Health care worker flu immunization policy implemented in B.C.

VICTORIA (Canadian OH&S News)

Health care workers in British Columbia have been told that if they are not willing to get jabbed with the flu shot, they will have to hide their faces.

The province’s Ministry of Health Services announced in late August that, beginning at the start of the flu season, any health care workers who come into contact with patients at publicly-funded health care facilities will have to wear a surgical or procedural mask if they refuse, for whatever reason, to get the influenza vaccine. Nurses not wearing the mask can face discipline up to termination, the policy states.

Dr. Perry Kendall, the provincial health officer, had been a big proponent of increased flu prevention measures. He said that the ministry had been trying for a decade to increase the number of workers choosing to get inoculated, and after numbers fell below 50 per cent last year — lower than in 2006 — it became clear that the voluntary education approach was not getting the results they needed to keep patients safe.

Similar programs in the United States have seen immunization levels of health care workers higher than 95 per cent, Kendall said. While he has not set a target, he hopes to hit those levels, acknowledging that it may take a couple years.

“We know that healthcare workers get influenza and they continue to work if they have mild symptoms and they can spread the virus and be infectious even before they get symptoms,” Kendall said, noting that approximately 10 to 20 per cent of nurses get influenza in a flu season, similar to the general population.

The problem with nurses not getting flu shots, Kendall said, is that studies have shown that nurses carrying the influenza virus often do not show any symptoms and would still come to work — and those that do get sick are still able to spread the virus for 24 hours before showing symptoms.

According to the new policy, which will likely come into effect in December, workers will get a sticker that will be affixed to their ID badges to show whether they have been immunized or not. In addition to being available from anywhere flu shots are available to the public, many health authorities are offering peer nurse immunizations.

The ministry decided against a mandatory immunization policy and offered the option of masks in an effort to avoid any court or labour challenges that might arise, Kendall said.

“[Mandatory immunization] is a hot-button issue and quite frankly we’d rather spend our energy on trying to educate and inform and produce a safer environment on patients than spending it in front of labour relations tribunals or dealing with the issues of mandatory programs.”

But wearing a mask for four months of the year is not a viable option for nurses who do not want to get the shot, said Margaret Dhillon, executive counsellor at the British Columbia Nurses’ Union, adding the mask is “not the optimal way to provide patient care” when you’re dealing with patients who speak English as a second language or have hearing problems.

“We prefer the voluntary educational approach. We encourage our members to get the flu vaccine, but we don’t support policies that make it mandatory,” she said. Under the new policy, if there is a flu outbreak, any nurses who have not been inoculated will have to be reassigned to another area or sent home with pay — the same as the old system.

The union is still having discussions with the ministry about the policy and is not talking about challenging it, Dhillon said, adding that the ID badge stickers are a point of contention and an invasion of the health care worker’s personal health information.

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