A compelling editorial on mandatory vaccines for health care workers

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We at ACSH are happy to promote Dr. Arthur s Caplan s recent Lancet article on the importance of mandating flu vaccines for health care workers. As Dr. Caplan, chair of the Department of Medical Ethics at the University of Pennsylvania, notes, Rates of influenza vaccination in health-care workers have averaged well under 50% for the past decade in many hospitals and long-term care facilities in the USA and in other nations. This dismal rate is highly problematic, he explains, in large part because vaccination of doctors and nurses plays such a crucial role in protecting patients from infection, illness, and death, especially among children, the elderly, and those who are immuno-compromised. Yet no amount of coaxing or reasoning has convinced the majority of health-care workers to get themselves vaccinated. All of which leads Dr. Caplan to ask an important question: Given the failure of voluntary vaccination strategies and the dangers low vaccination rates present to vulnerable patients, shouldn't all health-care workers be required to be vaccinated against influenza and other communicable diseases as a condition of their employment?

The answer, of course, is yes absolutely. It is time, says Dr. Caplan, to make clear what the ethical reasons are for requiring vaccination and then to get a mandate in place in all health-care institutions and clinics. And Dr. Caplan offers just such clarity in his op-ed, not the least of which are the following points:

[E]very code of ethics adopted by physicians, nurses, nurses aides, social workers, pharmacists, and other health-care professionals states very clearly, succinctly, and loftily that the interests of patients must come ahead of anyone else's...Whatever one's views about personal rights to choose, unless a valid medical reason exists to not vaccinate, the best interests of the patient trumps personal choice in the hierarchy of self-imposed professional values.

ACSH's Dr. Gilbert Ross, whose recent Guardian op-ed stressed the importance of mandating vaccination, emphatically agrees with Dr. Caplan on this point. He recalls the efforts of former New York governor David Paterson to mandate flu vaccination for health-care workers during the worst of the H1N1 outbreak efforts that folded under pressure from public fears of vaccination and a belief that personal rights to choose trumped medical concerns.
Mandates do work, Dr. Caplan writes. At the University of Pennsylvania's health-care system, where vaccination is mandatory, he reports that vaccination rates are now greater than 98 percent. Underscoring the need for such a policy on a national level, he concludes: It is time to acknowledge professional duty and make influenza vaccination of health-care workers a mandatory obligation.