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Too Far or Far Enough? Mandatory Flu Vaccine Policies in Healthcare

News  |  By Steven Porter  
   March 09, 2018

As one healthcare organization faces a DOJ lawsuit for allegedly violating religious rights with its mandatory flu vaccine policy, another explains how it has aimed to keep its toes on the right side of the law.

Now that the worst of the current flu season appears to have passed, it’s time for healthcare organizations to take a step back and assess whether their current vaccination policies are appropriate and effective.

Although the Centers for Disease Control and Prevention (CDC) recommend that all healthcare workers receive an annual flu vaccine, individual hospitals and health systems have some latitude to devise and implement policies based on their own strategies within the bounds established by state laws.

Rajesh Prabhu, MD, an infectious disease specialist and chief patient quality and safety officer for Essentia Health, based in Duluth, Minnesota, says his organization made the decision to switch last fall from a voluntary to a mandatory flu vaccine policy after studying the experiences of other institutions across the nation.

Related: DOJ Sues SNF Over Mandated Flu Shot, Citing Worker's Religious Rights

“In previous years, we had ‘mandatory participation,’ meaning that everyone had to declare a ‘yes’ or ‘no’ were they going to get the influenza vaccine,” Prabhu tells HealthLeaders Media.

Under the old policy, almost all Essentia employees participated as directed, with about 82% answering “yes” and getting the flu vaccine. Under the new policy, Essentia boosted its flu vaccination rate to about 98% for the current season, including staff involved in direct patient care, vendors, and volunteers, Prahbu says.

That success, however, didn’t come without a fight. Three unions filed legal challenges, and Essentia wound up firing as many as 50 of its more than 14,000 employees for their failure to comply.

Regardless, Prabhu says the policy change was necessary, carefully planned, and appropriately implemented.

Where’s the line?

If you’re going to implement a mandatory flu vaccine policy, you must be careful. Pushing too far or failing to include proper safeguards could violate worker rights.

That’s what the U.S. Department of Justice accused Lasata Care Center this week of doing. The county-owned skilled nursing facility in Port Washington, Wisconsin, required a certified nursing assistant to receive a flu vaccine or be fired.


Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.

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