Policy Statement—Recommendation for Mandatory Influenza Immunization of All Health Care Personnel

+ The purpose of this statement is to recommend implementation of a mandatory influenza immunization policy for all health care personnel. Immunization of health care personnel is a critically important step to substantially reduce health care–associated influenza infections. Despite the efforts of many organizations to improve influenza immunization rates with the use of voluntary campaigns, influenza coverage among health care personnel remains unacceptably low. Mandatory influenza immunization for all health care personnel is ethically justified, necessary, and long overdue to ensure patient safety. Pediatrics 2010;126:809–815 INTRODUCTION Health care–associated influenza outbreaks are a common and serious public health problem that contributes significantly to patientmorbidity and mortality and creates a financial burden on health care systems. Annual immunization of health care personnel (HCP) is a matter of patient safety and necessary to significantly reduce health care–associated influenza infections. Immunization rates of 80% or higher are essential for providing the “herd immunity” needed to have a significant impact on transmission of influenza by HCP in medical settings, but overall immunization rates for HCP remain near 40%.1 Mandatory immunization is not a novel concept. Many health care facilities currently require specific vaccines and a tuberculin skin test as conditions for working in specific areas of the institution or for employment. Despite the sustained efforts of many organizations to improve influenza immunization rates with the use of voluntary campaigns, influenza coverage among HCP in the United States remains unacceptably low. Mandatory programs for all HCP should be implemented nationwide. Mandating influenza vaccine for all HCP is ethically justified, necessary, and long overdue. Employees of health care institutions have both ethical and professional obligations to act in the best interests of the health of their patients. Medical and religious exemptions to required influenza immunization can be granted on an individual basis. Individual organizations and practices must decide at a local level the additional objections to vaccination, which may be required by state law (eg, philosophical), that are reasonable and the ones they are willing to accept for an individual to be granted an exception and be allowed to continue to work. Policies should be developed for management of exempted HCP during influenza season, including efforts to ensure patient and staff safety and to identify ill HCP. COMMITTEE ON INFECTIOUS DISEASES