Abstract
Vaccination of health care workers against influenza has been recommended over the years after identification of influenza as a leading cause of death in vaccine-preventable infections. Influenza is a contagious respiratory disease spread through contact with the infected respiratory fluid. The paper evaluates arguments and counter arguments on mandatory vaccination of healthcare workers for management of the virus in the healthcare setting. It examines in detail the discussion on vaccination of health care workers y assessing the need for mandatory vaccinations and the opposing views and claims against vaccinations. The controversy assesses whether immunization for healthcare workers should be mandatory or voluntary in the protection of vulnerable patients against diseases and safeguarding the employees from illnesses and absenteeism. The paper also evaluates a suitable plan to provide an effective approach to impacts of mandatory vaccination based on personal experiences and knowledge and expertise. A conclusion on the position on mandatory or voluntary vaccination among the health care workers has also been provided.
Should the Influenza Vaccine be Mandatory for Healthcare Workers?
Introduction
Influenza or the flu is a contagious infection that can be spread quickly from one person to another and is caused by a variation of viruses. As a respiratory disease that affects nose throat and lungs, the flu has adverse effects and presents a higher risk on the elderly, infants, young children and persons with different health conditions (Block et al., 2014). The infections are spread through droplets of the respiratory fluids through the air such as when an infected person coughs or sneezes others present can be infected by inhaling the airborne virus (Carter & Yentis, 2018). It is also spread through the surface as the virus can survive on surfaces for twenty-four hours. Flu is also easily transmitted in crowded places including hospitals, clinics or health care centers.
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Vaccination of health workers against the flu virus has been often recommended to reduce the mortality rates due to disease association with high death rate. Influenza has been ranked as the leading cause in the classification of vaccine-preventable diseases (Quach et al., 2013). The stress on health care workers vaccination arises from some characteristics of influenza such as its lack of symptoms. Thus, health care workers are prone to infection and transmission of the virus without knowledge due to lack of visible signs and symptoms. Healthcare workers may function well despite infection with the influenza virus. As they continue working, they pose a risk of exposure to the patients they attend (Carter & Yentis, 2018).
Healthcare workers are obligated to care and protect vulnerable patients by eliminating risks on patient’s life resulting from negligence or ignorance. They are required to address any threats to health care as in the cases of influenza infections and epidemics through proper protection. (Eaton et al., 2017). Research had indicated that conducting an annual influenza vaccination project for healthcare workers will drastically reduce the risk of infections and the spread of the virus among patients. Vaccinations also mitigate illness among healthcare employees and cases of absenteeism which helps in improving service delivery to patients (Block et al., 2014).
Controversy
The issue of mandatory vaccination for all health workers has raised disagreements with different positions on the best ways to address the influenza pandemic form a healthcare perspective. Healthcare organizations such as Center for Disease Control, The Joint Commission and the World Health Organization who strongly recommends vaccination of health care workers with an emphasis on the treatment of the mater as a priority and mandatory(Quach et al., 2013). The organizations claim that mandatory vaccination of health workers against diseases protects the healthcare workers, aids in maintenance and stability of the health care system and plays a huge role in the protection of vulnerable patient’s against infections. Mandatory vaccination is emphasized due to the reluctance of the healthcare fraternity to voluntary engage in the vaccination process due to various reasons and circumstances.
On the other hand, the health care workers and their unions oppose mandatory vaccination of health workers by claiming the right of workers to choose from options and make health care decisions (Quach et al., 2013). Oppositions are based on the influence of the media through the provision of misconceptions beliefs and attitudes which incites some health care workers against the influenza vaccination and leads to low immunization turn out.
I believe that mandatory vaccination of health workers against the influenza virus in the best interest for the workers, patients and the healthcare system at large and should, therefore, be implemented in all states and regions (Eaton et al., 2017). Mandatory vaccination is under healthcare professions ethics and morals that influence health workers to adhere and follow the strict guidelines in the protection of patients and themselves against threats and risks. Health care workers should not rely on patients’ immunity or vaccination due to poor resistance and constant exposure and should instead take personal precaution through immunization.
