New York Nurses United
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Mandatory Flu Vaccination - Resources - Updated

Q. What are the regulations main provisions?
A. The regulation requires hospitals, diagnostic and treatment centers licensed under Article 28 of the
Public Health Law (PHL), home care services agencies licensed under Article 36 of the PHL
including certified home health agencies, licensed home care services agencies, long term
home health programs including AIDS home care programs, and hospice programs certified
under Article 40 of the PHL to document that existing staff have had influenza vaccinations
each year by November 30 and that new staff entering on or after November 30th have
influenza vaccinations.

Q. Who must receive an influenza vaccine under the new regulation?
A. The regulation applies to all personnel who
  • are affiliated with hospitals, diagnostic and treatment centers, home care agencies
licensed under Article 36 of the PHL including certified home health agencies, licensed
home care services agencies, long-term home health program including AIDS home care
programs, and hospices, and
  • are paid or unpaid, including but not limited to employees, members of the medical staff,
contract staff, students, and volunteers, and either
  • have direct contact with patients, or
  • perform duties that, if they were ill, could infect patients or staff with direct
patient contact.

Q. Are there any exemptions for immunization?
A. Medical contraindications recognized by ACIP will be permitted.  These ACIP
contraindications and precautions will be posted on the NYSDOH website to guide
determinations made by individual practitioners as to the existence of a medical
contraindication.   (Click here for link)  

Q. Doesn’t the state have to allow religious exemptions to vaccination?
A. There is no legal requirement to allow religious exemptions to influenza vaccination.

Q. How will hospitals document medical exemptions for NYSDOH surveyors?
A. The NYSDOH will create a medical exemption form that hospitals and others may use to
document medical exemptions.   (Download the medical exemption form by clicking here)

Q. What if a health care worker refuses to be vaccinated?
A. Each organization must take whatever steps are needed to comply with this regulation.  Since
current public health regulation also mandate that direct care staff be immune to measles and
rubella and receive annual tuberculosis screening, the organization may want to adopt a
similar managerial or personnel policy for dealing with individuals without medical
exemptions who refuse to be vaccinated or tested.  One option for workers who refuse
influenza vaccination is reassignment to duties not covered by the regulation.

Q. Can a health care worker who refuses to be vaccinated be fired?
A. Again, steps like reassignment to non-covered duties is suggested.  Each organization must
comply with this regulation, just as the organization assures that health care personnel must
be immunized against measles and rubella.

Q. Does the new regulation apply to the novel H1N1 influenza vaccine?
A. If the novel H1N1 vaccine is released as a fully licensed vaccine, as expected, this
regulation will also require immunization against H1N1 as well as seasonal influenza
this coming season.  Further information will be provided when the Department
receives updates on the vaccine, its licensure status and availability this fall.




  • Package Inserts for 2009-2010 Seasonal Influenza Vaccine Formulas Available Here: Click on the product name to download the insert for information about that particular formula.

Fluzone
Fluarix
FluMist
Fluvirin
Afluria
FluLaval
 
  • The NYSDOH has posted a number for additional information on the health care personnel influenza vaccination requirements: 1-800-808-1987.  You can also contact the DOH Bureau of Immunization at (518) 473-4437.

This regulation was originally adopted as an emergency rule which means it was in effect for 90 days and expired on 11/11.  Under the regulation, healthcare workers had until November 30 to get the vaccinations or to present a medical exemption.  The NYSDOH did not renew this regulation for the 2009 flu season, and the regulation is now suspended.

The NYSDOH stated it intends to a persue a permanent rule regarding mandatory immunization of healthcare workers and will publish a notice of proposed rule making in the State Register at some future date.  This process will require a period of public comment and may include a hearing.

In the meantime, you can still write or call the New York State Department of Health with your comments or concerns regarding mandatory influenza immunization of health care workers.

