Give me Liberty, or Give me…Influenza Vaccine


Should States Make Influenza Vaccination Mandatory for Health Care Providers?  

Submitted by:
V. Ramana Feeser, MD
ACEP Ethics Committee
Assistant Professor, Department of Emergency Medicine
Virginia Commonwealth University Medical Center
 

YES: Influenza is a significant cause of morbidity and mortality worldwide. Public health authorities including the CDC and Joint Commission recommend vaccination of healthcare workers. Despite these recommendations, only about 40% get the vaccine. Based on this low percentage, voluntary programs don’t work and mandatory programs are needed. States like NY were concerned for the public safety and attempted to mandate vaccination against seasonal and H1N1 influenza. Do states have the right to do this? Dating back to 1905, a Supreme Court case involving small pox vaccination (Jacobsen vs. Massachusetts) upheld that state governments could pass laws to protect the public by requiring vaccination and that those that did not comply could be subjected to quarantines or penalties. This landmark law has been upheld many times since then. Governments should allow infringement on personal freedoms when there is significant risk to the public. Societal good overrides individual good. 

NO: Mandatory immunization violates individual liberty and the capacity for healthcare workers to make autonomous choices about their own healthcare. Vaccination is invasive and every person should have the freedom to make their own choices regarding procedures that violate bodily integrity. Personal values can override doing what is best for the patient in certain circumstances. For example, healthcare providers do not have to provide abortions or postcoital contraception (“morning after” pill) even when this may arguably be in the best interests of the patient. Conscientious objection to actions that violate personal beliefs is justified. Every patient has the right to decide if they get vaccinated and why shouldn’t this hold true for the healthcare provider as well? Individual freedom is a cornerstone of American society. Mandates are un-American and alternatives to this should be sought. 

What Side are You on? 

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