches the season’s circulating strain, because although every seasonal influenza vaccine includes three different strains, at least one of these guesses is wrong up to 20 per cent of the time.

Does this mean we’ve actually overestimated how well the flu vaccine really works?

Dr. Allison McGeer, director of infection control at Mount Sinai Hospital in Toronto and a leading flu expert, doesn’t think so, arguing that those hesitant to enforce mandatory vaccination should consider the shot’s purpose.

Prevention isn’t foolproof, but since the vaccine protects healthcare workers and saves patients’ lives, McGeer believes that making it compulsory should be considered.

British Columbia is the first Canadian province to make the flu shot mandatory for all healthcare providers. This policy, which came into effect in 2012, means that healthcare workers who don’t get the vaccine have to wear a mask while they’re in contact with patients during the flu season.

However, Debra McPherson, president of the B.C. Nurses Association, argues that forcing healthcare professionals violates their civil rights, because they should have sovereignty over their bodies and the right to choose whether getting vaccinated is the right thing to do.

An editorial in the October 2012 CMAJ called for obligatory vaccination within the health care community because patients’ lives depend on it. If workers feel they’re losing their choice, they need to consider the best interests of their patients, wrote Dr. Ken Flegel, the editor.

In a global atmosphere of increasing reluctance around vaccines in general, it’s crucial the medical establishment provides accurate information about the benefits of individual vaccines. It is only with an evidence-based dialogue that we can truly protect public health.