There has been an increasing push for mandatory vaccination of health care workers in Canada. In this country, vaccination against the flu for health care workers is mostly voluntary, with a maximum uptake rate of around 60%; in some US hospitals, influenza vaccination is mandatory, and vaccination rates can be 95% or higher.
However, the effectiveness of the influenza vaccine is now being challenged, write Drs. Michael Gardam and Camille Lemieux from the Infection Prevention and Control Unit, University Health Network and the University of Toronto, Toronto, Ontario. A number of recent evidence reviews and vaccine effectiveness studies have found that the influenza vaccine is only moderately effective - about 60% - in healthy adults; this number can be much lower during some flu seasons.
“Although expert opinion is a necessary element in making important policy decisions such as mandatory vaccination, these decisions should be driven primarily by the best available evidence,” write Gardam and Lemieux. “The aforementioned studies have highlighted major shortcomings with the current influenza vaccine that decision-makers should not ignore.”
Although the authors embrace yearly influenza vaccination and urge other health care workers to be vaccinated, they caution against imposing mandatory vaccination given the shortcomings of the current vaccine.
“If a better vaccine and more robust literature about influenza-specific patient outcomes were available, the debate would be moot in favour of mandatory vaccination of health care workers. Unfortunately, important questions remain unanswered, and the endless debate about the utility of the current vaccine needs to stop. We need a better vaccine,” the authors conclude.
“Mandatory influenza vaccination?First we need a better vaccine”,
MichaelGardam et al.
CMAJ 2013. DOI:10.1503/cmaj.122074