In a letter to Colorado public health officials, the Association of American Physicians and Surgeons (AAPS) opposes a rule requiring workers in health care facilities to have an annual influenza vaccination or lose their jobs. Workers who had a rare religious or medical exemption would be required to wear a mask in patient care areas from November through March.
The religious exemption is too narrowly drawn, AAPS writes, and should be a philosophical exemption, as accepted in many states, to “to avoid inquisitions into matters of faith.” The mask requirement “seems to be nothing more than a punitive retaliation against those who decline the vaccine” and should be dropped, the AAPS letter states, as both immunized and nonimmunized individuals can transmit influenza or other illnesses.
The New Mexico study cited in support of the policy shows a tiny effect: an adjusted odds ratio of only 0.97 for confirmed influenza “outbreaks” (at least one case) in residents of long-term care facilities where 60% of direct-care workers were immunized compared with facilities with a 51% immunization rate. This means that in facilities where more workers were immunized, residents were still 97% as likely to get influenza. “Many other factors could account for the small difference,” states AAPS executive director Jane Orient, M.D.
