Make Health-Care Workers Get Flu Shots, Society Urges

ALEXANDRIA, Va., Jan. 25 -- All health-care workers should be required to get a flu shot every year, unless they formally refuse in writing, the Infectious Diseases Society of America (IDSA) said today.

The society called on the federal government to plug what it called a "critical weakness" in the nation's influenza preparedness by ensuring health-care workers are protected.

"It's our professional duty to first do no harm," pronounced Andrew Pavia, M.D., chief of pediatric infectious diseases at the University of Utah and chair of the society's National and Global Public Health Committee.

"Voluntary systems haven't brought immunization rates up far enough," Dr. Pavia said, calling for a regimen with "more teeth in it."

"For the sake of our patients, all health-care workers must get a flu shot every year or they must be required to opt out in writing," Dr. Pavia said. He said fewer than 40% of health-care workers get an annual flu shot, although many are routinely exposed to the virus and therefore can spread it.

He told a news conference that the idea is not new. Health-care workers, for instance, are required to have hepatitis vaccinations.

Policing such a policy would be up to individual institutions, he said, but should be a quality indicator and potentially might be linked to Medicare and Medicaid reimbursement.

The call for mandatory flu shots for the nation's health-care workers is part of a 12-point program that the society says is critical to prepare for a possible pandemic flu strain.

"Responding to the perennial threat of seasonal flu will help us prepare for an influenza pandemic, and vice versa," said Kathleen Maletic Neuzil, M.D., M.P.H., of the University of Washington in Seattle, and chair of the society's Pandemic Influenza Task Force.

The IDSA program comes after Congress last year passed the Pandemic and All-Hazards Preparedness Act, but the society says passage of the act is just the beginning.

The society called on the federal government to establish a multinational pandemic influenza vaccine master program, "on the scale of the Apollo lunar project," to work with other countries and the private sector to develop a vaccine.

The U.S. should spend at least .8 billion for 2007 alone on such a program, the society said.

Dr. Pavia said that -- like the Apollo program -- a vaccine program would need to combine basic and applied science on a large scale, rather than just doing basic research.

The society also called for a wide-ranging program of research and development to find and test new antiviral drugs. The U.S. should consider tax credits and other incentives to transform R&D into new drugs, new diagnostics, and other new tools to battle both seasonal and pandemic flu.

During a pandemic, the society said, health-care workers will be at increased risk and should get priority access of vaccines and anti-virals. Also, the society said, the government should create an injury compensation plan and liability protection to eliminate barriers to health-care workers' participation in battling a pandemic.

The society also urged the government to:

• Build health-care systems that can respond to mass emergencies.
• Develop and test "community mitigation" measures, such as closing schools, sending workers home, and isolation and quarantine.
• Improve flu surveillance, working with international partners.

The society said the government needs to "commit money for the long term," noting that recent infusions of cash have been useful, but need to be sustained.

"Attention to pandemic flu is not what it was at this time last year, but pandemic flu is not last year's story," Dr. Neuzil said. "The threat has always been with us, and it will likely always be with us."

"If we hope to be ready the next time a killer virus emerges, we need a serious, sustained, long-term commitment," she said.