Hospitals nationwide are telling workers that refusing a flu vaccine will cost them their jobs, but some workers say it is a matter of patient rights and the choice is worth the price.  

At one Illinois health system, a "no shot, no job" policy requires workers to get vaccinated for the flu by Friday or face termination. As with many hospitals, the policy allows for religious or medical exemptions.

The system's CEO says the policy was adopted because hospitals have a responsibility to keep patients safe and prevent the spread of disease. Since implementing the policy, officials say the worker vaccination rate increased from 60% to 99.9%.

• Related: Hospitals fire staff for failing to get mandatory flu shots

According to the Chicago Tribune, health system officials say one nurse—Carrie Calhoun—may be the only employee in the five-hospital system to refuse the vaccination without obtaining a religious and medical exemption.

Although Calhoun has not had a flu shot in the 11 years she has worked for the health system, she says she supports flu vaccination. Instead, she says her decision not to vaccinate boils down to an "argument of patient safety over patient rights." She notes that patients have the right to refuse medical treatment under the Illinois Medical Patients Rights Act, and that hospital employees should have the same right to refuse flu shots.

"Something that I uphold and honor so deeply is being taken away from me," Calhoun says. She says that other hospital workers agree with her position, but have decided to comply with the policy. "Everybody is like, 'I believe in what you're saying, but I've got to feed the kids,'" she says.

However, public health officials argue that health care workers have a special responsibility to the public and that immunizations protect vulnerable patients from potentially deadly infections. According to CDC, higher vaccination rates translate to lower infection rates and some hospital-based outbreaks have even been traced to low immunization rates among staff.

• Related: Panel urges hospitals to 'strongly consider' flu shot mandates

Unions challenge vaccine requirement

According to the Chicago Tribune, unions have taken issue with vaccine requirements in the past. In 2009, New York unions protested the state's decision to mandate swine flu vaccines for all hospital workers, prompting state officials to back off the requirement. Meanwhile, unions in Washington won a federal ruling requiring a hospital to include flu shots in collective bargaining.  

Earlier this month in Rhode Island, Michael Fine—the state health director—announced a statewide policy requiring health care workers who have not had a flu shot to wear a surgical mask when treating patients.

Hours after the announcement, the SEIU Healthcare Employees Union District 1199 filed a lawsuit in federal District Court challenging the policy.

The suit argues that there is no evidence that vaccinations or surgical masks protect patients. As such, the suit alleges, the regulation illegally limits employees' rights to pursue their profession and violates a federal requirement to negotiate such issues with unions (McCoppin, Chicago Tribune , 12/9; Freyer, Providence Journal, 12/6, Freyer, Providence Journal, 12/6 [2]).