# Is it legal to fire employees for not getting a flu shot? **URL:** \ **Category:** Great Debates\ **Created:** [November 26, 2012, 7:52pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191 "2012-11-26T19:52:35Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![LavenderBlue](https://avatars.discourse-cdn.com/v4/letter/l/e95f7d/32.png) [@LavenderBlue](https://boards.straightdope.com/u/LavenderBlue)\ **Post date:** [January 9, 2013, 5:25pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/101 "2013-01-09T17:25:55Z")
> [@Kearsen](#): > > I would not require a 100% effective. Maybe 75% effective, but even at that. You are now firing people, or advocating that it is ok because they don’t prescribe to something that is less than 100% effective. > > To me, that is the rub. As far as I know no vaccine is 100% effective. If a health care worker does not want to adhere to basic public health measures that health care worker should find another job. Patients have the inherent right to get care from someone who isn’t a danger to them. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [January 9, 2013, 5:34pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/102 "2013-01-09T17:34:26Z")
> [@Kearsen](#): > > I would not require a 100% effective. Maybe 75% effective, but even at that. You are now firing people, or advocating that it is ok because they don’t prescribe to something that is less than 100% effective. > > To me, that is the rub. There’s no such thing as a medical intervention that’s 100% effective and 100% without risk. Allowing hospital workers to decline flu shots puts a particularly vulnerable population at risk of flu transmission (the elderly, immunosuppressed and infants, although even healthy young adults can succumb to flu due to overactive immune responses (cytokine storm). Should pediatric nurses be required to get immunized against pertussis (which again, disproportionately strikes young children and appears to be increasing in older children and adults once immunity from infection or vaccination wanes)? After all, the pertussis vaccine isn’t as effective as we might hope (the old whole-cell vaccine worked considerably better, but was eliminated due to concerns about side effects). Don’t want to violate the nurses’ rights, like in [this example](http://www.news-leader.com/article/20130108/NEWS01/301080030/coxhealth-nurse-fired-flu-vaccine-surgical-mask) of a “holistic” nurse who refused vaccination and then was fired by her hospital for refusing to wear a surgical mask (note that she got a “religious” exemption from flu vaccination, although she admits she isn’t particularly religious). ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [January 9, 2013, 5:37pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/103 "2013-01-09T17:37:45Z")
> [@Jackmannii](#): > > There’s no such thing as a medical intervention that’s 100% effective and 100% without risk. Allowing hospital workers to decline flu shots puts a particularly vulnerable population at risk of flu transmission (the elderly, immunosuppressed and infants, although even healthy young adults can succumb to flu due to overactive immune responses (cytokine storm). > > Should pediatric nurses be required to get immunized against pertussis (which again, disproportionately strikes young children and appears to be increasing in older children and adults once immunity from infection or vaccination wanes)? After all, the pertussis vaccine isn’t as effective as we might hope (the old whole-cell vaccine worked considerably better, but was eliminated due to concerns about side effects). Don’t want to violate the nurses’ rights, like in [this example](http://www.news-leader.com/article/20130108/NEWS01/301080030/coxhealth-nurse-fired-flu-vaccine-surgical-mask) of a “holistic” nurse who refused vaccination and then was fired by her hospital for refusing to wear a surgical mask (note that she got a “religious” exemption from flu vaccination, although she admits she isn’t particularly religious). You can flip that argument on end and attack it from the other direction. At what level do you find it acceptable of a risk in order to trample someone else’s personal space/right/privacy? Does the vaccine need to be effective at all? ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [January 9, 2013, 6:16pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/104 "2013-01-09T18:16:36Z")
> [@Kearsen](#): > > You can flip that argument on end and attack it from the other direction. > At what level do you find it acceptable of a risk in order to trample someone else’s personal space/right/privacy? > Does the vaccine need to be effective at all? The risk/benefit analysis is done at the time of FDA approval and monitored continuously. When the risks begin to outweigh the benefits (when a drug is approved and enough people begin taking it and for long enough time for rare side effects to become apparent) its approval is reviewed. The drug might be pulled or it’s warning labels etc get modified. The risk/benefit analysis becomes heightened when you include the risk to the patient of being around an unvaccinated person (in this case). Approval by the FDA generally means that the benefits outweigh the risks and it is generally safe 9with some exceptions, especially when no other treatments are available, riskier drugs might be approved). The risk to the patient in this case has been determined to outweigh the intrusion on the healthcare provider. So yes, the vaccine must work, or the risk of infection at injection site, side effects or allergic response is too great for no benefit to justify getting FDA approval in the first place. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 9, 2013, 6:27pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/105 "2013-01-09T18:27:47Z")
