In a report published today 18 October 2018, the Royal College of Physicians of Ireland says that the flu vaccine should be mandatory for healthcare professionals who work in high-risk areas, such as intensive care, cancer wards and emergency departments.
Professor Mary Horgan, President of the Royal College of Physicians of Ireland said doctors and all those working in direct contact with patients in hospitals and communities have a responsibility to protect where possible against infection:
“As doctors and healthcare professionals, we have a duty of care to protect our patients and in order to do that, we must protect ourselves. I fully support mandatory vaccination against flu infection in key healthcare personnel, in tandem with those already in place, to provide immunity to both healthcare workers and their patients.”
“Mandatory influenza vaccination is the only measure proven to achieve vaccination uptake rates of 95%. The vaccine has an 88% efficacy rate and is strongly recommended by the World Health Organization. Mandatory vaccination is widely used in North America and uptake rates of over 90% have been achieved. I strongly encourage all healthcare workers to get the flu vaccine to protect themselves, their families and their patients.”
The report, Influenza Vaccination of Healthcare Workers, led by the Faculty of Occupational Medicine, along with the Faculties of Pathology and Public Health Medicine at the Royal College of Physicians of Ireland, states that the needs of the patient population as a whole must take priority over the personal choice of the individual healthcare worker, in order to protect overall population health.
The Dean of the Faculty of Occupational Medicine, Dr Blánaid Hayes says that despite initiatives introduced in recent years to try to encourage voluntary vaccination, rates in healthcare workers remain far too low:
“Several initiatives, such as ensuring convenient access, after-hours vaccination clinics, education campaigns and peer-to-peer vaccination have been somewhat successful in increasing uptake rates in recent years (up to 40% in 2017/2018) but they remain too low to provide adequate protective immunity around vulnerable hospital patients, particularly those who are most at risk of severe influenza, due to illness or by virtue of age i.e. infants and older patients.”
“We are proposing that all healthcare workers working in high-risk areas, i.e. intensive care, cancer wards, emergency departments and other areas attended by immunocompromised patients be immunised well in advance of the winter season, when influenza infection is rampant.”
“Healthcare professionals working in hospitals and in the community with infants, elderly patients and pregnant women must also receive the vaccination or sign a declination form.”
Certain categories of healthcare professionals, i.e. surgeons already have to submit to hepatitis B vaccination or provide evidence of immunity to this blood borne virus, and the infectious risk posed to patients by this virus is much lower than that from someone infected with influenza.
“It is recommended that those few healthcare workers who need to decline the vaccination on medical grounds, wear a mask for the duration of the flu season and/or are moved to a lower-risk or non-clinical area for the duration of the season,” Dr Hayes said.
While the flu vaccine alone will not completely eliminate the spread of the virus, timely annual vaccination of healthcare professionals who work in hospitals and other clinical environments is one element of the multi-faceted approach recommended to healthcare institutions to minimise spread of the virus.
Other recommendations include segregation of patients who contract the flu infection, compliance by healthcare staff with good infection prevention and control practice as well as education of staff regarding the need to stay off duty when suffering from flu like illness.
Mandatory vaccination against influenza infection should be implemented alongside those measures already shown to be successful in increasing uptake rates i.e. annual information and education campaigns, incentives, convenient access to vaccination.