A vaccine is the most effective form of prevention. In the case of influenza, a vaccine can cut your risk of developing the disease by up to 90 percent, depending on a variety of factors, including...

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A vaccine is the most effective form of prevention. In the case of influenza, a vaccine can cut your risk of developing the disease by up to 90 percent, depending on a variety of factors, including the effectiveness of the vaccine that year. The Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. health care professionals get vaccinated annually against influenza.



Mandatory vaccination is a controversial strategy that pits health care professional and personal autonomy against patient/public safety and employee relations. Administrators planning to implement mandatory influenza vaccination policies for health care professionals must understand the implications involved in these policies.



To Prepare for This Discussion:



Review the peer-reviewed, professional journal articles and news article in this week’s Learning Resources, describing a dispute involving a health care facility’s mandatory vaccination or mask for seasonal flu. Select one of these articles for the Discussion, or find one of your own in a peer-reviewed journal or on the Internet. This dispute may involve an individual health care provider or facility.



By Day 3


Posta cohesive response to the following:



Format your post as if you are advising the CEO of the health care provider or facility identified in the journal/news article you read, and discuss the following implications:



Analyze the situation in light of health care service delivery.


Analyze the situation in light of patient and public safety.


Explain the conflict(s) that may arise as a result of this policy.


Explain any ethical issues raised by this policy.


Finally, explain your conclusion/position regarding mandatory seasonal flu vaccination or mask for health care professionals.



This is the article you will be writing on plus additional research



Mandatory influenza vaccination of healthcare workers:



is it necessary or sufficient to protect patients?


Allen C. Cheng1,2,3 FRACP, MPH, PhD Leon J. Worth1 MBBS, FRACP, PhD


1 Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Vic. 3004, Australia.


2 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic. 3004, Australia.


3 Corresponding author. Email: [email protected]


Abstract. In response to recent calls for mandatory influenza vaccination policies, we argue that these policies are


neither necessary nor sufficient to protect patients from healthcare-associated respiratory viral infection.


Additional keywords: mandatory policies, vaccine effectiveness.


Received 15 June 2014, accepted 2 July 2014, published online 24 July 2014


We note Chean and colleagues’ editorial suggesting


mandatory vaccination to protect patients from influenza.1We


strongly support influenza vaccination of staff to protect


themselves and patients from influenza. However, we suggest


that mandatory influenza vaccination is neither necessary nor


sufficient to protect patients from healthcare-associated


respiratory virus infections.


The influenza vaccine is clearly not sufficiently protective


to justify mandatory vaccination. Although it is commonly


quoted that the vaccine provides 70–90% protection, more


recent clinical trials employing the specific outcome of


confirmed influenza (by nucleic acid detection) have


estimated vaccine effectiveness to be ~59%,2 with efficacy as


low as 16% in some non-pandemic seasons.3 Enforcement of


the wearing of masks is impractical, and redeployment,


particularly for specialised clinical staff, may present


considerable logistical problems.


Although other vaccine-preventable diseases (VPDs) may


be less common, mandatory vaccination might be considered


first nationally for infections where vaccines are highly


effective, such as measles. However, Chean et al. cite NSW


data suggesting that a policy of mandatory vaccination or


reporting of immune status for VPDs (not including influenza)


resulted in only 50% of staff being compliant and a small


number of staff being terminated or redeployed.4 This raises


questions about the implementation and enforcement of the


policy for non-compliant staff, 2 years after release. Despite


recommendations, mandatory programs for VPDs have not


been enforced for healthcare workers within Australia,


and implementation remains a challenge. A recent study of


Victorian healthcare workers highlighted the requirement


for dedicated resourcing of vaccination programs to


satisfactorily implement strategies in accordance with


NHMRC guidelines for VPDs other than influenza.5


A principle of public health is that the least restrictive


policies should be used to achieve the desired outcome. We


dispute the assertion by Chean et al. that a goal of 75% of


staff being vaccinated would not be possible without


mandatory vaccination policies. At Alfred Health in June


2014, almost 90% of staff with patient contact had been


approached, with vaccine coverage close to 80% for the


2014 season. This was achieved using a social marketing


campaign supported by the hospital executive together with


reporting to managers listing staff not yet approached for


vaccination. These figures are similar to those reported in


2013 by the Royal Melbourne Hospital (pers. comm.) and the


Peter Macallum Cancer Centre,6 both achieved without


enforcement of mandatory policies.


We believe that the goal is to protect patients from


healthcare-associated infections with respiratory viruses, not


just influenza, as poor outcomes have been reported in patients


with non-influenza respiratory viral infections. To achieve


this, ‘horizontal’ interventions, such as reducing the


proportion of healthcare workers attending work while unwell


with respiratory illnesses (‘presenteeism’), are likely to be


more effective.7 This approach is readily accommodated by


promoting existing policies and would be expected to reduce


transmission of non-influenza respiratory viruses. It would


also be effective in seasons where there may be a significant


mismatch between circulating and vaccine strains, and for


vaccine failures.


Finally, there is little evidence that nosocomial influenza


poses a significant burden of illness to justify mandatory


vaccination. Although case finding may be incomplete, we


Journal compilation Australasian College for Infection Prevention and Control 2014 www.publish.csiro.au/journals/hi





Answered Same DayFeb 27, 2020

Answer To: A vaccine is the most effective form of prevention. In the case of influenza, a vaccine can cut your...

Soumi answered on Feb 27 2020
110 Votes
Running Head: COHESIVE RESPONSE                            1
COHESIVE RESPONSE        5
COHESIVE RESPONSE
Table of Contents
Analysing the Situation in terms of Healthcare Service Delivery    3
Analys
ing the Situation in terms of Patient and Public Safety    3
Possible Conflicts arising due to this Policy    3
Possible Ethical Issues arising due to this Policy    4
Conclusion regarding Mandatory Seasonal Flu Vaccination or Mask for Healthcare Professionals    4
References    5
Analysing the Situation in terms of Healthcare Service Delivery
    The mandatory implementation of influenza vaccines to the healthcare professionals has not been supported thoroughly by Cheng and Worth (2014) because from the perspectives of the systems for healthcare service delivery, it has been found that the causation of influenza within the clinical environment is not solely due to unvaccinated professionals. The other reasons that contributed towards the influenza infections of service users or patients were found to be the shortcomings in the healthcare service delivery system, such as the presence of other viral, non-influenza infections in the care organisations. As supported by Farlow (2016), the healthcare service delivery has to be devoid of external infectious agents that cause viral infections to patient, because if such agents are present in the healthcare setting, occu
ence of respiratory infections is inevitable.
Analysing the Situation in terms of Patient and Public Safety
    In light of public and patient safety, if the situation is viewed, it can be analysed that the implementation of mandatory vaccination to healthcare professionals is unjustified. As mentioned by Cheng and Worth (2014), if the patients are in contact with their acquaintances or family...
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