Content analysis of requests for religious exemptions from a mandatory influenza vaccination program for healthcare personnel

Antommaria, Armand H
Prows, Cynthia A

¹ Ethics Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
² Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
³ Division of Patient Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

Dr Armand H Antommaria, Ethics Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA; [email protected]

Received March 16, 2017

Received in revised form January 24, 2018

Accepted February 06, 2018

Journal of Medical Ethics 44(6):p 389-391, June 2018. | DOI: 10.1136/medethics-2017-104271

Objective

Having failed to achieve adequate influenza vaccination rates among employees through voluntary programmes, healthcare organisations have adopted mandatory ones. Some programmes permit religious exemptions, but little is known about who requests religious objections or why.

Methods

Content analysis of applications for religious exemptions from influenza vaccination at a free-standing children’s hospital in Cincinnati, Ohio, USA during the 2014–2015 influenza season.

Results

Twelve of 15 260 (0.08%) employees submitted applications requesting religious exemptions. Requestors included both clinical and non-clinical employees. All requestors voluntarily identified their religious affiliation, and most were Christian (n=9). Content analysis identified six categories of reasons used to justify an exemption: risks/benefits, ethical/political, lack of direct patient contact, providence, purity and sanctity of life. Individuals articulated reasons in 1–5 (mean 2.6) categories. The most frequently cited category (n=9) was purity; the vaccine and/or its mode of administration were impure, or receiving the vaccine would make the individual impure. Two individuals asserted that the vaccine contained cells derived from aborted human fetuses. Individuals (n=6) also volunteered information supporting the sincerity of their beliefs including distress over previous vaccination and examples of behaviour consistent with their specific objection or their general religious commitment. All requests were approved.

Conclusions

Less than 0.1% of employees requested religious exemptions. Partnering with religious leaders and carefully correcting erroneous information may help address requestors’ concerns.