Protest Over Nurse Firing for Refusing Influenza Shot

Alicia Ault

December 03, 2018

An unidentified nurse who was allegedly fired for refusing a flu shot drew the attention of protesters, who rallied in support of what they said was a violation of her conscience protection rights.

Mercy Hospital South in St. Louis, Missouri, allegedly fired the nurse on November 26 for refusing to comply with the hospital's requirement that all employees be vaccinated for influenza, according to a Facebook posting by a colleague, Nelia Aubuchon, who organized the protest.

The news comes as the Centers for Disease Control and Prevention (CDC) recently reported that vaccination rates among healthcare workers have plateaued over the past 4 years at a meager 74% overall. Rates are highest — 95% — in workplaces that require vaccination. Some two thirds of hospitals now require flu vaccination, according to a study published in June.

Mercy would not comment directly on the alleged firing but said in a statement emailed to Medscape Medical News that the hospital company — which has facilities in Arkansas, Kansas, Missouri, and Oklahoma — revised its flu vaccination policy several years ago and that it "requires compliance with the policy by all Mercy co-workers as a condition of employment." Mercy Hospital South spokeswoman Bethany Pope added that the policy aims to save lives, "especially those of our most vulnerable patients."

Protecting those vulnerable patients is the reason for universal healthcare worker vaccination, and that reason trumps conscience objections, said Arthur Caplan, PhD, the Drs William F. and Virginia Connolly Mitty Professor, founding head of the Division of Medical Ethics at New York University School of Medicine, and a contributor to Medscape.

"Private entities can say that they have public health and patient protection obligations that require vaccinations, and override the individual's decisions, for whatever reason," Caplan told Medscape Medical News. "In a healthcare setting with a specific mission to protect vulnerable people, I think the case is very strong that you can fire people who don't follow rules of protection."

Mercy Grants Exemptions

The Mercy system has occasionally granted exemptions from vaccination, said Pope. In 2018, it received 170 requests from its 44,000 workers.

"The majority of those requests have been accepted for meeting valid medical or religious exemption criteria," said Pope. Workers whose exemption requests were not accepted were to be notified the week of November 26 and would have the choice of being vaccinated or losing their job.

Aubuchon, the protest organizer, said that the hospital had not permitted alternatives to vaccination, such as wearing a mask, according to her posting. She also claimed that Mercy Hospital South had denied "all religious and medical exemptions for their employees," and that it also had "denied all doctor and religious leader signed exemption paperwork."

She said the protest was "not about the efficacy of flu shots/mists or a pro- or anti-vaccines conversation" but was about the denial of the exemption requests.

The St. Louis Post-Dispatch reported that the fired nurse had in the past been granted a religious exemption from flu vaccination while working for the hospital. At the time, the hospital was known as St. Anthony's Medical Center. It was acquired by Mercy in 2018.

But Caplan said he can't see any reason for a religious exemption from flu vaccines. Hospitals and other healthcare facilities need to require vaccination of their workers — unless there is a valid medical contraindication — to protect patients and staff.

"We can't exempt you, because we're going to put people at risk," he said.

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