Health care employees often care for sick or high-risk populations. Due to the nature of such work, workers are more likely to become ill themselves.
That’s why many nurses take as many precautions as possible to protect both themselves and their patients, especially during this year’s global pandemic. And one of the best ways to do so is by getting an annual flu shot.
Influenza is one threat we can take action against with a vaccine, and many health care workers receive the flu shot annually. In the 2019-2020 flu season, 80.6% of health care personnel got flu shots, including 92% of nurses.
The CDC recommends annual vaccination as the first and strongest line of defense against influenza. But can hospitals and other health care facilities legally require their staff to get a flu shot?
States Requiring Flu Shot for Health Care Workers
Currently, 18 states have flu shot requirements for hospital health care workers: California, Colorado, Georgia, Illinois, Maine, Maryland, Massachusetts, Nebraska, New Hampshire, Nevada, New York, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, and Utah.
Each state has unique laws regarding different settings, requirements, and exemption criteria. For example, eleven of the states listed above allow exemptions from getting vaccinations for those with religious, philosophical, or medical reasons.
Here are some examples of a few states’ flu vaccination laws for hospital health care workers:
- California requires all general acute care hospitals to mandate staff-wide influenza vaccination. Anyone who declines the vaccine must declare so in writing.
- Maine requires all general acute care hospitals to recommend and offer annual flu vaccines to all staff who provide direct patient care. Employees who don’t meet immunization requirements may continue to attend work if they present a physician’s written statement that “immunization against one or more of these diseases is medically inadvisable.”
- Massachusetts requires hospitals to ensure all staff are vaccinated unless an individual declines the vaccine.
- Nebraska requires general acute care hospitals to offer annual on-site flu shots to all employees.
- New Hampshire requires hospitals to provide annual flu vaccines to all consenting employees. Those who want to opt-out can do so due to medical or religious exemptions.
- New York requires hospitals to document vaccination status for each employee in their personnel files.
- Rhode Island requires hospitals to ensure all personnel receive a flu shot unless they decline vaccination. The hospital must then track the number of health care employees who decline for personal or medical reasons. For the duration of the flu season, unimmunized health care workers must wear a surgical mask for all direct patient contact.
- Utah requires hospitals to report the total number of health care workers employed along with the total number of those who have received a flu vaccine for the current season.
For further information and eligibility information, ask your health care organization.
Health Care Organizations
Mandatory influenza vaccination, with exceptions for medical contraindications, is recommended by the Association for Professionals in Infection Control and Epidemiology (APIC) of the CDC. This recommendation has been shown to increase vaccination rates among health care workers, decreasing the risk of employees getting and spreading the flu.
An increasing number of organizations are adopting flu vaccine mandates for employees, contractors, students, and volunteers, and they’ve seen high rates of staff compliance.
What Are Your Rights?
While the general population typically has the choice to opt-in or out of the flu vaccine, your state or facility may require it for all health care employees. This raises the question: What rights do health care workers have when it comes to mandatory vaccination?
Legally, health care workers have limited grounds to object. The precedent for mandatory vaccines for the public good dates back to 1905, when the United States Supreme Court ruled in favor of a vaccination mandate during the smallpox epidemic.
The court stated that despite constitutional freedom, each person may be subject to “manifold restraints” when needed “for the public good.” Applied today, the personal choice to vaccinate may be legally overruled by broader public health and patient safety implications.
Additionally, many states implement employment-at-will clauses, in which an employee can be terminated for any reason (with the exception of motivations such as race or disability status). Health care organizations may prescribe vaccination as a requirement for continued employment.
Most states with vaccination laws offer exemption criteria, including religious, philosophical, and medical objections; individual hospitals and health care facilities may also implement these criteria.
Consult with your organization and find out your state’s laws for more information on an exemption and the required documentation. Generally speaking, individuals with compelling medical contraindications (such as a severe allergic reaction to the vaccine) can legally seek exemption with a written doctor’s note.
Why Get the Flu Shot as a Nurse?
Even if you don’t fall under the exemption criteria for vaccination, you may have concerns about the effectiveness or any negative side effects of the influenza vaccine.
However, there are several compelling reasons for nurses to get their annual flu shot, including the following:
- The flu shot protects you from becoming sick. Influenza can be a serious disease. While most cases are mild, it can lead to hospitalization and even death. Working in a health care facility puts you at higher risk of getting sick than the general population — something that can be especially dangerous amid the coronavirus pandemic.
- The flu shot is safe. Influenza vaccines are made with either killed or weakened viruses, so they cannot cause the flu. Additionally, most people only experience mild side effects, if any. Barring medical contraindications, the flu shot is safe and low-risk for the general population.
- The flu shot allows you to protect others. Even those who are asymptomatic can still be infected with influenza and inadvertently spread it. By getting your flu shot, you’re not only protecting yourself, but you’re also protecting your patients, coworkers, loved ones, and the population at large.