Study: Risks of unvaccinated LTC workers spreading flu are 'exaggerated'

Evidence to back up mandatory vaccination policies must "justify infringement" of workers' rights, researchers said.
Evidence to back up mandatory vaccination policies must "justify infringement" of workers' rights, researchers said.

Mandatory flu vaccine policies for healthcare workers may be based on inadequate data that exaggerates the risks unvaccinated employees pose to patients, according to a study published Friday.

A team of Canadian researchers analyzed four previous studies of vaccination policies in long-term care facilities to determine how the research findings backed up “expansive” mandatory vaccination rules used by many providers. The research would have to demonstrate “patient benefit substantial enough to justify infringement of the personal rights” of healthcare workers, the study's authors wrote in PLOS One.

The results showed that previous research has attributed “implausibly large reductions” in patients' flu risks to healthcare workers receiving the vaccination. One of the studies reviewed by the team concluded that eight healthcare workers being vaccinated could prevent one patient death each year.

When applied to the roughly 1.7 million long-term care workers in the United States, that statistic would mean 212,500 resident deaths could be prevented annually through worker vaccinations. Add in the 5.5 million hospital workers to that figure and an additional 687,500 patients deaths would be prevented each year — more deaths than those estimated to be caused by the 1918 Spanish influenza epidemic, according to Stat.

The research team also noted that the four studies frequently cited as evidence the benefits of a mandatory vaccination policy took place in long-term care facilities — despite the fact that the policies have spread to hospitals and other settings.

Andrew Hayward, lead author of the study that reached the “one death prevented per eight worker vaccinations” conclusion responded to the new study in an accompanying opinion piece. He said that the effect of vaccinations is likely “greater in long-term care facilities for frail elderly residents.”

Still, the study authors wrote, persisting beliefs that unvaccinated workers put residents at an increased risk for the flu are “exaggerated.”

“An intuitive sense that there may be some evidence in support of some patient benefit is insufficient scientific basis to ethically override individual [healthcare worker] rights,” the authors wrote. “While [healthcare workers] have an ethical and professional duty not to place their patients at increased risk, so also have advocates for compulsory vaccination a duty to ensure that the evidence they cite is valid and reliable.”

Based on the data, non-vaccination approaches to flu prevention, such as a worker taking a sick day or wearing a mask when she or he has flu symptoms, appear to be effective,  the researchers noted.