Nudges or mandates? The ethics of mandatory flu vaccination

Dubov, Alex; Phung, Connie

doi:10.1016/j.vaccine.2015.03.048

Cited by 77 publications

(76 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although mandatory vaccination against highly contractible diseases like influenza could provide an effective solution, it also constitutes a complicated legal issue as it will compromise individual rights. 16 In conclusion, this study noted a remarkable lack of information on vaccination among HCWs. Therefore, proper training and professional advice are important to increase knowledge and acceptance of vaccination among HCWs.…”

Section: Discussionmentioning

confidence: 73%

Knowledge, risk perception and attitudes toward vaccination among Austrian health care workers: A cross-sectional study

Harrison

Brand

Forstner

et al. 2016

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

The aim of this study was to evaluate the vaccination coverage of Austrian health care workers (HCWs), their knowledge concerning the current guideline on vaccination for HCWs and their attitudes toward vaccination. A cross-sectional survey was performed by distributing 200 questionnaires among the nursing staff of several medical wards and intensive care units of the Vienna General Hospital. 116 questionnaires were returned for analysis with 77.4% female and 22.6% male participants. While certain vaccines like hepatitis B, tetanus and polio had high vaccination rates of up to 94% and good knowledge concerning the vaccination status, other vaccines like measles (59.8%), mumps (60.7%), rubella (70.5%), influenza (42.1%) or pertussis (58.2%) showed much lower coverage. The main sources of information were nursing school (59.1%), secondary school (46.1%), parents (45.2%) and media in general (45.2%). Only 21.9% of HCWs claimed to know the current guideline on vaccination. Those who knew the guideline were significantly more likely to consider certain vaccines like measles, mumps, rubella, diphtheria, polio and varicella as recommended (p 0.04). The most important reasons for receiving vaccination were selfprotection (87.5%), prevention of epidemics (54.5%), protection of others (55.4%) and of patients (42.9%). Fear of side effects (67.2%), negative experiences with vaccines (22.4%), the additional doctor's appointment (20.7%) and considering vaccines as an invention by the pharmaceutical industry (19%) were hindering factors for vaccination of HCWs. Considering the essential role of HCWs in preventing diseases, this study noted a remarkable lack of information on vaccination in this profession.

show abstract

Section: Discussionmentioning

confidence: 73%

Knowledge, risk perception and attitudes toward vaccination among Austrian health care workers: A cross-sectional study

Harrison

Brand

Forstner

et al. 2016

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

show abstract

“…Furthermore, unvaccinated HCP feed public distrust and fear of vaccines. 11 Health care-associated influenza creates a financial burden on health care systems and contributes to patient morbidity and mortality. Voluntary programs have failed to increase immunization rates to acceptable levels.…”

Section: Discussionmentioning

confidence: 99%

“…58 Although some argue that mandatory influenza vaccination violates an individual's right to make decisions about his or her own health and well-being, employees of health care institutions are obligated to honor the requirement of causing no harm and to act in the best interests of the health of their patients. 11 Although some have suggested that medical and religious exemptions be granted on an individual basis, 41,59 the US Constitution requires the granting of medical exemptions but not religious exemptions, so mandating influenza immunization for HCP can be ethically justified. Three criteria that a public health intervention must meet to justify mandatory status have been proposed.…”

Section: A Mandatory Recommendation As a Public Health Intervention Imentioning

confidence: 99%

“…10 Employees of health care institutions are obligated to honor the requirement of causing no harm and to act in the best interests of the health of their patients. 11 Medical exemptions to required influenza immunization (eg, life-threatening allergic reaction after receiving an influenza vaccine or severe allergy to a vaccine component) should be kept at a minimum to ensure high coverage rates and granted only on an individual basis. Rigorous standards, such as requiring counseling, detailing the benefits of influenza vaccination, and insisting on a signed affidavit stating an acceptable reason for opting out, will place a higher burden on nonadherent HCP and would make it more difficult for HCP to impose unnecessary risks on their patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Influenza Immunization for All Health Care Personnel: Keep It Mandatory

Byington

Maldonado²,

Barnett³

et al. 2015

Pediatrics

View full text Add to dashboard Cite

The purpose of this statement is to reaffirm the American Academy of Pediatrics’ support for a mandatory influenza immunization policy for all health care personnel. With an increasing number of organizations requiring influenza vaccination, coverage among health care personnel has risen to 75% in the 2013 to 2014 influenza season but still remains below the Healthy People 2020 objective of 90%. Mandatory influenza immunization for all health care personnel is ethical, just, and necessary to improve patient safety. It is a crucial step in efforts to reduce health care–associated influenza infections.

show abstract

“…HCW should be reminded that their choice to work in a healthcare setting comes with a set of ethical obligations. These obligations are: to place patients' interests above their own; "to do no harm" to protect the vulnerable, and to be an example for the public in terms of disease prevention (Dubov, 2015). Given the benefits to individual HCW and the subsequent impact on patients and costs-not to mention our professional obligation to do no harm-influenza vaccination should be mandatory for HCW (Wynia, 2007).…”

Section: Discussionmentioning

confidence: 99%

Ethical Approaches to Mandating Influenza Vaccinations for Local Health Department Workforce in Georgia

Miller

Akubu-Odero

Hunt

et al. 2019

JGPHA

View full text Add to dashboard Cite

Background: The seasonal influenza illness occurs every year in the United States during the cooler months from October to April, sometimes lasting longer. Although certain populations are more susceptible to this condition, data have shown that otherwise healthy individuals have experienced alarming rates of morbidity and mortality associated with these infections. Despite the CDC's recommendation for influenza vaccination for all HCWs, compliance have been lagging among local health departments' workforce. This practice arguably exposes a wide cross section of the U.S. population to the flu, while being served in these facilities. The utilitarian approach provides a framework to examine the ethical implications to the public of mandating influenza vaccination for these employees. Methods:A systematic review of peer-reviewed literature was conducted to address the following research questions: 1) Do local public health departments in Georgia mandate annual influenza vaccinations? 2) What are the ethical considerations for mandating influenza vaccinations for public health employees? and 3) What are the ethical considerations for mandating influenza vaccinations for the community? Twenty-five articles were included in the review.Results: Descriptive analysis shows that there is no mandatory vaccination policy in place for state or local departments in health in the state of Georgia. Most of the literature available relates to policy implementation within acute or long-term care facilities. A systematic review of mandatory influenza vaccination for public health workers focused on four areas: theoretical approaches to increase influenza vaccination coverage and support of, opposition to, and alternative strategies for influenza vaccinations. Conclusions:The utilitarian approach is sufficient for the influenza vaccination policy-making strategies and in the ethical approaches of mandating influenza vaccinations for local health department workforce in Georgia if need be, for vaccination targets are to be achieved.

show abstract

Nudges or mandates? The ethics of mandatory flu vaccination

Cited by 77 publications

References 28 publications

Knowledge, risk perception and attitudes toward vaccination among Austrian health care workers: A cross-sectional study

Knowledge, risk perception and attitudes toward vaccination among Austrian health care workers: A cross-sectional study

Influenza Immunization for All Health Care Personnel: Keep It Mandatory

Ethical Approaches to Mandating Influenza Vaccinations for Local Health Department Workforce in Georgia

Contact Info

Product

Resources

About