Ouch: Mandatory flu vaccines spark backlash

The flip of the calendar page to Jan. 1, 2013, adds a controversial new quality measure reporting requirement. Hospitals will need to report healthcare personnel's influenza vaccination to the Centers for Medicare & Medicaid Services (CMS). Payment determination based on the measure will begin in FY 2015 and represents a 2 percent reduction for failure to report.

The CMS requirement lays the groundwork for the Department of Health and Human Services Healthy People 2020 objective of a 90 percent annual vaccination rate among healthcare workers. Without required vaccination, approximately 40 percent of medical professionals comply with annual vaccination, according to a critique published in the winter issue of Journal of American Physicians and Surgeons.

But will healthcare workers comply with required vaccinations? When the American Association of Physicians and Surgeons conducted a survey about mandatory vaccination, 31 percent of the nearly 700 respondents indicated, “I will refuse [annual influenza immunization] … even at the risk of my job or medical staff privileges,” according to the critique.

In fact, required vaccines have launched a minor revolt. TriHealth, in Cincinnati, required free vaccines for its 10,800 workers in November. However, when 150 workers refused to comply with an initial deadline of Nov. 16, the provider threatened to fire them if they did not comply by Dec. 3. Eighty-two complied or provided a valid reason why they could not meet the requirement, according to WLWT News.

“If the facility actually went through and fired 150 nurses at once it would have tremendous economic impact,” Jane M. Orient, MD, author of the critique, told Health Imaging.

The Cincinnati incident follows the 2009 failure of a statewide mandate for New York state healthcare workers to receive the H1N1 vaccine and seasonal vaccine or face termination. Healthcare workers protested and several unions filed lawsuits. However, the mandate was rescinded based on a shortage of H1NI vaccine.

Orient predicted more clashes as CMS implements quality measures and hospitals revise policies. “For example, Marshall Medical Center in Placerville, Calif., requires workers either to provide documentation of influenza vaccination, or sign a declination form and wear a mask, citing California law and The Joint Commission requirements,” Orient wrote. Virginia Mason Medical Center in Seattle has required influenza vaccination since 2005; 0.2 percent of its staff left rather than comply, according to Orient.

Others are taking a proactive approach. A group of Colorado activists has formed a Facebook group Colorado Health Care Workers Against Forced Vaccination.

It remains to be seen which side will cry ‘uncle’ first, says Orient. Although nearly one-third of survey respondents indicated a willingness to risk their jobs or staff privileges, Orient predicted many would cave in to required vaccines rather than lose their livelihoods. On the flip side, hospitals that mandate vaccines may face economic and safety risks if they fire a large number of workers for noncompliance.