COUNTERPOINT: Opposed to Mandatory Vaccination

'Flu vaccination isn't a silver bullet.'

In response to low vaccination rates among health care workers, many nurses are being told they must submit to mandatory seasonal or H1N1 flu vaccination-in some cases both-or be fired. (In some instances, unions and the courts have successfully forced hospitals or health departments to rescind their mandates.) Yet in my more than three decades as a bedside nurse, I've seen how protective RNs are of their patients and how mindful they are of their role in infection control. I've also been reminded time and again that they're smart, skilled professionals who make life-and-death decisions every day based on their training and education. All of these observations factor into my opposition to mandatory flu vaccination for health care workers.

Flu vaccination isn't a silver bullet that single-handedly halts the spread of flu. Seasonal flu vaccines vary greatly in effectiveness from year to year. The CDC says the H1N1 vaccine is a good match; time will tell.

Overreliance on vaccination sometimes means that commonsense steps are ignored. There are several important measures health care facilities should take to protect patients and workers. Experts agree that comprehensive flu prevention also depends on education and adherence to good infection control practices, including handwashing and using adequate personal protective equipment.

One solution is a comprehensive vaccination program that educates workers on vaccination, gives them a chance to ask questions, and doesn't make them feel coerced. Vaccination must be offered on all shifts and on the weekend in convenient locations. As part of the training, health care workers should be advised of their right to compensation for adverse events through the National Vaccine Injury Compensation Program. They should also know that thimerosal-free vaccines are available and that the CDC will track adverse reactions to the vaccine. If workers don't want the vaccine after going through the training, they should have the option of signing a declination form.

Most nurses I know aren't opposed to flu vaccination itself-in fact, many routinely get vaccinated-but they're opposed to an unwarranted intrusion on their right to make an educated decision about their personal health. Some will argue that nurses are required to get polio, measles, and rubella vaccinations. But those are lifetime, not annual, immunizations. As nurses, we know that every time you take a medication there's a statistical risk of injury.

Nurses are not cogs in the health care machine, but highly educated health care professionals who also have their own personal health concerns. They should be given the opportunity to weigh the risks and benefits of flu vaccination and the right to make informed decisions for themselves. Trust the nurses.