Mandatory vaccinations improve health outcomes

It’s an uncomfortable part of medicine that doctors make mistakes. My dad returned home from a toe surgery two years ago, and when he came out from underneath the effects of the sedatives, he discovered three neat, tidy stiches still intricately embedded in his skin. It was hardly a life-threatening experience, but it illustrated just how easily something can go wrong during a surgery. That wasn’t even the complicated part.

Now, we’ve heard a lot in the last couple years about “government takeover of health care.” Although this phrase is vacuous at best, it’s been used to make a fairly simple argument: Health care is more effective and has greater value for individuals when they, not their societies, make the decisions about the type of care they want to receive. It has become a popular slogan for those who want to see less regulation in the health care industry.

But this rallying cry ignores the ways in which more regulation can make everyone safer, even if it comes at the cost of some personal liberty.

The Wisconsin State Journal reported that this year, following the lead of other local hospitals, such as Saint Mary’s, University of Wisconsin Health and Stoughton Hospital will make vaccinations against influenza mandatory for all their employees. As Dr. Nasia Safdar, head of infection control for UW Hospital, put it, “It’s a patient safety issue. … Why be satisfied with anything less than the ideal?”

Now there’s an argument to be made that mandatory requirements for vaccination, even with exceptions for religious or medical reasons, violate the personal autonomy that we accord to all citizens in the United States. As SEIU Healthcare Wisconsin — the organization that represents most nurses and therapists in the UW System — stated succinctly, “We support flu shots, but we don’t think they should be mandatory.”

While personal autonomy must be respected, there is more than enough justification for health providers to implement a policy of required vaccinations. When you consider the fact a single carrier of the flu virus could pass it on to a patient or co-worker, who could pass it off again, setting off a chain reaction of viral infection, the 85 percent vaccination rate at the UW hospitals last year seems precariously low. With mandatory inoculations, Safdar said she expects those numbers to jump up by about 10 points, putting UW in the more comfortable 95- to-98 percent immunized range.

Safdar is hardly alone. More doctors are recognizing the need for rudimentary regulations that can improve health care outcomes immensely.

Atul Gawande, a surgeon at a Boston-area hospital and an assistant professor at Harvard Medical School, introduced a mandatory checklist into his operating room a couple years ago and proceeded to spread it around his hospital. Checklist items included such basic instructions as “wash your hands” and questions like, “Is there enough blood on-hand in case of severe bleeding?”

When the doctors who had used the checklist were later polled, 94 percent indicated they would appreciate the use of the checklist if they themselves were undergoing a surgery. It appears the best defense against disaster is not fancy hardware or good fortune, but rather quality preparation and meticulously planned policies.

Nobody is perfect. But our society recognizes a doctor’s job is not like yours or mine. In an operating room, a mistake cannot be edited like words on a page or be re-done like a dish from a restaurant kitchen. Doctors know if they make mistakes people can die, and a large majority of them realize the role hospital policy can play in averting disaster.

We should all cherish our hard-won right to make our own choices. But sometimes, the best decision is to put yourself in a scenario where the paths have been chosen for you. And trust me, the flu sucks. Let’s all just get the shot.

Nathaniel Olson ([email protected]) is a senior majoring in political science, history and psychology.