> [@Kearsen](#): > > At what level do you find it acceptable of a risk in order to trample someone else’s personal space/right/privacy? As a condition of employment? There isn’t a right involved. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [January 9, 2013, 6:40pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/106 "2013-01-09T18:40:36Z")
> [@Really\_Not\_All\_That\_Bright](#): > > As a condition of employment? There isn’t a right involved. No, not as condition of employment. I live in a right to work state. The hypothetical morality of firing someone for not allowing an injection that is not infallible, may cause you damage in the future or some other harm befalls you. Is the government going to pick up the tab, should they? Or will the employer who fired you for refusing be the one left to pick up the costs (if any) I mean, this is a left leaning board surely you guys would be the ones floating this ideal, not me. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 9, 2013, 6:49pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/107 "2013-01-09T18:49:23Z")
The injection won’t “cause you damage in the future”. As to the hypothetical harm you propose, I have no idea what you are talking about. Yes, the government should pick up the tab if the vaccinations are required by law, or require an employer to do it. The employer should pick up the tab if it is the entity responsible for the mandate. I see nothing to indicate that is not the case here, in any event. ---
**Author:** ![CurtC](https://avatars.discourse-cdn.com/v4/letter/c/ce73a5/32.png) [@CurtC](https://boards.straightdope.com/u/CurtC)\ **Post date:** [January 9, 2013, 6:51pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/108 "2013-01-09T18:51:55Z")
> [@Kearsen](#): > > You are now firing people, or advocating that it is ok because they don’t prescribe to something that is less than 100% effective. But requiring that all the employees get flu shots is 100% effective at reducing the incidence of flu, which is a potential killer of their patients. In other words, if they require flu shots for patient-facing employees, there _will_ be fewer people infected with the flu. The hospital would be negligent if they _didn’t_ require vaccinations. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [January 9, 2013, 6:53pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/109 "2013-01-09T18:53:36Z")
> [@Really\_Not\_All\_That\_Bright](#): > > The injection won’t “cause you damage in the future”. As to the hypothetical harm you propose, I have no idea what you are talking about. > > Yes, the government should pick up the tab if the vaccinations are required by law, or require an employer to do it. The employer should pick up the tab if it is the entity responsible for the mandate. I see nothing to indicate that is not the case here, in any event. I added that due to **Jackmanii’s** post #103 ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [January 9, 2013, 6:55pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/110 "2013-01-09T18:55:11Z")
> [@CurtC](#): > > But requiring that all the employees get flu shots is 100% effective at reducing the incidence of flu, which is a potential killer of their patients. In other words, if they require flu shots for patient-facing employees, there _will_ be fewer people infected with the flu. > > The hospital would be negligent if they _didn’t_ require vaccinations. Ok, who is negligent if the vaccine prescribed is later taken off the shelves? due to some harmful side effect or other? ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [January 9, 2013, 7:04pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/111 "2013-01-09T19:04:09Z")
> [@Kearsen](#): > > Ok, who is negligent if the vaccine prescribed is later taken off the shelves? due to some harmful side effect or other? It doesn’t mean there is negligence. If there was negligence it would depend who the guilty party was- did researchers conceal problems? Did the gov’t not give correct oversight? However, and I speak from direct experience, rare side effects can sometimes not appear until the completion of Phase three trials and the medicine is now being taken by 10000+ people. A .01% dangerous side-effect might not show up in the smaller trials used to demonstrate safety and efficacy, simply due to probability. With mich larger numbers rare and unexpected effects may now appear in statistically significant numbers. That’s not negligence. There still may be responsibility to help people it hurt, but not because of malpractice or breeches in research ethics. That would add additional layers of responsibility on top. Life is not risk free. In general, the system we have of testing drugs is, if anything, too cautious, rather than too reckless. In a work-place scenario, workman’s comp generally covers injuries sustained as part of the work process. I can imagine that an documented side effect leading to harm or needing treatment would fall under that coverage. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [January 9, 2013, 7:10pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/112 "2013-01-09T19:10:22Z")
> [@IvoryTowerDenizen](#): > > It doesn’t mean there is negligence. If there was negligence it would depend who the guilty party was- did researchers conceal problems? Did the gov’t not give correct oversight? > > However, and I speak from direct experience, rare side effects can sometimes not appear until the completion of Phase three trials and the medicine is now being taken by 10000+ people. A .01% dangerous side-effect might not show up in the smaller trials used to demonstrate safety and efficacy, simply due to probability. With mich larger numbers rare and unexpected effects may now appear in statistically significant numbers. That’s not negligence. There still may be responsibility to help people it hurt, but not because of malpractice or breeches in research ethics. That would add additional layers of responsibility on top. > > Life is not risk free. In general, the system we have of testing drugs is, if anything, too cautious, rather than too reckless. > > In a work-place scenario, workman’s comp generally covers injuries sustained as part of the work process. I can imagine that an documented side effect leading to harm or needing treatment would fall under that coverage. Maybe negligence is too strong a word but if the government is going to condone, coerce or otherwise force you to do something (and in this case it may not be the government, it may be a corporation) then that entity is sure as hell responsible, or ought to be. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [January 9, 2013, 7:19pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/113 "2013-01-09T19:19:18Z")
