Influenza doesn’t mess around.
The virus every year sends hundreds of thousands of people to U.S. hospitals, and the Centers for Disease Control and Prevention estimates it has killed between 12,000 and 61,000 Americans each year since 2010.
Seven Hoosiers have died so far this flu season, according to the Indiana State Department of Health, and 113 were killed during the 2018-19 flu season that stretched from October to May.
Public health experts say doctors, nurses and others who work with patients are key to stopping the spread of the disease.Despite that, Indiana is among 32 states without regulations requiring health care providers to be vaccinated or for hospitals to develop guidelines for which employees should get flu shots.
Allen County Health Commissioner Dr. Deborah McMahan wants to see that change, whether locally or statewide.
“I think we should require it,” McMahansaid of health care worker flu vaccination.
Locally, Parkview Health and Indiana University Health require employees to be vaccinated against seasonal flu or risk losing their jobs. Lutheran Health Network strongly encourages it but doesn’t mandate it.
McMahan said people with the flu can spread it to others four days before symptoms of the virus show up, and she said it is critical for health care providers to be vaccinated so they don’t infect patients already facing other medical problems.
Children younger than 2, adults older than 65 and people already battling other illnesses face the most danger from the flu.
Indiana hospitals have developed their own guidelines.Dixie Platt, vice president of communications and federal relations for the Indiana Hospital Association, said compliance has been strong.
“Ninety-two percent of Indiana’s health care workers get the flu vaccine, which exceeds the national rate of 90%,” she said in an email. “Indiana hospitals have been, and will continue to be, committed to the highest levels of patient safety and are working to increase immunization rates across the board.”
The CDC recommends health care workers – the agency defines them as doctors, nurses, emergency medical technicians, dentists, students, laboratory technicians, pharmacists, volunteers and administrative staff – get flu shots and vaccines for other illnesses, including hepatitis B and chickenpox.
But Platt said leaving legislators out of the equation allows health care providers more flexibility in meetingpublic healthneeds.
“Very few states set out requirements in statute when it comes to vaccination requirements for hospital employees,” she said. “It appears that in most states, hospitals work with the department of health or other regulatory bodies, as is the case in Indiana, in addition to complying with federal rules related to infection control.”
“We feel this approach makes sense, as it allows for infection control professionals to update and adjust practices more quickly when, for example, the Centers for Disease Control or other entity with clinical expertise changes its recommended policies in this area.”
Parkview and IU Health require allhospital, clinic and physicians’ office employees get a seasonal flu shot – unless they have an approved medical or religious exemption.
“Anyone seeking an exemption is required to submit a formal application. All applications are reviewed on a case-by-case basis,” Parkview spokeswoman Tami Brigle said in an email.
“Co-workers who are non-compliant with Parkview’s mandatory flu vaccination policy and do not qualify for a religious or medical exemption risk losing badge and computer access and may be placed on administrative leave until compliance with the program is validated,” she added.
IU Health workers who fail to comply face unpaid suspension and, ultimately, termination.
Mandatory health care worker vaccination policies are endorsed by the CDC and many professional organizations, including the American Hospital Association, American Nurses Association, National Patient Safety Foundation, American College of Physicians, American Academy of Pediatrics and American Academy of Family Physicians, Brigle said.
The Parkview and IU Health standards apply to doctors and nurses who directly care for patients, but also to employees who schedule appointments and accept payments.
IU Health Ball Memorial Hospital in Muncie has achieved 100% compliance of nonexempt employees for the past two years,spokeswoman Courtney Thomas said. The policy also applies to workers in the provider’s Fort Wayne clinic and primary care practice.
But it extends beyond the positions people might expect. Dietary and housekeeping workers are included in hospitals. Vendors who venture into clinical areas are also included.
The goal, Thomas said, “is to minimize or eliminate the spread of influenza within the IU Health facilities.”
Lutheran Health Network leaders “strongly encourage everyone to participate to protect themselves and others unless a medical contradiction or religious objection exists,” spokeswoman Kara Stevenson said.
Lutheran considers the decision to receive a flu shot “each person’s choice,” however.
“Getting immunized is the best way to prevent contracting or spreading the flu,” Stevenson said in an email, adding that flu vaccinations are free to all employees, volunteers and physicians.
Asked what types of medical professionals should be vaccinated, state officials said flu shots are important for everyone regardless of whether they are in the medical field.
Flu shots are especially important for children, older adults, pregnant women and people with chronic health problems such as diabetes, asthma or heart disease, they said.
The state health department “doesn’t set policy, but does recommend a flu shot every year for everyone 6 months of age or older,” said Greta Sanderson, senior communications manager for the state health department.
That’s the same guideline the CDC adopted.