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8 Reasons Why COVID-19 Vaccination Should Be Mandatory for Healthcare Workers


Harvard clinicians say the case for mandating COVID-19 vaccination is stronger than it is for mandating flu shots — and give eight reasons why

In an opinion piece in today’s Annals of Internal Medicine, Michael Klompas, M.D., M.P.H., Madelyn Pearson, D.N.P., RN, and Charles Morris, M.D., M.P.H., of Brigham and Women’s Hospital in Boston give eight reasons for making COVID-19 vaccination mandatory for healthcare workers should be mandatory. Some of their reasons are framed as a comparison to flu shots, which some hospitals started to mandate more than a decade ago. Becker’s Hospital Reviewis keeping a running tally of the hospital systems that are requiring vaccination and as of today its count showed 26 systems that had taken steps to require vaccination. The Becker’s list also included the hospital associations in Washington, D.C., and the state of Maryland. Some systems have not set hard deadlines, according to Becker’s, and the Mass General Brigham system that Brigham and Women’s is part of is making the requirement contingent upon one of three vaccines with an emergency use authorization getting full FDA approval.

Here are eight reasons listed by Klompas, Pearson and Morris:

  1. The morbidity and mortality of COVID-19 far exceeds that of influenza. The mortality rate of influenza is 1 in 1,000, say Klompas, Pearson and Morris. For COVID-19, it is closer to 1 in 250, they say. They also note that post-COVID-19 symptoms tend be more pronounced than those that linger after a flu infection
  2. SARS threatens essential workers’ lives. Healthcare workers and other essential workers have higher rates of infection than workers in other fields, so the vaccines will disproportionately save lives.
  3. Nosocomial transmission is common. Staff-to-patient and staff-to-staff transmission have led to large clusters of cases.
  4. Vaccination of healthcare workers protects patients. Vaccination of healthcare workers protects unvaccinated patients because the vaccines are associated with fewer infections, less “silent” carriage of the virus and less transmission.
  5. The COVID-19 vaccines are more effective than the flu vaccine. Flu shots are 30% to 50%, depending on the flu season. By contrast, the Pfizer and Moderna vaccines are more than 90% effective.
  6. COVID-19 is more disruptive to hospital operations than flu. The pandemic has disrupted healthcare delivery in many ways, ranging from universal masking to limitation on visitors to cancellation of in-person meetings. “Universal vaccination is the pathway to rolling back these disruptions and returning to normal operations,” say the Brigham and Women’s clinicians.
  7. COVID-19 is disruptive to “workforce continuity.” Healthcare workers are usually allowed to return to work 24 hours after the fever from a bout of flu subsides. In contrast, a COVID-19 means 10 days of isolation, even if symptoms resolve early,
  8. The COVID-19 vaccines are safe. Klompas, Pearson and Morris acknowledge that some life-threatening side effects occur, but they also note that the incidence of “these complications is vanishingly small.”

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