H1N1 vaccinations: Professional obligation or personal choice?

To be honest, the following is a controversy I'd never have expected to see. Apparently, a subset of healthcare professionals have decided that they don't want to get an H1N1 flu shot. And we're not just talking about U.S. professionals, but doctors, nurses and other healthcare providers in Canada, the U.K. and elsewhere. In fact, a recent study published by the British Medical Journal found that less than half of healthcare workers responding to a survey were willing to be vaccinated.

From my vantage point, no one from the provider community has made a strong argument against the shot itself, such as allegations that it hadn't been tested sufficiently or that it might have dangerous side effects. It seems the dispute comes down to the notion that health professionals shouldn't be forced to take this step.

Since then, camps have emerged on both sides of the provider vaccination debate.

For example, in a recent column famed bioethicist Arthur Caplan came down strongly in favor of requiring healthcare workers to get the shot, suggesting that they should quit their jobs if they can't abide getting vaccinated. In fact, he argues that refusing the vaccine was actually lobbying for "the right to infect your patient and kill them." He notes that if vaccination rates come close to 100 percent, institutions could cut patient death rates from flu by 40 percent, with sick days among doctors and nurses falling by a similar amount.

Meanwhile, the California Nurses Association/National Nurses Organizing Committee--an aggressively political group that seems to have some clout--recently came out with a statement arguing against required  swine flu shots. The group's statement said that while every nurse should ideally be vaccinated against H1N1 infections, they shouldn't be forced to get the shot either.

While I think both sides of the argument have some merit, ultimately I come down on Caplan's side. With infection control being such a critical part of a provider's job, and a swine flu pandemic blossoming, now is the time to put aside personal fears and protect patients against germs you might carry.

However, I know not all of you will agree with me, so I'd love your take. How are you handling the H1N1 vaccination among your staff? Are you mandating that they get the vaccine, strongly encouraging them to do so, or relying on other methods, such as high-end masks, to address the problem? Please drop me a note and tell me what you think--I'd love to hear how you're working things out. -Anne