Midwest Health System Fires Staffers for Not Getting Flu Shot: Public Health Watch

We’ve heard of disgruntled employees using doctor’s appointments as an excuse to get out of work or, worse, to schedule job interviews.

Now, it seems, certain employers in the health care field are using staff-members’ decision to not visit the doctor as a justification for termination. At least that’s the gist of a story that went viral over the Thanksgiving weekend in the United States, reported by AOL/NBC and other outlets, in which a hospital group fired 50 employees for refusing to get a flu shot.

“Patients are in the hospital because they are sick,” Rajesh Prabhu, MD, an infectious disease specialist and Chief Patient Quality and Safety Officer at Essentia Health, the hospital chain in question, told NBC News. “That puts them at risk of a more severe outcome from influenza. People can die from influenza. We had a cutoff of November 20. If [employees] did not participate in the [vaccination] process, they would no longer be allowed to work at Essentia Health.”

According to its Wikipedia page, Essentia manages 17 hospitals, 66 clinics, 8 long-term care facilities, 2 assisted-living facilities, 4 independent-living facilities, and 1 research institute in Minnesota, Iowa, North Dakota, and Wisconsin. It has 12,000 total employees, including more than 1,500 “certified” staffers (doctors, nurses, and other clinicians). Until last year, its influenza vaccination program was voluntary, and some 70% of staffers participated, company officials said.

Given the dangers associated with influenza—the most recent US Centers for Disease Control and Prevention (CDC) estimates suggest as many as 50,000 Americans died from the viral infection and related complications in 2015-201616, and up to 700,000 were hospitalized because of the infection—Essentia officials were dissatisfied with employee vaccination uptake levels. They made vaccination against influenza mandatory this year; although they did allow some employees to apply for a medical and/or religious/philosophical waiver.

Company officials told NBC News that the 50 terminated employees failed to get vaccinated or successfully complete the waiver application process. Vaccine uptake at Essential hospitals is now above 99%, they added.

“You cannot get to a high immunization rate without some kind of mandatory flu vaccination program,” Dr. Prabhu told NBC.

Current CDC guidance recommends that all health care workers receive the annual influenza vaccine. This recommendation covers “physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual staff not employed by the health-care facility, and persons (eg, clerical, dietary, housekeeping, laundry, security, maintenance, administrative, billing, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from health care workers and patients.”

However, at least on Twitter, public response to Essentia’s decision to terminate non-compliant employees was mixed, with vaccine skeptics weighing in heavily as well as those concerned with workers’ rights-related issues.

Still, the Infectious Disease Society of America’s (IDSA) position on the matter is clear. According to an advocacy statement on the society web page, “Health care personnel are at risk for exposure to vaccine-preventable diseases and possible transmission to patients, their families, other personnel, and local communities. IDSA supports mandatory immunization of [healthcare workers based on the] recommendations of the Advisory Committee for Immunization Practices of the CDC.”

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.