The issue of mandatory vaccination for healthcare workers in Europe

Abstract

Mandatory policies have occasionally been implemented, targeting optimal vaccination uptake among healthcare workers (HCWs). Herein, we analyze the existing recommendations in European countries and discuss the feasibility of implementing mandatory vaccination for HCWs. As reflected by a survey among vaccine experts from 29 European countries, guidelines on HCW vaccination were issued in all countries, though with substantial differences in targeted diseases, HCW groups and type of recommendation. Mandatory policies were only exceptionally implemented. Results from a second survey suggested that such policies would not become easily adopted, and recommendations might work better if focusing on specific HCW groups and appropriate diseases such as hepatitis B, influenza and measles. In conclusion, guidelines for HCW vaccination, but not mandatory policies, are widely adopted in Europe. Recommendations targeting specific HCW groups and diseases might be better accepted and facilitate higher vaccine uptake than policies vaguely targeting all HCW groups.

Keywords::

• Europe
• healthcare workers
• mandatory vaccination
• policies
• vaccine recommendations

Financial & competing interests disclosure

E Galanakis was at the ECDC on Sabbatical from the University of Crete, Greece. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Our findings from two surveys are consistent with those previously reported, showing that mandatory vaccination policies for healthcare workers (HCWs) in European countries have been rather uncommon up to date; in addition, our findings further suggest that mandatory policies may not be easily accepted in the close future.

• Nevertheless, a common European-wide policy on HCW vaccination, not necessarily mandatory, would substantially contribute to adequate levels of HCW vaccination.

• Recommendations for HCW vaccination should thoughtfully take into consideration recent epidemiological data, and both potential individual risks for specific HCW groups and the risk of patients in the healthcare setting; furthermore, monitoring system on vaccination uptake would be helpful.

• Vaccination recommendations tailored for distinct HCW groups and appropriate diseases seem to be more promising than implementation of broad vaccination policies for HCWs.