Every winter controversy arises surrounding the flu vaccine and whether healthcare workers should be required to receive one. Winter is here in North Carolina and fall is when conversations get really interesting on “Tobacco Road.” Not only do we take our collegiate sports seriously, we have strong opinions about the many prestigious Medical Centers that call North Carolina home. Whether you are a Blue Devil, a Demon Deacon or you prefer that perfect shade of blue from Chapel Hill, chances are you have an opinion.  It just so happens there are a couple of things to talk about in North Carolina with regards to our respected Medical Centers that do not revolve around college rivalries. (I can hear the collective gasps up and down Interstate 40 now.)

Every winter controversy arises surrounding the flu vaccine and whether healthcare workers should be required to receive one.  In 2003 Center for Disease Control indicated that 64% of our country’s healthcare workers were unvaccinated against influenza.  I can assure you that those figures caused more of a ruckus then the night that UNC defeated Duke at Cameron Indoor with a last second shot. Essentially, the motivation here is clear; healthcare systems suffer staggering losses from flu related problems including employee absenteeism, hospital readmissions from secondary infections, increased overtime costs for covering work shifts for sick workers and shocking increases on insurance premiums. The economic impact was big. How big? The CDC estimated that the cost of a single severe influenza epidemic could cost a healthcare system in excess of $12 billion system wide.

Now, healthcare systems have had time to evaluate their policies and conclude whether voluntary, programmatic interventions are enough or whether they should institute Influenza vaccinations as a condition of employment.  As a whole, the healthcare system’s initial response was rather conservative; they were concerned about the effects mandatory vaccinations might have on employee morale and turnover, not to mention the ethical and legal complications a mandatory vaccine policy might present. All of these potential risks carry a substantial line item on the balance sheet.

It seems that most healthcare systems have agreed on several critical issues; all healthcare systems philosophically agree that all employees should strive to first do no harm. There is a clear ethical and legal argument that if vaccinations can prevent infections, they should be mandatory.  There is irrefutable evidence that people can infect others before they are even aware that they are sick. Healthcare systems strive for, and are measured by, the highest standard of care that they can provide. Most all healthcare systems came to eventually agree that the economic, philosophical and ethical measurements indicated that mandatory vaccinations were necessary.

What happened from there was quite complicated. Those in the Human Resources field are accustomed to making reasonable accommodations for employees on certain issues. In this case, the request from employees to be exempt from vaccinations run the gamut from fear of needles, to a preference not to introducing foreign matter into their bodies to religious reasons. As a whole, these requests were not deemed to represent a reasonable accommodation. Instead, mandatory vaccinations were deemed to be occupational requirements. Many healthcare systems looked at the requirement as nothing more than wearing protective footwear and a hardhat on a construction site.   There have been some exemptions granted on religious or documented medical conditions but, by and large, healthcare systems are holding tight to the mandate.

Surprisingly, the healthcare industry as a whole, has not felt “the sting” by requiring the vaccination. The voluntary and involuntary turnover ratio due to the requirement is reported to be negligible. While we cannot predict this year’s NCAA champions, we can predict mandatory flu vaccines will continue to be  heavily debated and likely healthcare systems will continue to assert they are bona fide occupational requirements.

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