Unlike patients who have a choice about getting the flu shot, many health care workers didn't have a say this year.
For the first time in Rhode Island, hospital and nursing home workers were told to roll up their sleeves, and hundreds of hospitals in other states have similar policies.
"No one likes to be coerced, and there were some people who objected,'' says Virginia Burke, CEO of the Rhode Island Health Care Association, which provides skilled nurses and rehabilitation workers to the state's nursing homes. "My fear when the mandate came out was we'd lose workforce. To my delight, that hasn't happened."
But more than 1,000 workers filed a petition to oppose the directive.
The episode highlights strains that have developed in the midst of one of the strongest flu seasons in years. Though the government recommends that health care facilities increase the number of workers who get vaccinated, nurses and other workers in some communities have put their jobs on the line by saying no.
Their argument: They have medical or religious reasons or doubt the effectiveness of the vaccine.
The employers' response: They have a responsibility to protect the health of patients and co-workers who need to stay healthy.
"It's not your inalienable right to not get a vaccine if you're helping care for vulnerable patients,'' says Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia.
Offit says two children who were patients at Children's Hospital several years ago couldn't get the flu shot because they were receiving cancer treatment. "They died from getting the flu at the hospital."
Depending on the severity of the flu, hundreds to thousands of people die from the illness each year.
Though the Centers for Disease Control and Prevention recommends Americans 6 months and older get a flu shot, only 63 percent of all health care workers had gotten the vaccine as of November (latest survey results) compared with about 40 percent of the public. The CDC reports findings that vaccines among the health care workforce help reduce patient fatalities and aims to have 90 percent compliance for health care workers by 2020. In most states, the individual hospitals set the policies.
"We had noticed places where we haven't been making progress in terms of workers getting the shots,'' says Michael Fine, director of the Rhode Island Department of Public Health. "From the integrity of professional practice, to put patient care first, we thought this was a reasonable requirement. "
If Rhode Island health care workers skip the vaccine, they are required to wear a surgical mask on the job.
The American Nurses Association and National Nurses United, which represent about 300,000 of the nation's nurses, have not tracked how many workers have been suspended or fired for refusing to get a shot. Both groups recommend the vaccination, but say it shouldn't be mandated and workers shouldn't be fired.
Among those who lost their jobs:
- Carla Brock was fired Jan. 7 from Springfield (Mo.) Cox South Hospital. She chose not to get a shot and was told she'd have to wear a surgical mask. "I have spiritual and religious reasons to not have those toxins in my body," Brock told the News-Leader. She didn't like wearing the mask because it gave her headaches.
- Joyce Gingerich is among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich says she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."
- Sakile Chenzira filed a lawsuit after being fired 14 months ago from Cincinnati Children's Hospital Medical Center. A U.S. district court announced in December it will hear her case. She refused to get the shot because she's a vegan and does not eat animal products or animal byproducts. The shots contain egg products. She worked as a customer service representative. "The court finds it plausible that (Chenzira) could subscribe to veganism with a sincerity equating that of traditional religious views," Judge S. Arthur Spiegel wrote.
Karen Higgins, co-president of the National Nurses United and a nurse at Boston Medical Center, says she won't get the shot again after having a severe reaction in December. The CDC says one to two people in a million suffer a severe reaction. Higgins doesn't want to take the risk again and will have to follow her hospital's policy to wear a surgical mask in the future or risk losing her job.
"I think the hospitals need to do more to prevent the spread of flu, though,'' she says. "There are many policies they can put in place that would help that don't involve forcing people to get shots or wear masks. Put masks on people who are coughing, not the other way around."
Cheryl Peterson, director of nursing practice and policy for the American Nurses Association, says more cases might end up in court.
"It's one thing to encourage health care workers to get the vaccine," she says. "It's another one to fire someone for not getting it."
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