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Mandatory Flu Vaccine for Healthcare Staff


People cannot ignore the fact that flu remains a worldwide burden that challenges human health and many social and economic aspects of life. The healthcare personnel are usually highly exposed to different respiratory pathogens due to the nature of their work. In most cases, immunization becomes a recommended preventive intervention for people of all ages, races, and genders that stops flu as shown in Figure 1 (Centers for Disease Control and Prevention, 2020). However, one should remember that vaccination may have both positive and negative outcomes, and in this presentation, the importance of the flu vaccine for healthcare providers will be discussed.

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Healthcare workers have a variety of responsibilities in regard to their chosen jobs. They need to take care of patients, constantly improve their knowledge, communicate with colleagues, and promote collaboration throughout hospitals or other care facilities. When the moment to be vaccinated comes, all employees are obliged to agree. However, there are no laws and guidelines to receive this vaccine, just recommendations. Therefore, it is correct to say that healthcare staff do not need to receive the flu vaccine if they do not wish to get it.


The reasons for not getting a flu vaccine vary, depending on personal, social, and even economic factors. Perceived risk is an opinion or belief about the vaccine, and if it is low, individuals choose specific behaviors. Besides, people deny any evident social benefits like extended financial rewards or increased self-perception. Some families may have negative memories about previous vaccination processes or inabilities to control the behaviors of other people. Finally, there are no clear rules that make vaccination an obligation because no guarantees that flu can be avoided are given.

Ethical Principles

There are four main ethical principles according to which healthcare workers must complete their tasks, namely autonomy, beneficence, non-maleficence, and justice. Each principle can be used either to support vaccination or to oppose this process:

  1. Autonomy means respect for autonomous decisions, and if a person does not want to be vaccinated, it is normal to rely on this concept and prove human rights. Van Hooste and Bekaert (2019) admit that if an employee rejects vaccination, the fear of vaccines is fed. However, healthcare workers are responsible for making rational decisions, and if they do not want to do something, their choice must be respected.
  2. Beneficence is a responsibility to behave for patient benefits and prevent harm. Several years ago, when no flu vaccines existed, healthcare workers were able to protect patients and help them. If simple rules of hygiene are followed (hand-washing or mask-wearing), vaccination may not be necessary.
  3. Non-maleficence equals no harm to patients, like no killing, causing pain, or offending. The flu vaccine rejection has nothing to do with all these harms. Thus, it is allowed not to accept it mandatory but focus on other aspects that improve health care.
  4. Justice promotes fair and appropriate treatment of healthcare workers in regard to other people. A flu vaccine is an independent decision that does not influence other people’s lives. Besides, if a healthcare provider rejects a vaccine and shares it with another person in need, it may be considered a just decision.

Theories and Evidence

Mandatory vaccination has its pros and cons, and the inability to demonstrate true attitudes toward this process results in low risk perception and other rationales for rejecting vaccines. The theory of planned behavior explains that human intention to do something is predetermined by their attitudes, subjective norms, and behavioral control (Corace et al., 2016). If those who impose vaccination neglect behavioral or normative beliefs but focus on control behaviors only, they can hardly achieve the desired outcome. At this moment, people report poor attitudes and no social benefits, which leads to rejection and negative attitudes. The risk perception attitude model proves that human actions depend on risk awareness and efficacy beliefs (Corace et al., 2016). If an employee has enough knowledge about a flu vaccine and rationally rejects it, there may be good reasons for this decision. The chosen framework supports the possibility to decline vaccination due to low risk perception. Finally, the power of presenteeism cannot be neglected because instead of being provided with time and resources to get well, many people have to continue working even with illnesses (Edmond, 2019). While this tendency exists, the effectiveness of flu vaccination is questionable. There are no grounds for specific laws and standards to introduce a flu vaccine as a safe obligation, which tells about its ambiguity.


At the end of this presentation, three main arguments against flu vaccination help develop a resolution:

  1. Healthcare staff should remember about all ethical principles to protect their rights;
  2. As there are no laws and regulations concerning mandatory vaccination, a person is free to choose;
  3. Until facilities face management shortages and poor behavioral control, a worth of vaccination is ambiguous.


Centers for Disease Control and Prevention. (2020). CDC seasonal flu vaccine effectiveness studies. CDC. Web.

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Corace, K. M., Srigley, J. A., Hargadon, D. P., Yu, D., MacDonald, T. K., Fabrigar, L. R., & Garber, G. E. (2016). Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review. Vaccine, 34(28), 3235–3242. Web.

Edmond, M. B. (2019). Mandatory flu vaccine for healthcare workers: Not worthwhile. Open Forum Infectious Diseases, 6(4).

van Hooste, W. L. C., & Bekaert, M. (2019). To be or not to be vaccinated? The ethical aspects of influenza vaccination among healthcare workers. International Journal of Environmental Research and Public Health, 16(20).

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