Compulsory flu shots for health workers called 'premature'

A better flu vaccine is needed before mandating the shots for health care workers, two Canadian infection disease experts argue.

Drs. Michael Gardam and Camille Lemieux from the Infection Prevention and Control Unit at Toronto's University Health said despite the increasing push for mandatory vaccination of health care workers in Canada, a recent review of the medical literature indicated influenza vaccines offer about 60 per cent protection in healthy adults, which the journal called mediocre.

"Like others in our field, we get vaccinated against influenza each year, despite the vaccine shortcomings, and we strongly encourage other health care workers to do the same," Gardam and Lemieux said in a commentary published in Monday's issue of the Canadian Medical Association Journal.

"However, we are uncomfortable taking the next step of compelling vaccination given the considerable limitations of the current vaccine."

Instead, the pair said a better vaccine is needed as well as more robust published evidence of its effectiveness.

The latest research on the effectiveness of flu vaccines comes amid exaggerations of flu deaths from models that are promoted by public health officials and publicized by media, Gardam and Lemieux said.   

The pair were responding in part to an editorial in the CMAJ earlier this flu season that called for the vaccine to be compulsory for health-care workers to avoid jeopardizing their patients.

In December, the B.C. government said it was temporarily backing off from mandating flu shots or masks for provincial health care workers. The province said disciplinary actions for workers who fail to comply with the policy won't start until next year.

Dr. Perry Kendall, British Columbia's chief medical officer of health, said health-care workers have an ethical responsibility to  to reduce the chance they'll infect their patients with the flu.

"I think everybody would agree that we'd like to have a better vaccine. I'm not convinced, however, that because the vaccine is less effective than we'd like, that it still doesn't offer benefits, particularly to vulnerable patients. The benefits are maybe less than we'd like to see, but they are still benefits," said Kendall.

Public Health Ontario, an arms-length government agency for health promotion has also called for flu shots to be compulsory for all health care workers in the province. Ontario Health Minister Deb Mathews has said that it has no plans to introduce such legislation.

A position paper from the Association of Medical Microbiology and Infectious Disease Canada, which represents those professionals also calls for annual flu immunization for health care workers who care for patients or spend time in such areas.