08/24/2012 03:21 EDT | Updated 07/22/2013 04:50 EDT

B.C. Flu Shot Policy 'Punitive' Says Nurses Union

close up vaccine injection and...

VANCOUVER - Britsh Columbia nurses are raising concerns about new regulations requiring health-care workers to either get the flu shot or wear masks during flu season, describing the policy — the first of its kind in Canada — as "punitive."

The province's health officer announced the policy this week, arguing low vaccination rates among health professionals are putting patients at risk.

But the B.C. Nurses' Union says the government should instead focus on educating health-care workers on the benefits of vaccines while keeping the vaccines voluntary.

"We would really like to see a provincewide strategy that includes a number of different things, and not a mandatory vaccine as their No. 1 approach," Margaret Dhillon, executive councillor for the union, said in an interview Friday.

Dhillon said the rule was "punitive," threatening to discipline workers who don't get vaccinated or agree to wearing a surgical mask for months at a time.

She said the union plans to meet with employers and a chief medical officer on Monday to raise the concerns and to hear more about the rationale for the new rules.

The new policy is expected to be in place for the coming flu season, which typically runs from late November or early December until the end of March. It will apply to all health-care workers — including doctors, nurses, administrative staff and medical students — who come into contact with patients.

B.C. will be the first province in Canada to implement such a policy, though several jurisdictions in the United States have already done so.

In introducing the policy, provincial health officer Dr. Perry Kendall pointed to low vaccination rates among health-care workers, which a news release said were less than 50 per cent.

Dhillon said there are many reasons for the low vaccination rate, including skepticism among some workers that the vaccines are safe and effective. She also said some nurses find it difficult to fit a trip to a vaccine clinic into their work schedules.

"Sometimes, it's just a matter of needing better education for the reasons behind it and to show that it actually is effective in preventing the spread of the flu and there are no side effects to the vaccine," she said.

"We've always supported and encouraged our members to comply with the flu shot, although I would like to see what the research has shown in the facilities in the U.S. where they have introduced mandatory flu vaccines. What is the research about the decrease in the spread amongst the patient population since it's been introduced?"

Dhillon also wants to see research on how effective surgical masks are in preventing infection. Even if they are, Dhillon said it's not ideal to work wearing a mask.

"It's very difficult to nurse patients and it's not ideal care when you're wearing a mask for the whole duration of your shift," she said.

Dr. Bonnie Henry, director of communicable disease prevention at the B.C. Centre for Disease Control, said it isn't easy to accurately measure how often patients are infected with influenza from health-care workers, making it difficult to quantify the problem or assess whether similar vaccination policies in the United States have reduced those rates.

However, Henry said it's clear the flu vaccine will reduce the risk to patients, particularly those with compromised health.

"Immunization is a benefit, not only to ourselves (health workers), but in preventing transmission to our families and to our patients," Henry said in an interview.

"We know that the influenza vaccine is really effective in young, healthy people and most of us in the health-care world are in that category, whereas it's not as effective in people who are sick or people who are elderly. There is an imbalance there, and this is something we can do that is safe, that's effective."

Henry said other provinces are also looking at similar rules, including Ontario, where an advisory committee recently recommended such a policy be implemented there.

The policy has also received the attention of the B.C. Civil Liberties Association, which said the burden is on the government to prove a mandatory vaccination policy is justified.

Michael Vonn, policy director at the .C. Civil Liberties Association, said her group would be examining the new policy but had yet to develop a formal position. She said the government must demonstrate that it's the least-intrusive way to prevent influenza transmission within the health-care system.

"We would very much like to know what evidence the government is relying on to justify the sweeping statements that they've made, including 'It will save lives,'" she said.

"We are looking for some transparency from the government as to what it is they are relying on and the assessment that they took to suggest that this is a proportionate response."

New York became the first American state to require flu vaccines for health-care workers in 2009. Individual hospitals throughout the United States have also introduced similar policies.

The B.C. government says jurisdictions with similar rules have seen vaccination rates among health workers climb to more than 95 per cent.