Authors from Brigham and Women’s Hospital and Harvard Medical school say the case for mandating SARS-CoV-2 vaccination among health care workers is substantially stronger than the case for mandating influenza vaccination, which has become widely accepted. The authors detail the many reasons for mandatory vaccination and strategies for gaining employee acceptance in a commentary published in Annals of Internal Medicine.

Organizations that are contemplating mandating SARS-CoV-2 vaccines may be reluctant to move forward while the vaccines remain under emergency use authorization. Some are concerned about legal challenges. They also must overcome various reasons for vaccine hesitancy among employees who have not yet been vaccinated. These health care workers may be persuaded to change their minds if the argument for vaccination were sufficiently clear.

Like the influenza vaccine, mandatory SARS-CoV-2 vaccination is intended to protect patients from health care-acquired infection and to protect the workplace from the disruption and expense of worker illness. This is important because SARS-CoV-2 infection is far deadlier than influenza, with a mortality rate of 1 in 100 to 250 compared to about 1 in 1,000 for influenza. Vaccines are extremely effective at decreasing infections overall, severe disease in particular, and transmission. They are therefore very effective instruments to both keep workers safe and decrease the likelihood that patients will get infected when they come for health care. Health care workers should be reassured that the benefits of vaccination outweigh safety concerns and other reasons they may object to vaccination, including fear of postvaccine side effects, concerns about fetal safety, philosophical disagreement, and perceived invulnerability to serious infection.

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