Tacoma’s MultiCare toughens flu shot policy, making immunization mandatory for workers

Tacoma’s MultiCare Health System has made flu immunization mandatory for all employees, a firmer policy than past years that has resulted in at least one nurse being suspended from work and others deeply upset.

Unless a committee of managers approves a medical or religious exception, getting a flu vaccine is now required for anyone who works for MultiCare, Pierce County’s largest private employer. The policy applies to everyone, including volunteers and others who don’t provide direct medical care.

The Washington State Nurses Association, which represents about 1,500 nurses throughout MultiCare, tried last month to stop MultiCare from following through on the termination part of the policy by requesting a restraining order in Pierce County Superior Court. Judge Ronald Culpepper declined to issue one.

“WSNA knows of one nurse who is suspended from work pending her internal appeal of MultiCare’s denial of her exemption based on her deeply held belief,” Lillie Cridland, WSNA spokeswoman said Tuesday. “Several other nurses, faced with loss of their jobs, took the vaccine despite their personal beliefs or doctor’s recommendation.”

One of those nurses, Maria Vishoot, works at Tacoma General. She is allergic to eggs, and typical flu vaccines contain some egg proteins. MultiCare then required an alternative vaccination. In court documents, Vishoot described her dilemma.

“This is an impossible situation for me,” she wrote, describing herself as the primary breadwinner. “I am terrified of the implications that losing my job would entail. ... I feel I must do what’s best for now and choose the ‘lesser evil’ ” of the alternative medicine.

No regularly scheduled employees have been fired as a result of the new policy, MultiCare spokeswoman Marce Edwards said Wednesday. Of the system’s 10,000 employees, about 120 people have been granted exceptions, and a dozen requests are pending. Several employees are being allowed to work while wearing a mask while an exemption request is being evaluated, she said. Some on-call employees are off the work schedule because of a lack of compliance with the policy.

CHI Franciscan Health, the county’s second largest private employer, has a less stringent policy that allows employees to decline flu immunization but requires those who do to wear a mask “when working in clinical areas when the flu activity level is high,” spokesman Scott Thompson said. About 90 percent of Franciscan employees have been immunized, he said.

MultiCare’s policy, announced to employees in May, was scheduled for completion by Dec. 15. After that date, noncompliant employees could be fired. That’s the day the WSNA first went to court.

WSNA said Tuesday it continues to consider other legal strategies. It also has filed an unfair labor complaint with the National Labor Relations Board, contending MultiCare did not bargain new policy in good faith.


Before this flu season, MultiCare’s employees could choose to be vaccinated against the flu, or wear a mask for the duration of flu season. About 94 percent of employees were considered compliant with this policy, Edwards said. Now, the compliance rate is 99.9 percent, she said. Those who have been granted exceptions are considered compliant with the policy.

“The flu vaccine is the most effective way to protect our patients and our health care workers from this virus,” she said in an email. “Health care workers who receive the influenza vaccination help prevent the spread in our community.”

State and federal health officials agree, even though this year’s flu vaccine is mismatched to the strain of virus that’s become dominant in the United States. Regardless, the vaccine significantly reduces both the number of people infected and the severity of those who get sick each year. Flu kills thousands of people each year, though exact numbers are impossible to tally.

Washington state does not require health care workers to be immunized. Policies of mandatory vaccination almost always face some push-back from employees regardless of the scientific rationale, said Paul Throne of the Washington State Department of Health.

“There’s an objection to being told what to do,” he said. “They don’t want to be told to take a medication. Many people who would be willing to do it take umbrage in being told that they don’t have a choice.”

The state doesn’t track how many health care workers are immunized against the flu, how many refuse, or what each hospital system’s policy is.

Many health care systems across the country mandate flu vaccine for its workers. Seattle’s Virginia Mason hospital was the first in the country to have such a policy, which was fully implemented in 2005.

“People are used to it now,” said Beverly Hagar, supervisor of employee health at Virginia Mason. Compliance there is over 99 percent, she said.


In its request for a restraining order, the WSNA said MultiCare was violating the state’s anti-discrimination law by not allowing some nurses to use a medically acceptable alternative — wearing a mask — to avoid taking a vaccination for medical reasons. MultiCare said exceptions to the vaccine requirement will be offered “for medical conditions that meet the ( federal Centers for Disease Control) contraindications for immunization.”

Some employees’ trouble lies in the gap between definitions. The CDC says the only “contraindication” — a condition that increases the risk of a severe reaction — for immunization is a history of severe allergic reaction. In other words, an allergic reaction that could kill a person. Other less-severe but very unpleasant reactions to vaccines don’t qualify, MultiCare contends.

A MultiCare employee who works at one of the hospitals in an administrative role, who did not want her name used for fear of losing her job, said she had a reaction to a flu shot several decades ago that resulted in trouble breathing and vomiting. Her doctor then advised her to not get a flu shot in the future, and she hasn’t since. So far she’s been denied an exception.

Vishoot, the nurse with the egg allergy, was told to take FluBlok. It was approved in 2013 and does not contain egg.

Ultimately she took FluBlok in early December, but was distressed by it because she believes it’s not intended for people over age 49. The Food and Drug Administration indicates only that it hasn’t studied the drug as thoroughly in people over age 49, but it’s approved for everyone over 18.

“As I cannot risk losing my job, I will be taking the FluBok vaccine despite my doctor’s instructions,” Vishoot wrote. “My husband and I prayed that God would neutralize the effects of this vaccine. So far, He has answered our prayers.”