Hospitals Try to Fend Off Flu by Requiring Workers to Get Shots

Andrew Kitchenman | November 5, 2013 | Health Care
Potential loss of some Medicare funds helps propel push to mandate vaccinations

Lisa Breza, chief nursing officer for RWJ Hamilton, says not requiring healthcare workers to get flu shots puts hospital patients at higher risk.
Time may be running out for New Jersey healthcare workers who have previously declined to get flu shots – many of their employers are now making it mandatory.

New Jersey hospitals are increasingly requiring workers to get influenza vaccinations, with some exemptions for medical or religious reasons. While state legislators have proposed making it a statewide requirement for healthcare workers, hospitals are increasingly taking action on their own.

The three Atlantic Health System hospitals, Capital Health Medical Center – Hopewell, Robert Wood Johnson University Hospital Hamilton and the University Medical Center of Princeton at Plainsboro are among hospitals that have adopted flu-shot requirements this year.

Lisa Breza, chief nursing officer for RWJ Hamilton, said allowing healthcare workers to opt not to have a flu shot puts people at risk.

“The flu is dangerous for anyone, but while we want to protect our patients, we want to protect our employees also from contracting the flu,” Breza said.

The hospital, which officially launched the policy on October 7, has given workers until November 30 to be vaccinated. Hospital officials said 81 percent of the roughly 1,600 hospital employees had been vaccinated by yesterday.

The Assembly passed a bill, A-2172 (S-1464), requiring hospitals, nursing homes and home health agencies to offer flu shots and for their healthcare workers to get them. The bill is awaiting action in the state Senate. A similar bill received a pocket veto – which occurs when a governor doesn’t sign a bill at the end of a legislative session – by Gov. Chris Christie in 2012. He wrote at the time that the change deserved more scrutiny, would burden healthcare facilities and interfered with workers’ decisions.

A new federal rule may be influencing hospital officials’ decision to give their flu vaccination policies closer scrutiny. The rule requires hospitals to provide federal officials with information on the percentage of their workers who have been vaccinated. Hospitals that fail to report the information stand to lose some federal Medicare funding.

Dr. James Romano, chief medical officer for St. Francis Medical Center in Trenton, noted that when his hospital adopted its flu shot mandate in 2010, few healthcare facilities in the state had the requirement. He believes it has already prevented flu cases.

“I would recommend it strongly” to other hospitals, said Romano, adding that other hospitals have talked with St. Francis officials about how to implement a mandate.

Romano said “less than a handful” of workers were fired because they refused to comply with the mandate.

“It’s beneficial to the hospital employees, as well as the patients that we care for,” he said. “And if it’s rolled out properly, with the proper education and the proper follow-up, the people that are not willing to comply are very few.”

Romano added that the federal reporting requirement also would likely have a positive effect on hospitals.

Flu vaccines are prepared annually, based on the strains that health officials believe are the most likely to affect people during the flu season, which runs from October to May. The early weeks of this year’s season have resulted in a low number of cases in New Jersey, according to state statistics submitted to the federal government.

State and federal health officials recommend that everyone older than 6 months get flu shots. Now is a good time to get them, since it takes two weeks for the vaccine to be effective and the season peaks in the winter.

New Jersey Hospital Association doesn’t track which of its members have flu vaccine mandates. However, association spokeswoman Kerry McKean Kelly found in an email survey yesterday that more than a dozen members had instituted such policies, including Deborah Heart and Lung Center in the Browns Mills section of Pemberton Township, Hackettstown Regional Medical Center, Hunterdon Medical Center, JFK Medical Center in Edison and Saint Clare’s three hospitals.

“We have seen a considerable increase of the hospitals mandating this policy this year as compared with last year,” McKean Kelly said, noting that nursing homes and home health agencies also are actively discussing mandates. “It’s fair to say that everyone is taking a look at their best policies.”

Opponents of flu vaccinations believe that health officials have overblown the potential benefits of flu shots while minimizing the risk of side effects. Sue Collins, cofounder of the New Jersey Alliance for Informed Choice in Vaccination, said hospitals are wrong to pressure employees to get vaccines.

“It’s everyone’s right to decide what does and does not go into their body,” she said. “To threaten people with something like (being fired), to me, it’s so wrong on so many levels.”

But healthcare officials appear to be treating the issue with increasing urgency.

Joyce Schwarz, the vice president of quality at RWJ Hamilton, said hospital leaders had been weighing the policy for three years. She said last year’s early and heavy flu season contributed to the decision to enforce the mandate.

She said giving employees information about the benefits of the vaccines – as well as providing information to dispel incorrect information — has been essential in implementing the new mandate smoothly.

“There’s a lot of myths and misconceptions about the vaccine out there and I think over the years we have tried very hard to educate our staff about those,” she said. “Sometimes it’s hard to dispel those kinds of pre-conceived ideas really about anything, but especially about the flu vaccines. Really education is the way to go — we just keep educating and educating.”