More Philadelphia-area health systems requiring employees to get flu shots

Try as they might, the hospitals in the Main Line Health system could persuade only about 60 percent of their staff to get flu shots each year even though it seemed obvious that the shots would reduce the odds that workers would get sick or spread the virus to vulnerable patients.

So this year Main Line Health Inc. is taking a much tougher stance, one that is becoming more common in the region and nation: It's requiring employees - and doctors - to get the shot or get fired.

"It's the right thing to do now," said Connie Cutler, director of infection prevention and control for Main Line Health. The system has ordered 16,000 doses of vaccine and will begin giving the shots to employees, physicians, volunteers, students, and contractors next month. There is an exemption if employees can prove their religion precludes vaccination or they have a medical reason to avoid the shots.

"I believe this is going to become something in the future that all hospitals are going to consider doing," Cutler added.

The trend raises ethical and legal questions about balancing employee autonomy and the needs of patients, whose weakened bodies make them less able to fight off a virus that kills thousands each year or to benefit from the vaccine.

Proponents of mandatory vaccination argue that health workers, who must get other vaccines such as measles before they can work, have a responsibility to protect patients. Some nursing organizations have fought the rules, saying that they should be part of negotiated contracts and that employees should be able to decide for themselves whether they need the vaccines.

Part of the rationale for giving the shots to virtually everyone - the Centers for Disease Control and Prevention recommends the vaccine for everyone older than six months - is the concept of herd immunity. The shot is not 100 percent effective in any group, but it works best in people with strong immune systems - the young and healthy. These are the people the virus is usually least likely to kill, but the object is to keep them from giving it to others. Plus, flu is contagious a day before people have symptoms, so they cannot just stay home to contain the virus.

Virginia Mason Medical Center in Seattle pioneered mandatory vaccination in 2005. It so far has fired only two employees, although seven more left voluntarily. About 50 hospitals or health systems now require employees to get flu shots, according to the Immunization Action Coalition.