Flu Vaccine Mandates for Hospital Staff Are Based on Flawed Evidence, Authors Claim

Study questions indirect patient benefit

Many hospital workers are required to get vaccinated against influenza or face consequences at work. Some hospitals make vaccinations a condition of employment; others require unvaccinated staff to wear surgical masks near patients for weeks during flu season. But a new study has suggested that the scientific evidence does not support those requirements, according to a report from STAT News.

The study, published in PLOS One, concludes that the research used to justify mandatory flu shots for health care workers is flawed, and that the vaccination policies cannot produce the benefits that had been assumed.

According to the study’s authors, four randomized controlled trials (RCTs) conducted in long-term care facilities (LTCFs) reported reductions in patient risk through increased flu vaccination of health care workers. (None of the studies was conducted in a hospital.) This evidence, in turn, led to expansive policies of enforcement that included all staff of acute-care hospitals and other health care settings beyond LTCFs. Researchers in Canada, Australia, and France conducted a study to evaluate the RCT evidence for indirect patient benefit that would support policies of mandatory influenza vaccination for health care workers.

One of the studies, conducted in Britain, calculated that one influenza death would be averted for every eight staff members vaccinated. The authors of the new study calculated that if that finding were extrapolated to the approximately 1.7 million LTCF and hospital staff in the United States, more than 200,000 flu-related deaths would be prevented each year. That number, however, far exceeds the total U.S. mortality estimates related to seasonal influenza each year. Recalibrating the findings based on actual patient data, the authors found that at least 6,000 to 32,000 hospital workers would need to be vaccinated before a single patient death could potentially be averted.

Lead author Dr. Gaston De Serres of the Quebec Public Health Institute said policies on vaccinating health care workers have evolved over the years, from a gut feeling that it would likely do some good to the idea that it should be demanded of health-care workers.

“Do we have scientific data supporting that? I think the bottom line of our paper is to say there is no valid scientific evidence, even now, underpinning enforced health care worker immunizations,” he said.

Sources: Stat News; January 27, 2017; and PLOS One; January 27, 2017.