The flu shot reminders started in August this year at my hospital. “Flu shot season is approaching! Reminder: flu shots are mandatory for continued employment.” In my hospital system, and at thousands of others across the country, nurses are required to get flu shots every fall. The CDC strongly recommends that health care workers get vaccinated annually. “Since health care workers may care for or live with people at high risk for influenza-related complications, it is especially important for them to get vaccinated annually,” says the CDC. The CDC does not issue requirements for mandatory vaccines, but state laws can, and employers may require vaccinations.

For many health care workers, there are only two possible reasons you can avoid getting the flu vaccine:

• Medical exemption – if you are allergic to the ingredients in the flu vaccine, have had a serious reaction to a previous flu vaccine, or have another medical reason for not getting the vaccine, then you may be able to get a letter from your physician stating it is not medical advisable for you to get the flu shot. However, your health care facility may choose to reject such a letter. One such situation is reported to have happened to Deonna Breton, a pregnant registered nurse from Pennsylvania, who had a history of miscarriages. Deonna was fired after her hospital rejected her doctor’s letter stating she could not get the flu vaccine.
• Religious exemption – Some hospitals require a letter from a religious leader or a religious statement. There are examples of this being battled in court as well. Some attorneys argue that hospitals do not have to offer a religious exemption. Last summer, a New Jersey appeals court ruled that First Amendment protections allowing people to refuse medical procedures on religious grounds also extends to those opting out of treatment for secular reasons. That case allowed a nurse to get unemployment benefits after being fired for refusing to get the flu shot. Similar cases may have different outcomes in another state. For most hospitals, philosophical disagreement with the flu shot is not a valid argument.

If you get an exemption, you will typically be required to sign a declaration stating something along the lines of “consequences of my refusing to be vaccinated could endanger my health and the health of those with whom I have contact, including: patients in this healthcare facility, my coworkers, my family, and my community.” In other words, Typhoid Mary, are you sure about this decision?

While the argument can be made that last season’s flu shot was only minimally effective against the flu, there are plenty of statistics that show the flu is deadly to hundreds of people annually. Nurses know those statistics, though, and may be concerned about the possible risks of the flu vaccine as one reason not to get vaccinated. Others simply believe they have the right to self-determination when it comes to making medical decisions for themselves.

Nurses who refuse to get the flu vaccine may get fired, or in some cases, may be forced to wear masks, even if they have no direct patient contact. It can be difficult to know how many nurses refuse to get the vaccine, but there are 30,000 members of the Nurses Against Mandatory Vaccines Facebook Page. They also offer a private website and newsletter. You can find other supporters looking for these hashtags: #ShowMeYourMask  #MyBodyIsNotForSale #2PercentRule #HospitalsTellTheTruth  #FluVaccineDoesntWork #NoMandatoryFluJabs.

Your health care facility has its own rules regarding the flu injections for nurses. If you aren’t sure about the expectations regarding your place of employment, then speak to your human resources manager.