Print Page   |   Sign In
ONA's Position on Seasonal Influenza Vaccination for Health Care Workers

ONA Position Statement

The Oregon Nurses Association (ONA) believes that all nurses and other health care workers should be vaccinated against seasonal influenza. Vaccination is a key method of protecting health care workers from influenza and helping to prevent the spread of influenza among patients and the public.

Recent flu seasons and the previous threat of an H1N1 pandemic have caused policy makers to focus on programs to protect Oregonians. Individual health care facilities have implemented a variety of procedures and policies related to influenza vaccinations for health care workers that have achieved varying degrees of success; these policies have had a range of implications for employees.  As Oregon’s largest group of health care professionals, nurses have seen and experienced the best and worst of this piecemeal approach to vaccinations, and are striving to propose an evidence-based, common sense solution that protects health care workers and the patients they serve.

Seasonal Influenza Vaccination for Health Care Workers

ONA actively promotes vaccination to become immunized within the nursing profession and provides education and information to Oregon’s nursing professionals and student nurses to assist them in making informed choices about receiving annual influenza vaccines. ONA opposes requiring influenza vaccinations of nurses and other health care workers as a condition of employment. Rather, education and access to vaccinations, when combined with other methods to prevent influenza transmission, are sufficient and effective in protecting patients and workers.

ONA advocates the following:

Education Campaign

All licensed health care facilities in the state should implement a health care worker education and immunization campaign to raise awareness of the importance of vaccination as a method of preventing the spread of influenza. This campaign should include:

  • The provision of standardized informational materials related to the influenza vaccine and associated risks and benefits to new and existing staff as well as visitors, vendors, contract personnel, students and volunteers.
  • Provision of convenient access to influenza vaccinations for their workforce (for example, making vaccinations available on every shift within a unit or department, providing vaccinations 24-7 at an onsite clinic or disseminating information about local clinic locations).
  • Education about all other available prevention methods such as hand hygiene, respiratory hygiene and cough etiquette, and follow national and state public health guidelines for influenza prevention.

Protected Health Information

Vaccination status of nurses and health care workers should be protected health information, as it is for facility patients. Any requirement for health care workers to identify their vaccination status, including compulsory use of badges or stickers, mandatory masking and other methods, violates the confidential nature of health information. No health care facility in the state should make influenza vaccination a condition of employment or take punitive or discriminatory measures against workers who decide to exercise their right to not be vaccinated.

Policies designed to prevent influenza transmission must be based on scientific evidence and research. Attempts by health care facilities to require health care workers to wear face masks or similar apparatus as a general measure for preventing influenza transmission have not proven to be effective, particularly when used on otherwise asymptomatic people. This does not impact the CDC recommendations or statutory requirements for the use of face masks or other respiratory protection such as N95 respirators in other specific required circumstances when there is potential exposure to patients with suspected or confirmed influenza.

Standardized Declination

All health care workers must be provided access to a standardized immunization declination form using language similar to that found in the Center for Disease Control (CDC) forms and includes a standardized ‘check box’ that identifies reasons for declining the vaccine.

These declination forms must be maintained in employee health files separate from personnel files and must be treated as a confidential medical record according to applicable state and federal law.

Data Collection

Evaluation of declination forms, including vaccination rates and rationale for non-participation, may be conducted by employee health staff and these findings may be de-identified and reported in aggregate form to the organization’s administration to assist in developing strategies for improving vaccination rates.

Each health care facility is expected to report aggregate information to the Oregon Health Authority.

Appropriate Sick Leave Policies

Health care facilities will monitor and manage ill health care workers as recommended by the CDC including implementation of sick leave policies that are non-punitive, flexible and consistent with public health guidance to allow and encourage health care workers with suspected or confirmed influenza to stay home. Non-punitive sick leave policies would not include any specified maximum absence for suspected or confirmed influenza illness.


Licensed Health Care Facilities – Includes hospitals, ambulatory surgical centers, long term care facilities, skilled nursing facilities, rehabilitation centers and outpatient clinics, home health care agencies, and emergency medical services

Health Care Workers – Includes all paid and unpaid persons working in health care settings who have the potential for exposure to patients, the patient environment and/or to infectious materials.

This includes (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, students and trainees, contractual staff not employed by the health care facility, and persons not directly involved in patient care (e.g., clerical, administration, dietary, house-keeping, laundry, security, maintenance, and volunteers) but potentially exposed to infectious agents that can be transmitted to and from health care workers and patients.


 For more information visit ONA's Seasonal Influenza and Flu Vaccination Center

Privacy Policy

Oregon Nurses Association
18765 SW Boones Ferry Rd. Suite 200, Tualatin, OR 97062
(503) 293-0011 or 800-634-3552 (Oregon Only)