Is B.C.’s flu-shot-or-mask policy for hospital visitors going too far?

Steve Mertl
National Affairs Contributor
Daily Brew
A woman wearing a face mask bicycles on a road in Beijing Tuesday, Oct. 22, 2013. Beijing is seeking to tame its smog emergencies by preparing emergency measures such as factory shutdowns and traffic limits to kick in when air pollution levels are high. (AP Photo/Andy Wong)

I finally got my flu shot just yesterday; walked into a local chain drugstore and had the needle within five minutes. It was free because my wife has a chronic illness. I do it every year and think nothing of it.

A good thing, too, because now I won't have to wear a surgical mask when I visit my mum at her assisted-living home.

A new policy that took effect Monday requires anyone in British Columbia who's visiting a hospital, long-term care home or other health facility to have either an influenza vaccination or wear a mask.

"Every year we have outbreaks, particularly in long-term care homes," Dr. Bonnie Henry, director of public health emergency management with the British Columbia Centre for Disease Control, told CBC News.

"Influenza can be really devastating for people in hospitals — people who are suffering from other illnesses and trying to recover, when their immune systems aren't working that well."

[ Related: B.C. policy requiring health-care workers to get flu shot or wear masks upheld ]

The B.C. Health Ministry's bulletin on the measure said it's part of the province's strategy to prevent the spread of the flu and protect vulnerable patients.

"The best way for visitors to help protect their loved ones in hospitals, long-term care facilities and other health-care facilities is to get vaccinated," the bulletin says.

However, no one will be demanding to see a vaccination card when you walk through the door.

"All health authorities will rely on the honour system to monitor visitor compliance with this policy," the bulletin says.

British Columbia has been among the most aggressive provinces in promoting flu immunization, making the vaccine easily available through doctors, nurses, pharmacists and other licensed practitioners.

That may be why in 2011, B.C. had the highest vaccination rate in Canada – 52 per cent, compared with bottom-ranked Quebec's 27 per cent, according to survey's done for the B.C. and Quebec Lung Associations. The province also had among the lowest percentage of self-reported flu cases, according to CBC News.

All B.C. health care workers already have to get a flu shot or mask up during flu season under a policy that took effect in 2012.

Unionized health workers challenged the requirement as an infringement on individual choice, but a B.C. Labour Relations Board arbitrator upheld the policy in a ruling last month.

Officials said they expect that extending the policy to hospital and care-home visitors will meet some initial resistance.

"Lots of people don't like change and this is change, but the reality is, with lots of good education the vast majority of people [adjust their behaviour]," Dr. Paul Hasselback, Vancouver Island Health Authority medical health officer, told the Nanaimo Daily News last week.

[ Related: Quebec public health launches flu shot campaign ]

British Columbia isn't the only place taking this approach.

Hospitals in London, Ont., are also instituting the shot-or-mask policy this year as well, according to London Community News.

Other health-care authorities will surely be watching what impact these policies have on flu rates in their facilities.

Influenza kills between 2,000 and 8,000 people in Canada each year, mostly the elderly and those with weak immune systems, said Henry.

Statistics Canada data for 2000 and 2009 show that it was the eighth leading cause of death (cancer was first).

We got a taste of the wear-a-mask approach during the SARS epidemic in Toronto, Ont., a decade ago, when anyone entering a hospital was required to mask up.

But there's sustained opposition to the efficacy the shot-or-mask policy as a way of minimizing the flu threat. Some people insist it's their right not to have a shot, whether out of concern about side effects or because they don't think it helps.

B.C. political commentator Bill Tieleman wrote a column in The Tyee last month suggesting the approaches don't actually work anyway.

"Dubious scientific evidence, heavy-handed government intervention, high costs for low results, healthcare professionals' opposition and an intrusion on personal freedom all add up to one conclusion: 'mandatory flu shots or else' is just plain wrong," Tieleman, a former NDP operative, concluded.

I have to wonder, too, how patients will feel having to interact with unvaccinated loved ones through the impersonality of a surgical mask.

It'll take a couple of years to demonstrate whether or not the B.C. policy has any impact on flu deaths in hospitals and care homes. Stay tuned.