Vaccines Should Be Mandatory for All HCPs, Group Says

Marcia Frellick

September 17, 2020

All healthcare personnel (HCP) should be required as a condition of employment to be immunized against vaccine-preventable diseases, the Society for Healthcare Epidemiology of America (SHEA) said in a statement today.

"Requiring appropriate immunizations as a condition of employment has been demonstrated to be the most effective strategy for maximizing immunization compliance among HCP," write statement authors David J. Weber, MD, Department of Infectious Diseases at the University of North Carolina, Chapel Hill, and Thomas R. Talbot, MD, Vanderbilt School of Medicine in Nashville, Tennessee, and colleagues.

SHEA says the requirement should apply to everyone working in all healthcare settings, including employees, volunteers, students, and contractors.

The statement emphasized that, "in particular, all healthcare personnel should be immune to vaccine-preventable diseases."

The new SHEA recommendations follow those of the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) for all child and adult immunizations. Those include vaccines against measles, mumps, rubella, influenza, and varicella. Healthcare personnel who may have exposure to blood or other potentially infectious body fluids should have hepatitis B vaccinations as well.

Medical contraindications, the recommendations say, should be the only exception to being immunized.

Healthcare settings, the statement explains, include "long-term acute-care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (eg, mobile clinics), and all types of outpatient facilities, such as dialysis centers, physician offices, and others."

In addition to addressing the immunization status of HCPs themselves, the authors note that clinicians should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients.

Healthcare providers should also be aware of the common misconceptions given for not wanting to get the vaccines — such as vaccines will cause disease or that they aren't effective or safe — and should be ready with answers. To help with those answers, the statement links to a video from the American Academy of Pediatrics.

SHEA, the CDC, ACIP, and other groups are united in their rationale: Immunization is essential to improve public health and cut healthcare-associated spread of infections, and the benefits outweigh the risks.

The SHEA statement points out that vaccines have wiped out many diseases once common in the United States, such as smallpox and polio, and reduced hospitalizations and deaths caused by many other infectious agents, such as invasive Haemophilus influenzae type B, influenza, varicella, pertussis, hepatitis A, and hepatitis B.

The statement adds that the World Health Organization (WHO) estimates that "immunization currently prevents 2-3 million deaths every year and that an additional 1.5 million deaths could be avoided if global vaccine coverage improves."

No mention was made in today's release about the importance of an influenza vaccine amid the COVID-19 pandemic, but the CDC highlighted that recommendation in recent months. Nor did the new statement address vaccines against SARS-CoV-2, which are anticipated to be available in the next year.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News and and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick

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