The Rhode Island Department of Health (HEALTH) has announced that it has adopted new amendments to its Rules and Regulations for Immunization and Testing For Healthcare Workers that will make flu immunizations mandatory for all workers, students, trainees, and volunteers who may have routinely anticipated face-to-face interaction, also known as "direct contact," with patients at a healthcare facility. It is the first state in the country to adopt such a requirement.

"HEALTH listened closely to all stakeholders and used that feedback to craft amendments that addressed the concerns of healthcare workers and volunteers, while protecting patients from the threat of influenza," said Michael Fine, MD, director of HEALTH.

Healthcare workers and volunteers who have a medical reason for not getting a flu shot may obtain a medical exemption from their doctor, licensed physician's assistant, or licensed nurse practitioner. This exemption must be renewed annually and submitted to the employing facility by December 15 each year.

Healthcare workers and volunteers who are opposed to having a flu shot but are not medically exempt must submit a form annually by December 15 that states their refusal to be immunized against influenza and indicates their understanding that they are obligated to wear a surgical face mask during each routinely anticipated direct patient contact during any declared period in which the flu is widespread. That determination will be made by the Director of Health, and healthcare facilities will notify all workers that "a period in which flu is widespread" has been declared for the facility.

"Those who care for and interact with patients in a healthcare setting have a duty to protect the health and safety of those for whom they care," said Dr. Fine. "A flu shot for all those who interact with patients as part of their employment or volunteer efforts at a healthcare facility is the best way to prevent the spread of influenza to some of our state's most vulnerable populations."

These regulations do not apply to patient family members or to friends who visit or otherwise assist in the care of that patient in a healthcare facility.

The newly amended rules and regulations are available at http://sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/7083.pdf.

Editor’s note: According to media reports, nurses’ and other healthcare unions in the state have indicated they may challenge the regulation.