HCAD 600
Hospital Policy on Influenza Vaccinations
University of Maryland Global Campus
HCAD 600
Hospital Policy on Influenza Vaccinations
There are several considerations when adopting new policies that affect both the work
force and patients. According to the American College of Healthcare Executives (ACHE),
healthcare executives must “prioritize patient care above other considerations'' (2021).
Achieving this standard, as it pertains to mandatory flu vaccination in the workforce, has
significant legal, ethical, and vaccine efficacy considerations.
As healthcare professionals, we have an obligation to the well-being and overall health of
the patients who are in our care. Although we all have the personal choice to receive (or not
receive) an annual flu vaccination, it is our obligation to the health of not only our patients, but
to the health of the communities we serve. Some healthcare professionals have voiced their
concerns that a mandatory flu vaccine policy could eliminate an individual’s right to being
immunized (Quanch, et al., 2013). Although this is a serious concern which may be
considered when drafting mandatory flu immunization policy, the burden of nonmaleficence
and beneficence falls on both the individual health care professionals, and the organizations
who employ them.
Vaccine Efficacy Considerations
One of the main arguments against receiving the vaccine is concerns about vaccine efficacy. The
effectiveness of the vaccine changes from year to year depending on how well it is matched to
the current strain of virus (Steckel, 2007). Because of the variations between the years, some
healthcare workers doubt the effectiveness of the vaccines, and refuse voluntary immunization
, efforts. Unfortunately, in order to achieve herd immunity, a large portion of a given
community must be vaccinated so that the virus “cannot gain traction and spread in the group”
(Steckel, 2007).
Another common concern amongst healthcare workers is side effects to the vaccine itself. Most
recently, minimal side effects are noted and generally only include soreness at the injection site
for one or two days (Steckel, 2007). Other side effects have been documented, but serious side
effects have been documented in less than 1% of those vaccinated and thusly should not be a
consideration to refuse immunizations.
Legal Considerations
From a legal standpoint, compulsory vaccination was ruled constitutional in the 1905
Supreme Court decision Jacobson vs. Massachusetts. As a result of this case, four standards of
compulsory vaccinations were introduced. These standards are necessity, reasonable means,
proportionality, and harm avoidance (Gostin, 2005). According to these four standards, there
needs to be a necessity for the vaccine in order to ensure the safety of the public. The vaccine
should also be reasonably engineered to prevent an outbreak. Proportionality states that the
vaccination should be proportional to the expected benefits. The vaccine itself should not harm
the person receiving the vaccine. “...[laws] allow governments to infringe on personal liberty to
prevent significant risk to the public in the face of public health threats” (Steckel, 2007). When
crafting policy for compulsory workplace flu vaccine programs, these guiding standards should
be followed, as they provide the legal framework from which to justify such a program.
Ethical Considerations
Nonmaleficence, an ethical principle which holds that there is an obligation to do no
harm, is a guiding principle by which the decision to mandate flu vaccines to the healthcare
worker can be made. Health care workers are simply at a higher risk of infection given the
Hospital Policy on Influenza Vaccinations
University of Maryland Global Campus
HCAD 600
Hospital Policy on Influenza Vaccinations
There are several considerations when adopting new policies that affect both the work
force and patients. According to the American College of Healthcare Executives (ACHE),
healthcare executives must “prioritize patient care above other considerations'' (2021).
Achieving this standard, as it pertains to mandatory flu vaccination in the workforce, has
significant legal, ethical, and vaccine efficacy considerations.
As healthcare professionals, we have an obligation to the well-being and overall health of
the patients who are in our care. Although we all have the personal choice to receive (or not
receive) an annual flu vaccination, it is our obligation to the health of not only our patients, but
to the health of the communities we serve. Some healthcare professionals have voiced their
concerns that a mandatory flu vaccine policy could eliminate an individual’s right to being
immunized (Quanch, et al., 2013). Although this is a serious concern which may be
considered when drafting mandatory flu immunization policy, the burden of nonmaleficence
and beneficence falls on both the individual health care professionals, and the organizations
who employ them.
Vaccine Efficacy Considerations
One of the main arguments against receiving the vaccine is concerns about vaccine efficacy. The
effectiveness of the vaccine changes from year to year depending on how well it is matched to
the current strain of virus (Steckel, 2007). Because of the variations between the years, some
healthcare workers doubt the effectiveness of the vaccines, and refuse voluntary immunization
, efforts. Unfortunately, in order to achieve herd immunity, a large portion of a given
community must be vaccinated so that the virus “cannot gain traction and spread in the group”
(Steckel, 2007).
Another common concern amongst healthcare workers is side effects to the vaccine itself. Most
recently, minimal side effects are noted and generally only include soreness at the injection site
for one or two days (Steckel, 2007). Other side effects have been documented, but serious side
effects have been documented in less than 1% of those vaccinated and thusly should not be a
consideration to refuse immunizations.
Legal Considerations
From a legal standpoint, compulsory vaccination was ruled constitutional in the 1905
Supreme Court decision Jacobson vs. Massachusetts. As a result of this case, four standards of
compulsory vaccinations were introduced. These standards are necessity, reasonable means,
proportionality, and harm avoidance (Gostin, 2005). According to these four standards, there
needs to be a necessity for the vaccine in order to ensure the safety of the public. The vaccine
should also be reasonably engineered to prevent an outbreak. Proportionality states that the
vaccination should be proportional to the expected benefits. The vaccine itself should not harm
the person receiving the vaccine. “...[laws] allow governments to infringe on personal liberty to
prevent significant risk to the public in the face of public health threats” (Steckel, 2007). When
crafting policy for compulsory workplace flu vaccine programs, these guiding standards should
be followed, as they provide the legal framework from which to justify such a program.
Ethical Considerations
Nonmaleficence, an ethical principle which holds that there is an obligation to do no
harm, is a guiding principle by which the decision to mandate flu vaccines to the healthcare
worker can be made. Health care workers are simply at a higher risk of infection given the
