In Ontario, Canada, a policy is being debated called the “Vaccine or Mask Policy” in which health care workers are required to either get a flu shot or wear a mask when caring for patients. This policy has already put in place in British Columbia and in 8 hospitals in Ontario in 2013.
With the rise of Enterovirus D68 and and the distant threat of Ebola, this flu season threatens to be one that gives rise to more public concern regarding the spread of infection. In places where the policy has been instated, the vaccination rate has risen from 55% to 70%. Though there is evidence that this decreases incidence of death from the flu, there are no reliable current studies to show that increase in vaccination rates has a direct correlation to decrease in mortality rates related to the influenza virus.
According to ImmunizeBC, the mask policy is “the most effective method of protection against influenza infection and transmission remains vaccination” and “As a condition of employment with the health authority, all staff are required to either be vaccinated each year or, for those staff unable or unwilling to receive immunization, wear a surgical mask when in patient care areas, during the designated ‘vaccination required period,’ typically from the end November to the end of March.”
In answer to the question of why health care workers should wear masks if not immunized, the reply is as follows: “Masks can serve as a method of source control of infected health care workers who may have no or minimal influenza-like illness symptoms. Masks may protect unvaccinated health care workers from as yet unrecognised infected patients or visitors with influenza. Masks in conjunction with hand hygiene has been shown to have reduced rates of influenza like illness in residents of college dormitories and households. Masks can filter influenza virus to undetectable levels when measured at a distance of 20 cm from an infected patient.”
With the above named benefits, there remains controversy. Does such a policy violate individual rights? Are the outcomes measured or measurable? The Ontario Nurses Association has filed grievances regarding the violation of human rights in stigmatizing nurses who don’t or can’t get the flu shot and are required to wear a mask. In addition, they address the fact that hospitals are failing to acknowledge “that even those who are vaccinated are not fully guaranteed to be protected against contracting the flu.”
The president’s message states “that nurses and other health care workers should have the right to choose when it comes to the influenza vaccination. It’s time the government stepped in and ensured that health care facilities are doing all they can to protect patients while at the same time respecting the rights of nurses to make personal health decisions and have personal health privacy.”