Letters Health worker flu vaccination

Big brother with little evidence for mandatory vaccination of healthcare professionals

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e4034 (Published 19 June 2012) Cite this as: BMJ 2012;344:e4034
  1. Domnick d’Costa, consultant physician1
  1. 1Royal Wolverhampton Hospitals WV10 0QP, UK
  1. dcostad{at}aol.com

The article on mandatory vaccination of healthcare professionals is highly provocative and seems like an authoritarian recommendation with little evidence of benefit.1 The authors acknowledge this in their final paragraph, pointing out that good quality randomised controlled trials are needed to firmly establish this policy. The benefits of the vaccine have been shown in high risk groups, such as people over 65 years and those with chronic medical conditions. Would the authors then argue that it should be mandatory in these groups too?

A Cochrane review showed that vaccinating healthcare workers who cared for a high risk group of institutionalised elderly people had no effect on laboratory confirmed influenza, pneumonia, or death from pneumonia.2

Given the lack of sufficient evidence, the limited efficacy in healthy people, and the possibility of over-riding personal autonomy, it is probably impossible to predict a number needed to treat to prevent one nosocomial infection. As such, the recommendation for healthcare workers to be vaccinated should remain just that—a recommendation pending further high quality studies.


Cite this as: BMJ 2012;344:e4034


  • Competing interests: None declared.