news-record.com

When people quit their jobs rather than submit to a flu shot, it's evident they have a serious objection.

Do they have a legal case?

This fundamental question of rights versus responsibilities hasn't really been tested, but it could be as health systems and other employers require workers to receive vaccinations against H1N1 and even the seasonal flu.

Three employees of Moses Cone Health System resigned last week rather than comply with a mandate to get seasonal flu shots. Some 8,500 other employees and volunteers complied.

Moses Cone also is requiring H1N1, or swine flu, vaccinations as the vaccine becomes available. It has set a priority list that begins with pregnant women, then goes to neonatal intensive care unit staff, pediatric staff, other staff at The Women's Hospital, respiratory therapists, emergency department personnel and intensive care unit staff.

That's a sensible progression and a good policy aimed at protecting patients and employees. But the fact is that some people don't want to be protected, or fear the vaccination more than the disease. That's irrational, perhaps, but part of human nature.

To what extent people, even in the health care industry, have a right to refuse is a matter for debate and eventually court rulings.

Some legal experts warn that employers must demonstrate a compelling reason to require vaccinations. That's no problem when the employee is a neonatal nurse or someone else who comes into frequent, close contact with patients -- or even casual contact. It's more difficult to make the case for a clerical worker or groundskeeper who never gets within sneezing distance of a patient.

School is another setting where flu can spread rapidly. Schools require immunizations for several communicable diseases but not flu. Should they? If all students, teachers and staff were vaccinated, the chance of a major outbreak throughout society would be substantially reduced. Yet, a national survey found only 40 percent of parents plan to have their children vaccinated. That number will rise as the flu spreads, but it indicates there likely would be resistance to a program of mandatory immunization.

Often, public health concerns are too important to let individuals make unwise choices that can increase everyone's exposure to infection. Widespread H1N1 could trigger a national emergency if it keeps millions out of work or forces many schools to close, and especially if hospitals are severely affected. Unfortunately, slow-to-arrive supplies of H1N1 vaccine could undermine plans to protect the population.

It makes sense to administer vaccine to as many people as possible as quickly as possible, particularly people in critical occupations, as well as populations most at risk.

Requiring vaccinations, though, raises difficult issues. When does obligation to the greater good outweigh an individual's right to refuse what's good for him? It's time to find out.