Hmmmm...should we follow evidence or dogma?

So there's another systematic review of the literature on influenza vaccination of healthcare workers in the August issue of Emerging Infectious Diseases (full text here). Guess what? The results are quite similar to those of the Cochrane Group. The authors of the new study write:

"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.