Legal Aspects of Healthcare Worker Influenza Vaccination Mandates

Background:  Recent years have brought an increasing awareness of the burden of nosocomial influenza and the potential to protect patients by vaccinating healthcare workers.  Many institutions have increased the intensity of their efforts to encourage their employees to be vaccinated against influenza, using a variety of incentives and persuasive techniques, including mandates of varying strengths.  At least one U.S. state has also begun the implementation of an influenza vaccine mandate for healthcare workers.  The strongest of these mandates, however, have met with protests and legal challenges from employees.

Objectives:  This research sought to clarify the conditions under which healthcare workers may legally be required to be vaccinated against influenza.

Methods:  This project compared the pertinent provisions of constitutional, employment, and public health law with the arguments offered against such mandates.  The body of information on which the research was based included case law, the academic legal and medical literature, news reports, and public commentary.  It examined the biological and epidemiological characteristics of influenza in order to assess the applicability of health laws to the potential for influenza transmission.

Results:  The research pointed toward conclusions about the essential defensibility of vaccine mandates in the healthcare setting as well as situational variables that affect their vulnerability to challenge.

Conclusions:  In most cases, healthcare worker influenza vaccination mandates are on solid constitutional footing, although failure to provide for the protection of certain fundamental rights could invalidate such a mandate.  Labor agreements, however, may limit employers’ ability to enforce these mandates for unionized employees.  State public health laws and regulations can affect employers’ latitude to implement broadly applicable and strictly enforced healthcare worker influenza vaccination mandates.