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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...

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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: XXXXXXXXXX

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

Solution

Soumi answered on Feb 27 2020
96 Votes
Running Head: COHESIVE RESPONSE                            1
COHESIVE RESPONSE        5
COHESIVE RESPONSE
Table of Contents
Analysing the Situation in terms of Healthcare Service Delivery    3
Analysing 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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