"HCWs would be justified in claiming that the current evidence base is not especially strong and heavily weighted toward the benefits to patients receiving care in long-term care facilities, although limited evidence would not necessarily legitimize nonacceptance."The authors go on to state that vaccination seems reasonable since there is likely some protection of high-risk patients.
On the basis of this new analysis, I haven't changed my mind. I still think HCWs should get vaccinated against influenza. I even think that we should make it hard for them to not get vaccinated (require signed declination, mandate educational sessions, etc). But I continue to believe that you can't fire HCWs who are not vaccinated based on the current state of evidence. To do so makes a mockery of what epidemiologists are supposed to espouse above all--decisions made on evidence, not dogma.