Argument
Vaccination against influenza for health care workers should be implemented on a mandatory policy with a serious emphasis common to other severe infections like measles, rubella and mumps due to the high risks that influenza pose on patients and workers. Statistics have revealed that four out of five children and adults (80%) (Drees et al., 2015) infected with the influenza virus do not have symptoms. The assessment indicates increased risks and vulnerability of spread the infections from one person to another. The results in the health care setting are devastating as healthcare workers effectively spread the virus to the patients.
Research also indicates that on average, more than 3,500 Canadians die each year from complications of influenza, and over 12,000 are hospitalized (Quach et al., 2013). In other reports, influenza contributes to 36,000 excess deaths and >200,000 hospitalizations in the United States annually. The mandatory policy is necessary and will be effective due to the low rates of voluntary and personal efforts to get vaccinated. A report shows that voluntary vaccination against influenza still experience a little turnout, especially among US healthcare workers at 44.4% which widens the risk gap of infections and outbreaks which should be prevented (Eaton et al., 2017).
Current law and policies encourage voluntary participation and informed consent on immunization. However, failure to acquire vaccination is a violation of human rights especially when the choice has a significant impact on vulnerable patients through death or high costs in managing outbreaks. The Ministry Of Health through the District Health Board Based Healthcare Workers Projects has increased influenza coverage rates to 65–66% in the last years and still aims at to achieve its goal of 80% in 2018 (Looper et al., 2017).
The need for mandatory vaccination is also based on the seasonality and climatic changes which increase influenza infections. There is a high tendency of influenza outbreaks in America between November and April and affects 25% of the population every year (Block et al., 2014). There also exists the risk of stronger epidemics after every 2 or 3 years and affects larger populations in given areas and seasons. The strong outbreaks can also appear several times in a year worsening the risk of infections and death especially when influenza develops complications such as chronic pneumonia (Drees et al., 2015).
Based on personal experience with the infection and close association with people infected as a result of exposure and failure to get the vaccination, I advocate for mandatory vaccination of health workers. This is for prevention and to safeguard populations from health risks. Introduction of a mandatory policy would improve coverage and offer protection to populations and credibility to the health care system as concerned in the prevention and eradication of infections, illnesses, and diseases.
Counter Argument
The mandatory policy has been opposed and criticized for various reasons. Mandatory vaccinations have been challenged as a violation of human rights of choices. Many healthcare workers argue that compulsory immunization violates their rights to decide on immunization and requires organizations to obtain informed consent before implementation (Eaton et al., 2017). However, the mandatory policy is not an initiative to coerce people into being forcefully vaccinated. Mandatory vaccination policy seeks to empower healthcare workers to fulfill their duties by being protected and healthy and to ensure their safety by adhering to rules and regulations (Quach et al., 2013).
Counter arguments presents claims based on misconceptions and interpretation of data for the media and the internet on mandatory vaccination. They claim that the vaccines are not effective in preventing influenza and associated them with the emergence of new diseases gained after the flu shots. However research has shown that every individual reacts differently to flu shots depending on the health status of the individuals. An individual with other medical complications and infections is unjustified to claim that diseases and infection emergencies from flu shots (Looper et al., 2017). Influenza vaccines are effective in prevention and protection against the virus and research has indicated that a high risk of infection towards those who are yet to receive vaccination on exposure.
Other claims presented against the need for vaccines involve populations that consider themselves healthy. People who lack underlying medical conditions fail to recognize the need for vaccines as they assume health on their healthy physical appearance. The belief is a misconception. Influenza is a respiratory virus and will affect any person who comes into contact with infected respiratory fluid regardless of his or her health status (Eaton et al., 2017). Other claims oppose vaccination through claims that the vaccine affects pregnant women and disease sensitive individuals. The claims are unjustified as it has been proven that influenza does not affect pregnancy nor are disease sensitive individuals affected. Vaccines safeguard health by reducing their risks upon exposure, thus protecting people from infections that can severely harm their health (Drees et al., 2015).