Every hospital I’ve worked at that offered flu vaccination (whether mandatory or not) paid for its employees and medical staff to get them. Flu vaccines are not as effective year-to-year as most other routine vaccines, due to the difficulty of predicting and matching vaccine strains to what will be circulating come flu season. Still, given the risk to hospital patients from flu transmission and the very low risk associated with receiving the vaccine, responsible professionals (including the American Academy of Pediatrics and infectious disease expert organizations) [endorse mandatory flu vaccination](http://news.cincinnati.com/article/20130108/EDIT02/301080158/Mandatory-shot-best-policy) for health care workers. There is no “right” to work in health care, so what’s really at stake is the right of patients to expect that hospitals will take all reasonable steps to protect them from hospital-acquired infections. ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [January 9, 2013, 8:02pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/114 "2013-01-09T20:02:49Z")
> [@Kearsen](#): > > Maybe negligence is too strong a word but if the government is going to condone, coerce or otherwise force you to do something (and in this case it may not be the government, it may be a corporation) then that entity is sure as hell responsible, or ought to be. Yes, in general any problems that occur at work would be covered under workman’s comp. FOr example, my friend slipped in the hall and broke her elbow at the College I worked. The college paid for her medical care and for a driver to take her to and from work. THere was no negligence (water on floor etc), but simply she got hurt while at work. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 9, 2013, 8:17pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/115 "2013-01-09T20:17:19Z")
Unless the vaccination is actually being performed _at_ the hospital (maybe Jackmanni can address that) it’s unlikely that side effects would be covered by workers’ compensation. I don’t think signifies, though. > [@](#): > > Maybe negligence is too strong a word but if the government is going to condone, coerce or otherwise force you to do something (and in this case it may not be the government, it may be a corporation) then that entity is sure as hell responsible, or ought to be. So if I get run over by a bus while taking my suits to the dry-cleaner, is my employer responsible? They made me wear the suits. ---
**Author:** ![artemis](https://avatars.discourse-cdn.com/v4/letter/a/91b2a8/32.png) [@artemis](https://boards.straightdope.com/u/artemis)\ **Post date:** [January 9, 2013, 10:37pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/116 "2013-01-09T22:37:11Z")
> [@Jackmannii](#): > > There is no “right” to work in health care, so what’s really at stake is the right of patients to expect that hospitals will take all reasonable steps to protect them from hospital-acquired infections. Agreed. And it’s not just about directly infecting patients, either. Ever thought about what would happen to the quality of patient care if 20% of the hospital staff was out sick with the flu (which could happen happen in a bad flu year)? ---
**Author:** ![artemis](https://avatars.discourse-cdn.com/v4/letter/a/91b2a8/32.png) [@artemis](https://boards.straightdope.com/u/artemis)\ **Post date:** [January 9, 2013, 10:38pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/117 "2013-01-09T22:38:18Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Unless the vaccination is actually being performed _at_ the hospital (maybe Jackmanni can address that) it’s unlikely that side effects would be covered by workers’ compensation. My hospital vaccinates all of us on site, for what it’s worth. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 9, 2013, 10:58pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/118 "2013-01-09T22:58:04Z")
Then any complications from the procedure would be industrial injuries covered by workers’ compensation. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [January 9, 2013, 11:20pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/119 "2013-01-09T23:20:09Z")
> [@artemis](#): > > My hospital vaccinates all of us on site, for what it’s worth. Same at all the hospitals I work at. There’s an employee health office that takes care of that and other matters like TB testing. Speaking of which, I wonder if the “holistic nurse” who refused the flu vaccine because her spiritual beliefs forbid letting "toxins’ into her body, also refused TB testing (which involves subcutaneous injection of TB “toxins” to determine if a person has been exposed to TB). I would also like to have known how someone who wears synthetic clothing, uses makeup, brushes her teeth, eats, drinks etc. manages to avoid soiling her holy bodily temple with “toxins”, but that’s another matter. :dubious: ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 9, 2013, 11:47pm UTC](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191/120 "2013-01-09T23:47:22Z")
TB testing? Don’t you have BCGs or whatever they’re called now here? [Previous page](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191.md?page=5) [Next page](https://boards.straightdope.com/t/is-it-legal-to-fire-employees-for-not-getting-a-flu-shot/642191.md?page=7)