Ottenberg drafted and revised the article. Wu assisted with the drafting of the article and provided legal analysis. Jacobson provided scientific expertise, clinical input, and article review.
Koenig provided ethical analysis. Tilburt assisted with the drafting of the article, provided ethical analysis, and performed a detailed critique. All authors approved the final article. Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza Mandating flu shots legality rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety.
When public health is jeopardized, and a safe, low-cost, and effective
Mandating flu shots legality to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent.
Mandating flu shots legality recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce. Notwithstanding these legal challenges, overwhelming scientific, ethical, and legal justifications support mandating health care worker vaccination.
The annual morbidity and mortality caused by influenza is a serious public health issue. Each year in the United States, seasonal influenza causes on average more than hospitalizations and 36 deaths. On June 11,the World Health Organization officially recognized the influenza A H1N1 virus pandemic, and on October 24,President declared a national public health emergency.
Health care organizations have enacted a variety of vaccination policies and interventions to guard against the known hazards of nosocomial influenza transmission, including longer patient stays, absenteeism, interruptions in health care delivery, and inpatient death. In the United States, professional infectious disease societies Infectious Diseases Society of America and National Foundation for Infectious Diseasesprofessional infection control associations Society for Healthcare Epidemiology of America and Association for Professionals in Infection Controland professional clinician societies American College of Physicians and American Academy of Pediatrics have all independently called for requiring influenza vaccination of health care workers.
Various approaches to mandatory vaccination of health care workers have been successfully used throughout the United States. Currently, 15 states mandate health care worker vaccination for at least one disease, and of those, eight allow for an exemption. These organizations' experiences with the benefits of mandatory vaccination of health care workers against influenza complement ethical and legal principles that also justify such policies.
We have elaborated elsewhere the ethical arguments underlying mandatory vaccination. The important questions are as follows: As professionals in occupations that are freely chosen, clinicians are granted special privileges and powers by society; as a result, health care workers assume special obligations and responsibilities. Health care professionals have obligations to do no harm, to do good, to respect patient autonomy, and to treat all patients fairly.
Similar justifications have been offered by other bioethics analysts. Public health focuses on interests of the community and the maintenance of an environment that supports and promotes good Mandating flu shots legality. Higher health care worker immunization rates reduce the spread of influenza and help maintain a sustainable and effective health care workforce. Laws and regulations that restrict individual liberties are frequently needed to ensure community health and safety.
Even staunch libertarians acknowledge this need. In our view, laws or regulations mandating influenza vaccination of health care workers are similarly legitimate and necessary exercises of state power. Mandatory influenza vaccination of health care workers fits within the framework of constitutional powers that the government possesses to promote the public's welfare.
Government has both the responsibility and the power to restrict individual activities that threaten liberties of others and the common good.
Under the US Constitution, the power to restrict individual liberties for public health purposes is primarily reserved for individual states through police power.
Laws and regulations that restrict individual liberties are routinely enacted to protect and promote public health and welfare. These laws and regulations pervade our society, including sanitation laws, traffic laws, occupational health and safety laws, and environmental regulation. Historically, the judiciary has affirmed mandatory vaccination as a proper exercise of state police power.
Although the principles articulated in the cases of Jacobson and Wong Wai continue to inform analysis of public health actions, the standards for the constitutionality of state action have evolved significantly since Today, the US Supreme Court evaluates the constitutionality of laws burdening individual liberties by applying a hierarchy of rights and corresponding standards of review.
Public health regulation usually involves liberties that trigger rational basis review, "Mandating flu shots legality" lowest standard. The rational basis standard requires that state action must be justified by a legitimate state interest and that the action be rationally related to the state's interest.
Therefore, to be constitutional, mandatory health care worker immunization laws first must show a legitimate state interest. The state's interest is clear: Second, states must show that mandating influenza vaccination is rationally related to reducing Mandating flu shots legality influenza burden. Courts do not require large-scale, randomized trials to support constitutionality of state action; rather, to meet the rational basis standard, a state must establish only a plausible scientific relation between the proposed action and the state's interest.
Considerable scientific evidence supports the conclusion that vaccination reduces both the transmission and the incidence of influenza.
Article I of the US Constitution gives Congress the power to tax, spend, and regulate interstate commerce. These powers have been interpreted expansively by courts, resulting Mandating flu shots legality far-reaching power to regulate and promote public health and safety.
Thus, the federal government also holds broad influence to encourage or potentially mandate health care worker influenza vaccination. The commerce clause enables the federal government to regulate virtually any activity that affects interstate commerce, including elements of the health care industry that relate to infectious disease management and containment.
