Looking at one hospital's health care worker flu vaccine mandate

Earlier this week we wrote about the opposition in some quarters to the growing number of health care workers being required to receive flu vaccinations. In the past few days, media coverage of this issue has continued to grow, much of it centered on the state-wide policy recently introduced in New York and a recent protest against it.

Far more common, however, are policies created by individual hospitals or health systems. Shortly after our last post on this topic, we learned that our own institution, the University of Pennsylvania, had recently announced an influenza vaccination requirement for all personnel working in one of Penn's hospitals or other patient care facilities. This includes physicians, students, staff, and volunteers, regardless of whether they have direct patient contact. The requirement is for both seasonal flu vaccination annually and (depending on availability) the H1N1 vaccine this fall.

The policy -- available here -- is a useful case study for how one of the nation's most prominent health systems is implementing and enforcing the annual requirement, described as "a condition of employment or access to Penn Medicine facilities." The vaccines will be administered at no cost to employees. Exemptions are available for medical or religious reasons, supported by a letter from an employee's physician or clergy, respectively. Exemptions will be evaluated on a case-by-case basis; those employees for whom exemptions are granted will be required to wear face masks at work for the duration of flu season.

After a warning, those failing to receive the vaccine or an approved exemption "will be subject to further disciplinary action up to termination of employment." More information is available in this Q&A document distributed with the new policy.

Policies will surely differ slightly among health care institutions, but the Penn policy provides a good example of the evidence and arguments cited by disease control specialists in support of health care worker flu vaccination requirements.

Again, it's worth repeating that this and every other flu vaccine mandate in the news lately involves only health care workers, part of an initiative launched long before the current H1N1 situation. Public health officials remain unequivocal that there are no plans to require H1N1 vaccination for the general public, a message at risk of getting lost amid coverage of this related, but distinct policy debate.