Plan- Overview
Health care workers must protect and safeguard the interests of their patients from infections. There is the need for health workers to ensure that all healthcare workers are vaccinated to reduce the risk of infections, outbreak and untimely deaths caused by influenza (Quach et al., 2013).
Cost implications and effective use of resources
Mandatory vaccination will reduce expenses and costs endured in managing outbreaks such that the resources can be invested elsewhere. Management of influenza through the introduction of mandatory vaccination will help in the maintenance of a healthy workforce as it reduces employee illness and low turnover as a result of diseases and infections (Carter & Yentis, 2018). The elderly and young children and those with other underlying medical problems who are at high risk of infection will be safeguarded by reducing the risk of contamination through the healthcare workers who will reduce mortality and morbidity rates among the population.
Local State and Federal Laws and Policies
They focus on mandatory vaccination of health workers for decreasing costs and loss through expenses incurred in the care of the aged and the young children prone to illnesses from the influenza virus (Block et al., 2014). Apart from a few, most states in the United States have implemented a mandatory policy for vaccination of all healthcare workers against influenza. This policy has seen high outcomes in coverage, increased productivity, disease prevention and protection especially in the vulnerable populations (Looper et al., 2017).
Relationship to Healthy People 2020
The mandatory policy of vaccination of healthcare workers is in line with the healthy 2020 people summary which believes that immunization is the most effective way of preventing influenza increased hospitalization and death cases (Quach et al., 2013). Healthy 2020 has developed strategies to achieve their coverage goal where they aim to ensure that every healthcare worker is annually vaccinated against influenza through the implementation management and offering of vaccination programs.
Anticipated Impact on Shareholders
The introduction of mandatory influenza vaccination policy will impact shareholders differently where healthcare workers may experience coercion and view the forceful requirement as a violation of their rights in their profession (Block et al., 2014). The policy will also have profound effects on the health care system by increasing survival rates of the aged children and individual with underlying conditions. Health care leaders and the ministry of health and government will be positively impacted while the community will benefit by existing in disease-free environments and experiences of bountiful health.
Conclusion
Influenza poses health risks to healthcare workers, patients, societies and countries. There is a need to formulate policies to protect and act on the dangers presented, the introduction of a mandatory vaccination policy for health care workers is a step towards creating a conducive environment for human survival. Health care workers should protect and guard vulnerable patients against infections and exposure to harmful viruses. They should, therefore, adopt influenza vaccination as the preventive measure that shields them from the disease in the risky healthcare environment of pathogens and infections. Mandatory influenza vaccinations should be availed to all health care workers without exceptions unless on viable medical reasons.
References
Block, L., Pitts, S., & Perl, T. M. (2014). Barriers and Facilitators of Implementation of a Mandate for Influenza Vaccination among Healthcare Personnel. Infection Control & Hospital Epidemiology, 35(6), 724-727.
Carter, A. H., & Yentis, S. M. (2018). Ethical considerations in the uptake of influenza vaccination by healthcare workers. Public health, 158, 61-63.
Drees, M., Wroten, K., Smedley, M., Mase, T., & Schwartz, J. S. (2015). Carrots and sticks: Achieving high healthcare personnel influenza vaccination rates without a mandate. Infection control & hospital epidemiology , 36(6), 717-724.
Eaton, J. L., Mohr, D. C., McPhaul, K. M., Kaslow, R. A., & Martinello, R. A. (2017). Access, Education and Policy Awareness: Predictors of Influenza Vaccine Acceptance among VHA Healthcare Workers. Infection control & hospital epidemiology , 38(8), 970-975.
Looper, P., George, D., Johnson, E. J., & Conway, S. E. (2017). Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus. Journal of American College Health , 65(7), 513-517.
Quach, S., Pereira, J. A., Kwong, J. C., Quan, S., Crowe, L., Guay, M., & of Canada, P. H. A. (2013). Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory policies. American journal of infection control , 41 (11), 1017-1023 .
