Infection Control

New York requires flu vaccines for healthcare workers

Briefings on Infection Control, November 1, 2009

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As medical facilities around the country begin their flu vaccination programs, IPs and employee health directors simultaneously struggle to find ways to convince frontline staff members to receive the seasonal influenza vaccine.
But some hospitals have quit trying to convince healthcare workers and moved straight to requiring them to get immunized.
An even more uncommon precedent has been set
in the state of New York. For the first time, a state requirement will force nearly all healthcare workers to be immunized by November 30. The regulation will include the H1N1 vaccine, which was approved by the FDA on September 15..
However, not many employees are thrilled with
the mandate. As flu season approaches and vaccinations become available, required immunization is a debate that will continue between unions, workers, and healthcare facilities.

The New York regulation
On August 13, the New York State Hospital Review and Planning Council passed an emergency regulation that requires healthcare workers at general hospitals, diagnostic treatment centers, certified home health agencies, long-term home health programs, AIDS home care programs, licensed home care services agencies, and hospices in New York to receive the seasonal
and H1N1 flu shots.
The regulation applies to healthcare workers who have direct contact with patients and who work in facilities that are established, operated, and regulated under public health law Article 28, 36, and 40, which include most healthcare facilities aside from nursing homes and privately owned physician practices. Employees are exempt from the vaccine if they are medically contraindicated.
“The regulation requires that healthcare providers report to us on November 30 of each year on their flu vaccinations of their personnel and how they have met the requirements,” says Claire Pospisil, spokesperson for the New York Department of Health (DOH). “If someone has not been vaccinated by the 30th, they would not be able to participate in direct patient care.”
For the time being, the state will not enforce fines on hospitals that don’t vaccinate all healthcare workers, but it’s a possibility down the road, says Pospisil. Additionally, this regulation will include the H1N1 vaccine that was licensed by the FDA last month.
Pospisil says the DOH considers this a patient safety issue, and it has initiated the regulation to better serve patients.
“There is extensive information in the medical literature about the transmission of flu to patients by healthcare workers,” Pospisil says. “Unvaccinated healthcare workers are a danger to their patients. Patients in hospitals are particularly vulnerable to become infected with the flu because in many cases, their immune systems are compromised.”
The New York State Nurses Association (NYSNA) has publicly opposed the regulation. Nancy Webber, spokesperson for NYSNA, says the organization supports the effort to vaccinate healthcare workers but opposes the idea that it should be mandatory.
“It’s not like polio or smallpox where you can eradicate a disease through vaccination,” Webber says. “The flu, as you know, mutates constantly, so even if you have a flu
shot, there is no guarantee you are going to be immune from the particular strain that is circulating. Patients will still be exposed to the flu virus through other means, so there are a great number of questions about that.”

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