Patient Safety Clarion Call: Honoring Mandatory Influenza Vaccination for Healthcare Workers

In recognition of the hospitals, professional organizations, and government entities who have sounded a clarion call for patient safety by strengthening mandatory influenza vaccination policies for healthcare workers, the Immunization Action Coalition (IAC) announces its online “Honor Roll for Patient Safety.” The Honor Roll serves as a repository of model mandates that could be adopted by other organizations seeking to enhance patient safety.

“We hope that the Honor Roll will grow to include thousands of organizations who become part of the movement to protect patients through truly mandatory influenza vaccination policies,” said Deborah L. Wexler, MD, IAC’s Executive Director.

Vaccination is one of the most effective ways to prevent influenza transmission in healthcare settings, but U.S. healthcare worker influenza vaccination rates have only reached 50 percent. Key elements of the stronger policies that have recently been initiated in some healthcare settings are the inclusion of barrier measures to prevent influenza transmission and the discontinuation of policies that allow workers to exempt themselves from influenza vaccination because of their personal beliefs.

To be included in the Honor Roll for Patient Safety, an organization’s mandate must require influenza vaccination for employees and must include serious measures to prevent transmission of influenza to patients from workers who cannot or will not get vaccinated. Such measures might include a mask requirement, reassignment to non-patient-care duties, or dismissal of the employee.

According to bioethicist Arthur Caplan, PhD, Director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, “If you can get close to 100 percent vaccination rates [among healthcare workers] you can cut patient death rates from flu by 40 percent.”

Dr. Caplan has resolutely promoted universal healthcare worker vaccination as a patient safety issue. IAC applauds his ethical leadership as well as the work of Gregory A. Poland, MD, MACP, FIDSA, Department of Medicine, Infectious Diseases, Mayo Clinic and Foundation in Rochester, Minnesota. Dr. Poland’s research has significantly heightened the healthcare community’s awareness of the importance of healthcare workers being vaccinated against influenza.

The Infectious Diseases Society of America (IDSA) has issued an authoritative policy statement on influenza vaccination for healthcare workers (Pandemic and Seasonal Influenza Principles for U.S. Action). On September 30, 2009, IDSA updated its policy to include 2009 H1N1 influenza vaccine; to disallow declination for personal reasons; and to specify the steps that should be taken to protect patients from being infected by unimmunized healthcare workers.

In a recent editorial (“Health workers must get flu shot or quit,” published online at, October 8, 2009), Dr. Caplan says patient safety trumps personal beliefs: “Enough already with the whining, moaning, demonstrating and protesting by health care workers. Doctors, nurses, respiratory therapists, nurses’ aides, and anyone else who has regular contact with patients ought to be required to get a flu shot or find another line of work.”

IAC recognizes the following healthcare institutions on the Honor Roll for Patient Safety: Barnes Jewish Corporation (BJC) HealthCare, Missouri; Children’s Hospital of Philadelphia; Creighton University; Hospital of the University of Pennsylvania; Loyola University Health System, Illinois; MedStar Health, Maryland and Washington, DC; TriHealth, Good Samaritan and Bethesda North Hospitals, Cincinnati, Ohio; University of Iowa Hospitals; and Virginia Mason Medical Center, Seattle.

In addition, IAC names IDSA to the Honor Roll, as well as the State of New York for creating an influenza vaccine mandate that applies to hundreds of healthcare institutions in the state, and the U.S. Department of Defense for its policy requiring all personnel in military healthcare facilities to be vaccinated against influenza.

Clinics, hospitals, professional organizations, and states that have implemented mandatory influenza vaccination policies for healthcare workers may nominate themselves for inclusion on the Honor Roll for Patient Safety by submitting this online application form.

The Immunization Action Coalition (IAC) creates and distributes educational materials for healthcare professionals and the public that enhance the delivery of safe and effective immunization services. IAC also facilitates communication about the safety, efficacy, and use of vaccines within the broad immunization community of patients, parents, healthcare organizations, and government health agencies. Since 1995, the Centers for Disease Control and Prevention has been a major financial supporter of IAC for the purpose of educating healthcare professionals about U.S. vaccine recommendations. IAC’s website ( is designated by the World Health Organization as one of 30 international vaccine safety websites meeting credibility and content good information practices criteria.

View or print a fully formatted PDF version.

This page was updated on .