Eastern Maine Medical Center in Bangor has announced it is giving just about everyone who works at the hospital a choice this flu season:
Get a flu vaccine or wear a mask.
“When flu season begins, those who decline the vaccine will need to wear a mask at all times while at work,” James Raczek, the hospital’s chief medical officer, said in a news release.
Well, “except when eating and drinking,” the release stipulates. That would be messy.
EMMC isn’t alone. Hospitals in Maine and across the country are instituting similar policies, aiming to prevent the spread of the illness, particularly to vulnerable patients. You might think of the flu as a seasonal annoyance, but it kills tens of thousands of people in the U.S. every year and hospitalizes many more.
How would you feel if your employer imposed that choice on you? Critics of the policies say they amount to little choice at all and infringe on employees’ personal freedom.
That leaves hospitals grappling with the question of which takes precedence, patient safety or employee rights?
Nurses unions, including a powerful national one that represents EMMC’s nurses, have vigorously opposed policies that require vaccination as a condition of employment.
Beyond personal freedom, the objections to mandatory vaccination have included religious beliefs, skepticism about the flu shot’s effectiveness and worries about adverse reactions. There also is a concern that hospitals rely too heavily on the vaccine to stem transmission, focusing too little on other methods such as stringent hygiene practices.
Outside of Maine, some hospital employees have lost their jobs for refusing a flu vaccine. In early 2012, a hospital in Indiana fired eight workers who declined to be vaccinated. At least 15 more hospital workers in four states were let go for the same reason the following winter.
EMMC acknowledged its workers’ right to refuse a vaccination in the news release.
“While we hope that all employees who are able to receive the vaccine choose to do so, we respect any individual’s right to decline,” Raczek said in the release.
But those who do must wear a mask. A hospital representative confirmed that “employees who are not in compliance with hospital policies, including this one, may face progressive discipline, which could eventually include termination.”
While these policies haven’t led to a proliferation of lawsuits, some employees have sued. In 2011, a customer service representative at Cincinnati Children’s Hospital filed suit after she was fired for refusing the vaccine because she was a vegan. (The flu vaccine often contains small amounts of egg protein). The Massachusetts Nurses Association sued Brigham and Women’s Hospital in Boston to block a flu shot mandate in 2014.
The issue took a different turn in California last year, though, when one of the country’s largest hospital unions agreed to a flu-shot-or-mask policy as part of a new contract.
Historically, flu vaccination rates aren’t stellar among health care workers. During the last flu season, about 64 percent of health care workers got a flu shot, according to the U.S. Centers for Disease Control. That’s significantly higher than the national average of 47 percent across the general population. But the CDC is aiming for 90 percent among health care workers.
At EMMC, the vaccination rate has been about 80 percent, according to the hospital.
“We know that health care workers are some of the most caring people, and would not want to put patients at risk. This change in policy ensures that everyone at EMMC is doing the right thing to keep our patients safe,” Raczek said in the release.
The vaccine is the best defense against the flu, according to federal health officials. It reduces the risk of getting sick by 50 to 60 percent during seasons when it’s well matched to the strains of the virus that are circulating. (During some seasons, it doesn’t work quite so well.)
EMMC officials expect the new policy will boost the organization’s vaccination rate. That’s happened elsewhere: Flu vaccination is higher among health care workers whose employers require it (85.8 percent) or recommend it (68.4 percent), according to the CDC.
The hospital’s policy applies quite broadly to office staff and clinical personnel alike. It affects “all employees, physicians, volunteers, students, trainees and contracted staff working in an Eastern Maine Medical Center facility.” That also includes the EMMC Healthcare Mall, EMMCCancer Care, and primary and specialty care practices.
The hospital will offer several clinics to provide health care personnel with the flu shot at no cost and masks will be available throughout the hospital for those who do not get vaccinated, EMMC said.