By: Nawa Arsala Lodin
Last week, Essentia Health reportedly fired 50 employees who refused to get a flu shot. Essentia Health is a health system based in Minnesota, Wisconsin, North Dakota and Idaho, with 15 hospitals and 75 clinics. Essentia’s Chief Patient Safety Officer warned that staff that do not get the flu shot could lose their jobs. Additionally, staff with religious or medical reasons, were exempt from the requirement.
Requiring vaccinations in the school setting or in the healthcare setting are not novel. They are generally a condition of employment or attendance. Further, vaccination laws are not novel. In fact, the very first laws requiring the smallpox vaccination dates back to 1809. There are no federal requirements for vaccinations, as it is considered the police power of the state. All 50 states have some level of mandated vaccinations. While there are no federal requirements for vaccinations, the Center for Medicare and Medicaid Services does consider the number of healthcare staff with the vaccination a factor in its Inpatient Quality Reporting Program.
Further, the Center for Disease Control and Prevention recommends that all U.S. healthcare workers get vaccinated annually for the flu. The CDC itself does not mandate immunizations, but its recommendations are impactful and considered in decisions made by state legislature. Essentia’s chief patient safety officer and the American College of Physicians both believe that healthcare workers have an ethical obligation to vaccinate against the flu. However, an ethical obligation does not necessarily mean a legal obligation.
The constitutionality of mandating vaccinations has been solidified, so long as it is necessary, not discriminatory and not arbitrary. The two common exemptions considered persuasive by the courts are medical exemptions and religious exemptions. Both are widely accepted by schools, workplaces and the judiciary. The judiciary traditionally examines medical expertise in its review of mandatory immunizations. This analysis is how the courts determine if the vaccination, and not getting the vaccination and being terminated as arbitrary. In the case of the flu shot, the scientific evidence is undoubtedly sufficient to support a mandatory vaccination. Essentia is one of hundreds of healthcare systems that mandate the flu shot. Considering the common exceptions, the warning prior to termination and the clear scientific evidence to support the immunization, it is unlikely claims against Essentia will be successful.