8. Lack of free vaccinations
11 states have either "offer" or "ensure" laws for influenza vaccination of healthcare providers. CA, IL, ME, MD, MA, NE, OK, and TN have "offer" laws, meaning the flu shot must be offered to HCP by healthcare facilities, though staff may decline vaccination. AL, RI, and NH have "ensure" laws for influenza vaccination of HCP, through which vaccination of non-immune HCP is mandatory in the absence of a specified exemption or refusal. 

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