"It gives you a false sense of security that you're vaccinated against three viruses that cause the flu. There are hundreds of viruses that cause flu-like symptoms," Burger said. "The vaccine itself is anywhere from 60-90 percent effective."
However, the chief medical officer of HCA, Dr. Jonathan B. Perlin, said the company chose to mandate the flu vaccine because of compelling studies that showed it saved lives and kept health care workers well and at work. More than 120,000 HCA employees will be offered a free vaccine or can go get a free vaccine at CVS before the end of the month.
"The reason is really straightforward: a woman shouldn't come into a hospital to deliver a baby and leave with the flu," said Perlin.
"When you achieve that perfect level of vaccination, there is a 40 percent reduction in death from the flu among patients," he added. Perlin said having 100 percent vaccination can also reduce sick days among health care workers by 41 percent, citing statistics gleaned from several studies over the past 10 years.
The HCA is not alone in their decision. Hospitals across the nation from the Virginia Mason Health System in Seattle, to the Loyola University Health System in Chicago, BJC health Care in Missouri, Emory in Atlanta, and the University of Pennsylvania and the University of Maryland have implemented flu vaccine mandates this year.
The penalties for employees who refuse vary from dismissal, to the requirement of wearing a surgical mask for the whole of flu season.
"Legally, in most states, employers do have that right… unless there's a specific exception in a contract," said Field. "You could also say that if you have chosen to work in the health care field, you have chosen to put yourself in a position where you can affect the lives and health of many others."
Opponents of the mandates also cite the rushed safety trials of the H1N1 vaccine as cause for concern, and that nurses and other health care workers should have a right to refuse the new vaccine for that reason.
In response to the New York state vaccine mandate, the New York State Public Employees Federation (PEF) released a statement stating "vaccination for influenza is not as effective in the control of disease as vaccination for diseases such as polio, measles, and mumps. The safety of the H1N1 vaccine has not been as thoroughly established."
Field acknowledged that the H1N1 vaccine was manufactured and tested quickly over the summer, but the rush didn't concern him.
"H1N1 has gone through a much faster testing process than others because the time frame is so much less so we don't have as much of a data trail to support it," said Field. "But what we've seen so far clearly demonstrates effectiveness."
Field also pointed out that seasonal flu vaccines have had a good track record since 1976, when a number of people reported symptoms of an autoimmune reaction called Guillain-Barré. The reaction attacks the person's nerves and can lead to paralysis.
"The fear with vaccines often relates back to the 1976 scare of Guillain-Barré syndrome," said Field. "But even though it was associated with the flu vaccine, it was extremely rare."