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Flu shots mostly not mandatory

Young children and older people are particularly vulnerable to life-threatening complications if they get the flu. But the people who care for them in day care centers and nursing homes are not required to be immunized, in most cases.

Illinois doesn't require anyone to get flu shots, even in years like this when flu is widespread.

The state mandates health care employers offer influenza vaccinations to employees and keep track of who gets them. Many suburban hospitals report they require employees to get flu shots.

Several large long-term care and day care providers contacted by the Daily Herald “strongly recommend” flu shots and provide them to workers, but they don't require them. This winter Illinois has had 244 flu outbreaks in institutional settings such as nursing homes, schools, prisons or hospitals, reports the Illinois Department of Public Health.

People shed influenza virus a day before they start feeling symptoms, which means a health care or day care worker can expose someone without knowing it, said Dr. Jorge Parada, medical director of the infection prevention and control program at Loyola University Medical Center in Maywood.

Public health officials say flu shots not only protect those getting vaccinated, but also the people around them, including cancer patients or others with weakened immunity, babies under 6 months who aren't yet vaccinated, and elderly people for whom the flu vaccine can be less effective and the disease particularly dangerous.

Sixty-one percent of the 830 ICU admissions for flu this season have been among people 65 or older, the Illinois Department of Public Health reports.

Only eight states require health care workers to get flu shots: California, Colorado, Massachusetts, Nebraska, New Hampshire, New York, Rhode Island and Tennessee, with some exempting people for medical, philosophical or religious reasons, according to the Centers for Disease Control and Prevention.

Some local health care institutions, including hospitals, require employees to get the shots or face discipline, including being fired.

Loyola University Medical Center, which has about 8,000 workers, was one of the first to mandate flu shots in 2009. Employees who don't get a shot each year by the deadline in late fall are suspended without pay. They can apply for exemptions from the flu shot requirement, but medical claims require documentation, Parada said.

Loyola boasted this fall that more than 99 percent of its workers and volunteers were immunized.

Presence Health, Northwestern Medicine and Advocate Health Care also require the shots.

“To protect the safety of our patients and workforce, influenza vaccinations are mandatory for associates, physicians, volunteers, students and contracted services,” said Adam Mesirow, a spokesman for Advocate, which has about 37,000 workers.

Requiring flu shots can raise other issues, however. The Equal Employment Opportunity Commission has sued hospitals that refused to grant exemptions or make reasonable alternative accommodations (such as requiring them to wear a surgical mask near patients) for employees who objected based on religious beliefs. (Societal, political or economic beliefs are not protected.)

Several suburban day-care and long-term care providers report they push workers to get flu shots but don't require it.

“We encourage all of our teachers and staff members to stay up to date on all of their immunizations as recommended by state health and child-care licensing officials,” said Colleen Moran, spokesman for KinderCare Education, which has more than 1,300 facilities nationwide.

A 2015 law passed after a measles outbreak centered at a Palatine day care center sickened 15 children requires day care workers to be immunized against measles, tetanus, diphtheria and pertussis.

“We strongly encourage all team members to get a flu shot,” said Richelle Keas, spokeswoman for Sunrise Senior Living, which has 18 facilities in Chicago and the suburbs. The company gives flu shots for free at an on-site clinic or pays for employees to get them at a pharmacy.

Brookdale Senior Living, which has facilities nationwide including many in the suburbs, also encourages workers to get vaccinated and provides shots for free.

“We take all necessary precautions for the health and well-being of both our residents and associates, and we try our best to minimize the spread of an illness through education, even before flu season begins. This includes providing information on the vaccine, reminders on protocols in case of the flu and actions to take to prevent illness,” said spokeswoman Heather Hunter.

If there is a flu case on site, facilities activate a plan that includes closing the dining room and serving meals to residents in their apartments and suspending group activities and transportation outside the residences.

• Daily Herald staff writer Russell Lissau contributed to this report.

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Dr. Jorge Parada, medical director of infection prevention and control at Loyola University Medical Center, favors requiring health care workers to be immunized against influenza.
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