COMMENTARY

The Law: Get a Flu Shot or Wear a Mask, Healthcare Workers!

Arthur L. Caplan, PhD

Disclosures

November 07, 2013

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I am Art Caplan, from the NYU Langone Medical Center Division of Medical Ethics.

Should all healthcare workers (HCWs) be required to get a flu shot? As flu season begins all around the United States, the issue comes up: What about vaccination for HCWs -- doctors, nurses, people who have any clinical contact with patients?

Historically, we have encouraged HCWs to get flu shots, with all kinds of incentives to get that shot. We bring a cart to the hospital units, give it away for free, have a clown show up, have some kind of free food, create a jamboree to persuade HCWs to get their flu shots.

Year after year that has been tried, and it has not worked: The highest rates of vaccination achieved in the average hospital or nursing home range between 30% and 60%.[1] A few pediatric centers have done better, but generally speaking, the track record for getting HCWs vaccinated against the flu stinks. Thus, the question comes up: Is this something you should have a choice about, or should a flu shot be required for people to work in a hospital, a nursing home, or a homecare program?

The resistance to a mandate or a compulsory program has been strong, but now, for the first time New York State has made a decision to make it mandatory. New York State is moving forward this year by saying, either you get a flu shot or you have to wear a mask at all times if you are around patients. That is the only other option if you do not get a flu shot. This will apply to all HCWs. Anyone who has clinical contact with patients, even food handlers and people who transport patients, are required to get this shot or wear a mask.

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