Taking the long view...

This week there was a flurry of emails amongst hospital epidemiologists about approaches to influenza vaccination of healthcare workers. I was surprised at the number of hospitals mandating the vaccine. Another approach being implemented at some hospitals is to require that unvaccinated healthcare workers wear a surgical mask at all times (how practical is that?). In addition to masking, one hospital is also requiring unvaccinated healthcare workers to wear some type of tag noting their noncompliance. While the tough tactics might be useful PR tools, I think it's a punitive, petty and mean-spirited approach to your hospital's most precious asset. I also think it's dangerous, because the ill will that will be created by such tactics is likely to have impacts on other infection control outcomes. While an effective infection prevention program requires creativity, good policies, and sound interventions, infection rates are ultimately determined by what happens at the bedside. Most interventions are wholly or partially behaviorally based, so we need healthcare workers to cooperate in implementation. Thus, infection control programs need to be forging healthy, trusting relationships with their healthcare workers. Strong arming is short-sighted, adversarial, likely to backfire, and infection control in general will be undermined. And if there's a serious adverse vaccine related event in a healthcare worker who was forced to be vaccinated, I suspect that will not only be the end of mandates, but compliance with vaccination in future campaigns will plummet, and the responsible infection control program will lose credibility. So plead, cajole, beg, sing songs, do whatever it takes to get them vaccinated, but stop short of issuing mandates or stigmatizing providers.