For example, the Public Health Service Act 48 gives authority to the federal government to make and enforce rules to prevent the spread of infectious disease from other countries into the United States or from one state to another, including the power to establish vaccine clinics and to isolate and quarantine infectious individuals.
Through these mechanisms, the commerce clause grants significant power to the federal government to regulate, encourage, or potentially mandate the vaccination of health care workers against influenza and ensure fair processes to adjudicate complaints related to vaccination. The federal government also may regulate public health through the power to spend. The federal government may require states to meet federal standards in public health as a prerequisite to receiving federal funds.
The federal government exerts influence on state and local authorities to comply with federally established standards through the use of conditional appropriations. Most states and local authorities comply because they can rarely afford to lose federal Mandating flu shots legality. For example, extensive federal standards are attached to receipt of payments through Medicare and Medicaid. Although the federal "Mandating flu shots legality" may not have clear authority to mandate directly, the federal government has a broad range of powers to indirectly induce state, local, and institutional authorities to mandate vaccination.
The example of the H1N1 public health emergency compels health care organizations and policymakers to rethink current practices, asking whether minimally effective, expensive, voluntary health care worker influenza vaccination programs are adequate to protect patient safety for both seasonal and pandemic influenza.
The available evidence suggests that voluntary vaccination programs enacted in various forms over three decades have failed to achieve acceptable rates of health care worker influenza vaccination. In mandating health care worker vaccination, health care organizations must ensure that vaccination is an informed process—health care workers should be clearly told the benefits and risks associated with influenza vaccination—and that vaccines are offered conveniently and free of charge.
Special consideration may need to be in place for medical, religious, and perhaps philosophical exemptions, although no data are available on how exemptions affect rates of health care worker vaccination. The implementation of mandatory vaccination also must address the unfounded fears and misconceptions about vaccine safety.
The National Vaccine Injury Compensation Program added influenza to its list of covered vaccines in to address rare instances of adverse events that can be reasonably linked to the influenza vaccine. Over time, successful control of seasonal and pandemic influenza with repeated safe vaccine administration to health care workers will allay fears and promote public trust. Mandatory health care worker vaccination programs help health care workers carry out their professional duty to provide care to all patients without the threat of undue harm caused by nosocomial influenza transmission and ensure that the public's trust in health care organizations is well placed.
The public has a right to expect that health care workers and the institutions in which they work will take all necessary and reasonable precautions to keep them safe and minimize harm. This lays the burden on health care organizations and the government to ensure that health care workers fulfill their obligations.
Low voluntary vaccination
Mandating flu shots legality leave only one viable option to protect the public: Koenig, and Jon C. Tilburt have no disclosures. Jacobson serves as the Principal Investigator on a Pfizer-funded study examining PCV 13 in adults, which involves, in part, adult receipt of the influenza vaccine.
National Center for Biotechnology InformationU. Am J Public Health. MA, Joel T. PolandMD, Robert M. JacobsonMD, Barbara A. KoenigPhD, and Jon C. Author information Article notes Copyright and License information Disclaimer. Ottenberg and Joel T. Correspondence should be sent to Abigale L. Reprints can be ordered at http: Accepted May 3, This article has been cited by other articles in PMC.
Abstract Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for
Mandating flu shots legality than three decades, adversely affecting patient safety. TIME FOR CHANGE The example of the H1N1 public health emergency compels health care organizations and policymakers to rethink current practices, asking whether minimally effective, expensive, voluntary health care worker influenza vaccination programs are adequate to protect patient safety for both seasonal and pandemic influenza.
Mandatory flu vaccine for health care workers: Accessed October 19, Health care facility personnel: Chan S, Hartocollis A. Judge halts mandatory flu vaccines for health care workers. Accessed October 20, Mandatory vaccination of health care workers. N Engl J Med. Patterson announces suspension of flu shot mandate for health care employees due to shortage of vaccine [press release].
Accessed October 26, Key facts about seasonal influenza flu Accessed November 13, Requiring influenza vaccination for health care workers: Mortality associated with influenza and respiratory syncytial virus in the United States. World now at the start of influenza pandemic [press release]. Related: DOJ Sues SNF Over Mandated Flu Shot, Citing Worker's Religious Rights Three unions filed legal challenges, and Essentia wound up firing as many. Are mandatory vaccination policies legal?
to receive vaccinations – such as the seasonal flu vaccine – brings up a number of employment law issues. So are "Mandating flu shots legality."
So, is it legal for a business owner to adopt a mandatory flu shot policy? Under most circumstances, it is legal for a business to enforce a flu.