Can Employers Require the Flu Shot? Many Hospitals Do

Each flu season, many in the general public ignore doctors’ advice to be vaccinated against the latest strains of influenza.

But many healthcare workers don’t have the option to forego the flu shot. The Cleveland Clinic, MetroHealth Medical Center and University Hospitals all require workers to be vaccinated.

“We have an obligation to not harm our patients,” Dr. Jennifer Hanrahan, MetroHealth’s medical director for infection prevention, said. “The reason the flu shot is important is that a lot of people end up sick in the hospital and actually end up dying from influenza.”

Flu and pneumonia were the eighth leading cause of death in Ohio in 2015, according to the Centers for Disease Control and Prevention. Ohio ranked 19 ^th in the country for flu and pneumonia mortality that year.

In a recent CDC online survey, about 42 percent of healthcare workers said their employer required the shot during last year’s flu season. Nearly all of those workers, or 98 percent, said they received the vaccination. Overall, the share of healthcare workers who report receiving flu shots has risen from 64 percent in 2010 to 79 percent last year.

Dr. Steven Gordon, the chairman of the Cleveland Clinic’s department of infectious diseases, said healthcare providers can do three things to ensure more employees receive the vaccine.

“One, provide the vaccine on site. Two is provide it for free. And three is actually have employee mandates,” Gordon said. “I understand as Americans we don’t like to have anything mandated, but there is evidence base behind that.”

The Clinic, UH and MetroHealth offer the vaccine for free to workers. Employees can get the shot on their way to lunch just outside the MetroHealth cafeteria, Hanrahan said. The hospital system offers an egg-free vaccine for vegans or those with allergies.

MetroHealth workers can opt out of the shot for religious or other reasons. Non-religious exemptions must be approved by a committee that includes a medical ethicist, a spokesperson said in an email. Though Hanrahan didn’t have specific figures, she said only a small number receive an exemption each year.

“If there are people who have specific medical concerns about getting the vaccine, that is reviewed as well,” Hanrahan said. “For people who have concerns about allergies, we have them seen in the allergy clinic.”

Cleveland Clinic employees must also be approved for a religious or medical exemption to skip the flu shot, a spokesperson said in an email.

University Hospitals requires the shot for employees who interact directly with patients, a spokesperson said in an email. Workers who provide other patient services, such as cleaning rooms or preparing food, must also be vaccinated. Employees who opt out of a required flu shot at UH must wear a mask when working with patients.

State Rep. Christina Hagan, a Republican, introduced a bill this year that would bar employers from penalizing employees who decline flu vaccines. But it may not come to a floor vote in the near future. Ohio House Speaker Cliff Rosenberger said the bill needed more time in committee, the Statehouse News Bureau reported.

“Most employment is at will, so you know, you can fire someone for any reason or no reason, as long as it’s not an unlawful reason,” Cleveland-Marshall College of Law professor Matthew Green said.

But he said employers would have to make reasonable accommodations for an employee’s sincerely held religious objection.

“There have been instances where employers have granted these exemptions, or accommodated someone by saying: ‘You don’t have to get the flu shot, but you have to wear a mask,’” Green said.

There are examples across the country of hospitals firing employees who refuse to get the flu shot. But at least one hospital system faced pressure to reverse that decision.

Last year, St. Vincent Health Center in Erie, Pa., fired several workers who refused to get the vaccine after they were denied religious exemptions.

The U.S. Equal Employment Opportunity Commission sued, alleging religious discrimination. The hospital system agreed to rehire the workers and pay $300,000 in back pay and damages.

Gordon said that the Cleveland Clinic has already seen flu cases among patients in October.

“Influenza is here and circulating in Cleveland,” Gordon said. “So don’t wait until Thanksgiving. Go and get it.”