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Re: BMJ: Influenza vaccination in healthcare professionals
Influenza vaccination in healthcare professionals
In a recent editorial, Nair and colleagues argue that influenza vaccination among health care workers (HCW) should be mandatory, based in a series of arguments1. In the last paragraph they say ?good quality studies are still needed to firmly establish that vaccinating HCW prevents nosocomial flu in patients?. In our opinion this is a strong reason why it should not be mandatory. Although we agree that based on the results of observational and modeling studies vaccinating health care workers should be recommended (mainly because the potential benefits outweigh the disadvantages), there are other concerns that have not been addressed in the editorial.
As stated previously2, vaccinating HCW would go against the principle of autonomy and restrict the right of HCW in the context that a public health intervention should be proportional to the available evidence on benefits of vaccinating. In this case, it does not seem justified since there is not available a highly effective seasonal flu vaccine3 and grade A evidence about the effectiveness of influenza vaccination among HCW preventing flu morbidity and mortality in patients is nonexistent4. Besides, vaccinating against influenza it is not a universal recommendation and infection has other ways to reach patients, since coverage does not confer herd immunity. Moreover, the unpredictability of their efficacy (there is not always a good match between circulating and vaccine virus strains) must be acknowledged.
