Flu Vaccines: Should They Be Mandatory For Health Care Professionals?

10/25/2010 09:39 am ET | Updated May 25, 2011

The American Academy of Pediatrics issued a statement on September 13, 2010, supporting a policy of mandatory flu vaccination for all health care workers (allowing for medical exemptions, of course). They state that it is "ethically justified, necessary and long overdue to ensure patient safety." I agree that the flu vaccine is important. I agree that it is useful for health care workers to get a flu vaccine in order to lower their chance of catching the flu and passing the illness to patients. A doctor, such as myself, would be contagious for a day or two before even feeling sick. Then when I did get sick, I'd likely keep working if my symptoms were minor. I'd wash my hands and wear a mask, but I'd still be exposing some patients. Of course, with a fever or severe flu symptoms, I'd take a few days off (like last year, when I caught the H1N1flu, I took a Friday off and was back to feeling normal by Sunday). So I'm not arguing that the flu shot isn't important for health care workers. Those who choose to not be vaccinated should take some extra responsibility to take time off work if they do catch the flu.

What I take exception to is the thought that the government or medical boards would make it mandatory. Absolutely, without exception, lose-your-license-if-you-don't-comply, mandatory. That makes me shiver. I could understand such a policy if the flu vaccine was 100 percent harmless to every single person that got one. But it isn't. There are very rare but very severe, even fatal, reactions to the vaccine every year. There are a lot more fatalities from the actual flu then there are severe vaccine reactions, but nevertheless the vaccine does have some element of risk.

Here is just an example of what one vaccine product insert lists as reported (but not verified or proven) reactions to flu vaccine: bleeding from low platelet blood cell counts, severe anaphylactic allergic reactions, Guillain-Barre Syndrome (temporary paralysis), seizures, inflammation of the brain and spinal cord, dysfunction of the nerves in the eyes, face, or arm, inflammation of blood vessels, shortness of breath, Stevens-Johnson syndrome (severe allergic reaction involving the skin and some organs), and chest pain.

I find it interesting that less than half of health care workers get a flu vaccine each year. Why is that? Is it because they've all read the vaccine product insert and don't like that long list of possible, but unlikely, side effects? Or do they just not get around to it for no particular reason? I don't know.

In my opinion, no government has the right to force anything potentially dangerous on anyone. We should all have the freedom to choose between a flu vaccine and risking the disease. Patients who come into a doctor's office or hospital take a small risk every time, but not primarily from the doctor. There's far more risk of catching something from another patient. So, if this policy passes, what's next? Denying hospital admission or even health care to anyone who doesn't get a flu vaccine? After all, that patient would be putting others in the hospital or office at risk, and we can't have that. And why stop at the flu vaccine? Let's make all vaccines 100 percent mandatory for everyone! Hey, why don't we just burn the constitution?

Dr. Bob Sears
Pediatrician and author of "The Vaccine Book: Making the Right Decision for Your Child"