Ethicist Wants Mandatory Flu Shots for Health Workers

January 26, 2015 Updated: January 26, 2015

We should be more afraid of flu than we are of Ebola, according to Arthur L. Caplan, Ph.D. “We are so used to flu deaths we don’t take it seriously,” he said.

Caplan is an expert on medical ethics. He thinks health care workers should have to get an annual flu shot. The Flu kills children and elderly people more than others, and to contract the flu in a hospital, where a person goes because he or she is already ill, is especially dangerous.

Caplan is the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics and Director of the Division of Medical Ethics at NYU Langone Medical Center. With a fierce expression, he said of people who won’t get a flu shot, “If you choose not to do that I can sue you if you kill my kid.”

The flu vaccine is far from perfect, but it is our only real defense against this illness.
— Amesh A. Adalja, MD, University of Pittsburgh Medical Center

As of Jan. 17, 56 children had died of flu this season in the U.S., according to the Centers for Disease Control and Prevention (CDC). This year’s most dominant strain of flu, H5NI, is more deadly than most. It is also not a good match for this year’s vaccine. Those who developed the vaccine did not predict well, and the vaccine is only 25 percent effective. That is still effective enough to save a life. According to the CDC, it can reduce the severity of the illness even if it is not a perfect match for the primary circulating strain.

Infectious disease physician, Amesh A. Adalja, MD, FACP Senior Associate, Center for Health Security at the University of Pittsburgh Medical Center, who does a lot of work on influenza preparedness, recommends that people get vaccinated, even with this 2015 imperfect vaccine. Adalja said via email he supports Caplan’s proposal of mandatory vaccinations for health workers.

“The flu vaccine is far from perfect but it is our only real defense against this illness. Flu vaccination as a condition of employment for healthcare workers is a good means to increase rates of vaccine uptake. Not only do such actions protect healthcare workers from acquiring flu and/or having a severe course, they also protect patients from being infected by their healthcare providers,” he wrote.

One of the hazardous things about flu is that people are infectious before they feel sick. That means they can be out and about shedding virus and infecting others. If an infected person is a healthcare worker, he could be on the job, caring for people, and infecting them at the same time.