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Requiring unimmunised nurses to wear masks in high 'flu season is backed in a Ministry of Health letter to district health board chief executives.  The letter also hints that voluntary immunisation may not work.

But when Nursing Review asked the Ministry whether this meant it endorsed Waikato District Health Board's controversial 'vaccinate or mask' (VOM) policy it declined to directly answer.

Instead in a written statement chief nurse Jane O'Malley said the Ministry supports DHBs in their efforts to raise the rate of influenza immunisation amongst staff.  "How they choose to do this is for each DHB to decide."

The strict implementation of Waikato's VOM policy last year saw three DHB staff suspended and saw six unions seek mediation after members talked of feeling bullied and co-erced by the policy. (See April 12 newsfeed article)

The Ministry letter, sent on March 7 by acting chief medical officer Andrew Simpson and chief nursing officer Jane O'Malley, named Waikato amongst five DHBs that had made "particularly impressive gains" last year in immunising their staff.

"Most DHBs are actively supporting all staff to be immunised and some are requiring unimmunised staff to wear masks during patient contact in high influenza season," says the letter.  "The Ministry supports these initiatives and notes that there has been recent research indicating voluntary immunisation is not sufficient to reach the highest levels of coverage. 

In the Ministry statement O'Malley said immunisation of health care workers was widely recommended by pubic health and while some DHBs had made real improvements others still had a long way to go.  She said the intention of the letter to DHB chief executives was to encourage DHBs to work with their staff to increase vaccination rates.

"DHBs should work with their staff who don't wish to be vaccinated on what other measures can be taken to reduce the risk of harm to patients and staff from the flu," said O'Malley.  "Other measures for consideration as part of a package of initiatives to reduce the risk of infection include staying at home when sick, consistent and mindful adherence to hand washing and the use of personal protective equipment where appropriate.  The priority remains protecting the health of patients and staff."

The Waikato VOM policy requires unimmunised staff to not only wear masks when caring for patients during the flu season but also when present in a clinical area.

Early last year the National Bipartite Action Group (NBAG) released guidelines for DHB vaccination policies that endorsed vaccination as the best protection available against influenza.

The joint guidelines were negotiated by unions and the 20 DHBs and set a new target of more than 85 per cent of staff receiving a 'flu shot each year. The parties also agreed that a "positive health message is more effective than negative, consequential or threatening messaging or activity" when promoting vaccination.