Contact the Commissioner and copy the Governor:
Richard Daines, MD
New York State Department of Health
Corning Tower
Empire State Plaza,
Albany, NY 12237
518-474-2011
DOH general mailbox: dohweb@health.state.ny.us.  Put "Attention Commissioner Daines" in the subject

David A. Paterson
State Capitol
Albany, NY 12224
518-474-8390

Also cc your comments to:
Office of Regulatory Reform (GORR) by email RegComments@gorr.state.ny.us
Put the ID number of the Rule in the subject line of the email: I.D. No. HLT-35-09-00007-E

Text of rule and any required statements and analyses may be obtained from:
Ms. Katherine E. Ceroalo
NYS Department of Health
Bureau of House Counsel, Regulatory Affairs Unit
Corning Tower Building, Room 2438
Empire State Plaza
Albany, NY 12237
(518) 473-7488
(518) 473-2019 –FAX
REGSQNA@health.state.ny.us

Check the NYS Register for updates and notice of proposed permanent rules:
  • In the middle of the page, click on "2009" in the area below "PDF Format"
  • Click on the dates that appear underlined to see the contents of the NYS Register for that date
  • Check if there are rulle making activities listed for "Health, Department of"
  • Download the entire document by clicking on "Rule Making Activities" (above the list of contents)
  • On the next page, click on "search for words"
  • Type "health care personnel vaccination" in the text box and click on the "search" button to look for the most recent notice concerning this rule.

State Hospital Review and Planning Council- This is the regulatory body responsible for approving the suspended mandatory immunization regulation.

Web Site-  http://www.health.state.ny.us/facilities/state_hospital_review_planning_council/

SHRPC Meeting Schedule and Locations http://www.health.state.ny.us/facilities/state_hospital_review_planning_council/timeline.htm

Also check our Discussion Board to see what nurses are saying about mandatory immunization and post your comments.
*Go to our Flu Discussion Board to see what nurses are saying about  mandatory immunization and post your comments- no registration required!
"Randomized trials assessing the impact of staff vaccination on patient outcomes in acute care facilities have not been conducted..."
     Another quote from a 2009 MMWR:  http://www.cdc.gov/mmwr/pdf/rr/rr5808.pdf
"Additional data on indirect effects of vaccination also are needed to quantify the benefits of influenza vaccination of HCP in protecting their patients (308)"

  • WHO recommends public health imperatives regarding vaccination
The following excerpts focus on vaccine safety and side effects, testing and monitoring of vaccine reactions, and primary safety recommendations: engineering controls & techniques.
http://www.who.int/csr/disease/swineflu/notes/h1n1_vaccine_20090713/en/
Regarding H1N1, it would indicate that health workers are playing a role as first recipients and thus de facto study subjects.
Additionally, if workers indicate that they have a history of a negative systemic response to the seasonal flu vaccine, public health advocates should support a voluntary exemption on behalf of the health worker.
If some form of mandation of flu vaccine is identified as a critical public health need, a liberal waiver should be in place for the above-cited population.
For H1N1, with pressured rapid vaccine development by pharmaceuticals anxious to negotiate lucrative contracts with the government and huge health facilities, testing, safety and efficacy could be questionably reliable. Thus, vaccine recipients should have an opt-out capability.
  • Mandatory Flu Shot Regulation Suspended- for this flu season!
On October 22, 2009, Governor Paterson announced the suspension of the flu vaccination mandate for healthcare workers.  A letter to facility administrators was sent by NYS DOH Commissioner Daines. (download a copy by Clicking Here)

On October 23, 2009, Daines wrote "... I hereby suspend the requirement for the health care personnel to be vaccinated against both influenza viruses for the current influenza season (through April 1, 2010)." But added, "Instead, the DOH is advancing a permanent regulation requiring health care personnel in these settings to be vaccinated. Draft regulations will be published soon for a period of public comment."

All stakeholders need to be prepared as this issue will be revisited in the near future.  The documents pertaining to the original emergency mandatory influenza immunization regulation have been preserved here (they are no longer on the NYS DOH web site) to be available as resources in this ongoing struggle.

Links to the NYS Register are at the bottom of the page to enable monitoring of rule making activity for proposals to establish mandatory flu vaccination as a permanent rule.  Check this site and www.nynursesunited.org often for updates and further developments.