SALT LAKE CITY — Health care systems across the nation are changing their immunization policies to protect the public, beginning with mandatory flu shots for employees.

Changes at a large Utah health care employer are coming on the heels of a recommendation from local health officials, as well as the Immunization Action Coalition, which works closely with the U.S. Centers for Disease Control and Prevention.

Early this month, Intermountain Healthcare officials handed down an edict that all employees must receive a flu shot each year or face disciplinary action. It's an act that Dr. Brent Wallace, Intermountain's chief medical officer, said will help to fulfill their mission, "to provide the best care to our patients."

"It's the next step in working to provide the protection for our patients that we need to have and making sure we do everything possible that they not come into one of our facilities without influenza and leave with it," he said.

The new policy, which will take effect Aug. 1, is in line with others regarding communicable diseases, making the MMR and Hepatitis B vaccines required for Intermountain Healthcare employees.

"Requirements such as this are becoming a national standard and we have identified more than 80 other health systems around the nation that have instituted similar requirements," Wallace said.

In addition to health care workers, he said Intermountain also encourages members of the community to receive the flu shot every year.

"There is good science and substantial data showing the importance and safety of the flu immunization," Wallace said.

Employees will still be allowed an opportunity for exemption, based on religion and/or medical reasons to not get the vaccine. But one specialized care nurse at Intermountain's McKay-Dee Hospital said she is completely opposed to the flu shot for ethical reasons and therefore faces the risk of termination if she doesn't comply.

"I don't believe in vaccinations," the woman, who asked to remain anonymous, said. "It goes against anything I've ever known."

She said she is often ridiculed for her beliefs, but holds to them and doesn't immunize her own children because of all of the supposed risks involved.

"Many of my co-workers ask me why I don't support immunizations and it boils down to this, 'I am more afraid of brain damage than I am of the chicken pox or the flu,'" she said.

The most common objection to the flu shot is from people afraid of getting sick from the vaccine, which Wallace said is not possible.

"It is a legitimate belief that they have but there is not a real scientific validity to it," the doctor said, adding that another reason is that some people just don't like shots.

A letter from the Utah Healthcare Associated Infections Governance Committee was sent to various organizations in April, stating that unless they had achieved an internal vaccination rate greater than 95 percent by other means, a policy of compulsory annual influenza vaccination should be implemented.

Intermountain has reached 85 percent in past years, according to spokesman Daron Cowley.

To better create transparency in health care quality in the state, the Utah Department of Health is going to start collecting influenza vaccination rates for the first time during the upcoming season. Those numbers are expected to be released to the public sometime in the first half of 2012 and will include data from all licensed Utah hospitals.

"Working with patients who may carry influenza, unvaccinated health care personnel themselves face some of the highest risks of infection," the HAI letter states. "Beyond their own health, they may carry harmful infections back to their own family and local community."

While all health care systems see patient care and safety as a top priority, some don't see the need to impose rules on vaccinations. And employees opting out of the various immunization programs at Utah hospitals are required to wear a mask or be reassigned through the duration of flu season, which typically starts in November and sometimes lasts until May.

MountainStar Healthcare, which oversees six hospitals from Brigham City to Payson, achieved a 97 percent vaccination rate in 2009 and 95 percent in 2010. Last year, 5 percent opted out for religious, medical or philosophical reasons, according to Kevin Allred, MountainStar's vice president of human resources. He said employees there "will again take action to protect patients, caregivers, other health care workers and the community at large from influenza" this year.

Like most health care systems, including Intermountain, MountainStar offers the influenza vaccinations to employees at no cost.

University of Utah Health Care spokesman Chris Nelson said flu shots are not imposed on every employee within their organization, but the system has a goal of 100 percent documentation, meaning everyone who declines the vaccine must have a written and approved reason. Anyone who does get sick is required to sit out of work until after their fever is gone.

"We really do feel a responsibility to our patients that our staff not contribute to disease," Nelson said.

Every year, 5 to 20 percent of Americans get the flu, according to the CDC. Approximately 200,000 are hospitalized from the sickness and 36,000 die from influenza related infections. Utah does not have a statewide immunization law that requires flu shots in any form.

Parents are encouraged to immunize their children or provide a letter of exemption to their corresponding school districts opting them out of the strictly scheduled program of immunizations through junior high school age.

Employees at Intermountain Healthcare have until Oct. 31 to inform management of their choice.

"We're doing this in effort to really provide the best safety for patients in our hospitals and clinics during flu season and to really seriously follow through on our mission to provide the best care for the patients that we can," Wallace said.


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