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Euro Surveill. Ethics of mandatory vaccination for healthcare workers

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  • Euro Surveill. Ethics of mandatory vaccination for healthcare workers

    [Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

    Eurosurveillance, Volume 18, Issue 45, 07 November 2013


    Ethics of mandatory vaccination for healthcare workers

    E Galanakis <SUP>1</SUP>, A Jansen<SUP>2</SUP>, P L Lopalco<SUP>2</SUP>, J Giesecke<SUP>2</SUP>
    <SUP>1 </SUP>Department of Paediatrics and Joint Graduate Programme in Bioethics, University of Crete, Heraklion, Greece; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

    Citation style for this article: Galanakis E, Jansen A, Lopalco PL, Giesecke J. Ethics of mandatory vaccination for healthcare workers. Euro Surveill. 2013;18(45):pii=20627. Available online:
    Date of submission: 03 February 2013


    Healthcare workers (HCWs) are at increased risk of contracting infections at work and further transmitting them to colleagues and patients. Immune HCWs would be protected themselves and act as a barrier against the spread of infections and maintain healthcare delivery during outbreaks, but vaccine uptake rates in HCWs have often been low. In order to achieve adequate immunisation rates in HCWs, mandatory vaccination policies are occasionally implemented by healthcare authorities, but such policies have raised considerable controversy. Here we review the background of this debate, analyse arguments for and against mandatory vaccination policies, and consider the principles and virtues of clinical, professional, institutional and public health ethics. We conclude that there is a moral imperative for HCWs to be immune and for healthcare institutions to ensure HCW vaccination, in particular for those working in settings with high-risk groups of patients. If voluntary uptake of vaccination by HCWs is not optimal, patients’ welfare, public health and also the HCW’s own health interests should outweigh concerns about individual autonomy: fair mandatory vaccination policies for HCWs might be acceptable. Differences in diseases, patient and HCW groups at risk and available vaccines should be taken into consideration when adopting the optimal policy.