Mandatory flu vaccination for healthcare workers ‘difficult’, MPs told

Professional groups already place a duty on healthcare workers to be vaccinated, but switching to a mandatory vaccination system may not be a simple thing to do.

Flu vaccine being administered

Making seasonal flu vaccinations mandatory for healthcare workers would be difficult, the national medical director at NHS England has told MPs.

At a hearing of the House of Commons Science and Technology Committee’s inquiry into the flu vaccination programme, Steve Powis said that although most professional groups already placed a duty on healthcare workers to be vaccinated, switching to a mandatory system “would not necessarily be a simple thing to do”.

“But there is more that can be done in terms of making it easy for staff to be vaccinated; and to put in various local incentive schemes,” he said, adding that the past year’s vaccination figure is approaching 70% in frontline clinical staff and healthcare workers, the highest to date.

Sue Crossland, president elect at the Society for Acute Medicine, agreed that mandating vaccination would be problematic.

“If we get to a stage where the vaccine is universal, and is effective every year, that makes for a much easier case,” she said. “We already vaccinate against hepatitis in health care workers and you’re not allowed to practice without it, on the front line.

“But while you can still get flu despite having the vaccine… I think that’s much more difficult to mandate.”

Paul Cosford, director for health protection and medical director at Public Health England, told MPs that his views were “stronger than those of my colleagues” and said all healthcare workers should be vaccinated. One reason for this, he said, was that between 30% and 50% of cases of flu are “subclinical” so there was a risk of passing the disease on to patients even when not showing clinical symptoms. 

Having the vaccine also reduces sickness absence and helps the NHS to keep operating through winter, he said, but he accepted that the current situation “doesn’t necessarily argue for mandation”.

Cosford told the committee that healthcare workers, and the trusts they work in, had a dual responsibility for raising vaccination rates. Currently, 21 trusts across the country have a vaccination uptake of more than 80%, he said, whereas rates in other trusts are between 30% and 40%. This disparity should be addressed through operational management routes, he said.

“I don’t like this solely being deemed as an issue of professional responsibility – when [vaccination is] made easy, people will take it,” he said.

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The Pharmaceutical Journal, Mandatory flu vaccination for healthcare workers 'difficult', MPs told;Online:DOI:10.1211/PJ.2018.20204509

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