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Can a facility’s administration force nurses to take the flu vaccine? What are my rights?

Nurse attorney Nancy Brent, MS, JD, RN, addresses a nurse’s question about her right to choose whether or not to receive an influenza vaccination.


Dear Nancy,

I was wondering if a facility’s administration can force nurses to take the flu vaccine? What are my rights?


Nancy replies:

Dear Tracey,

Your question raises many legal and ethical issues that cannot be easily responded to in this column. However, some general comments can be made.

Ethically, when a nurse works with patients, it is generally supported by the nursing profession that those nurses should get the flu vaccine. Indeed, the American Nurses Association’s Code of Ethics for Nurses with Interpretive Statements clearly supports this throughout its many provisions, including Provision 3, which states, “The nurse promotes, advocates for and protects the rights, health and safety of patients.”

Not getting a flu shot can result in serious risk to patients, to co-workers and to yourself.

There are some individuals, including nurses, who opt out of taking the flu shot. The refusal is most often based on religion reasons, a medical reason or a philosophical objection to the flu vaccine.

However, there is controversy over whether flu shots should be voluntary or mandated among healthcare workers, including nurses. Although most states recommend that healthcare workers get flu vaccinations, only 21 states have a law that requires healthcare workers to get flu vaccinations and the law in states that require the vaccination vary based on healthcare settings, exemptions, types of workers and enforcement methods.

Likewise, many employers are mandating flu shots unless an established exemption is present. For those nurses who are members of a union, unions have fought mandatory flu shot requirements when a refusal results in a job termination.

Interestingly, the CDC has reported that for the final 2013-1014 flu season, flu vaccination coverage among healthcare workers was 75.2%. The highest coverage of healthcare workers where flu vaccination requirements were in place was 97.8%.

Ask your nurse administrators about your state’s laws in relation to the flu vaccination or find out from you state board of nursing. In addition, consulting with a nurse attorney or attorney in your state about your ability to refuse the mandatory requirement at your work place and its ramifications, would be a good idea.


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By | 2021-05-28T17:21:30-04:00 March 9th, 2015|Categories: Uncategorized|25 Comments

About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.


  1. Avatar
    Kim October 18, 2018 at 3:34 am - Reply

    Can you please list the 21 states that are legally requiring nurses to get the flu vaccine. I live in Colorado, which does require it, and I would love to move to a state that doesn’t. This is fundamentally a point of freedom. This country was founded on freedoms, and I for one would love to have the freedom again (I moved here from Texas) to say “No” to the flu shot. Even though our state allows for philosophical exemption of vaccines, our hospital tells us that we can not get a exemption from a philosophical or religious standpoint. And if you do get a medical exemption (the only one our hospital allows), you have to wear a mask all winter (through April). I don’t have a reason for a medical exemption, so I suck it up and take the vaccine. But I don’t want to for the rest of my career.

    • Avatar
      Gina N January 26, 2019 at 7:45 am - Reply

      You would seriously move to another state just to avoid having to take an annual flu shot for work?? Seriously??

      • Avatar
        mike March 9, 2019 at 3:27 pm - Reply

        will you agree to a political view to just to keep your job? Many Germans were against what Hitler and the Nazis did, yet they agreed to turn their eyes to stay alive.

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          Adam May 2, 2020 at 10:07 pm - Reply

          If you are so close minded that you equate mandatory vaccines, which are meant to protect the human race as a whole, to Nazis, who only wanted to propogate the perfect white race, then you are a complete idiot. Hypocratic oath should apply to nurses and not only doctors. You want to be a health care worker, but don’t want to protect society at large? Kindly commit senpoku.

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            Dustin December 17, 2020 at 4:28 pm

            I don’t think thats I idiotic statement, the idea of herd immunity was dirived from Nazi useless eater idea. Look it up if you don’t believe it. There is also a obvious concern that a flu vaccination is useless. Cochran foundation found as much in their reviews of the studies. The vaccine companies have convinced the hospitals that it helps nurses get over the flu faster which means less sick days.

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        Shanna May 17, 2020 at 9:55 pm - Reply

        Will you just comply with anything even if it is against your beliefs? I have never had a flu vaccine. I am 36. I have never had the flu. As a matter of fact I am never sick because I don’t abuse my immune systems by overloading it with unnecessary vaccines. I am not anti-vaccines, but I don’t take vaccines for viruses that attack RNA and replicate/mutate so quickly that they are not effective. My husband is an epidemiologist and used to push vaccines and now that he has more experience in the field he is seeing things he can’t turn a blind eye to and will never take another vaccine. Vaccines will eventually turn into population control and sense you appear to have such a narrow view hopefully you will continue to take them 🙂

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          Mary Jones December 17, 2020 at 12:44 pm - Reply

          i totally agree with what you (hence why the covid one scare the daylights out of me) have said including your last line. How do you avoid the mandatory vaccines if you work in a hospital

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          L Nicole January 25, 2021 at 12:19 am - Reply

          Shanna, what state do you all live in and can your husband help me to avoid having to get a flu shoot for my job? With my religious believes I don’t believe in vaccines, I was forced to get a vaccine in my early 20s I had never been sick the flu since I was nine years old. After I got that vaccine for the flu I was so sick I couldn’t get out of my bed. About to never get another flu shot. I’m in the process of trying to find another job and they are requiring that I take a flu shot in order to be hired. Plus they’re saying something about another vaccine if I’ve never had it that I have to get that too smh. I have a very healthy immune system I never get sick only thing I’ve ever had were headaches/migraines or tooth pain or monthly cramps. I have never believed in putting anything in my body that I could not get back out.

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            Lois Grissom February 17, 2021 at 9:03 pm

            If anyone refuses to get a vaccine regardless the reason it is their right
            JUST AS an employer has the right to make it a requirement to work there.
            Seems to me someone should decide what is more important.
            ALSO want to add to the person who asked what’s next COVID vaccinations!!
            My advice is if you want to work in healthcare you need to be willing to do what’s best for patients NOT YOU. Vaccines are well proven to be better than not and all we got. Sorry !

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          Lauren May 9, 2021 at 8:44 am - Reply

          What a perfect reply. I am an APRN working foe the federal gov in the VA and required for the first time last year to get the flu shot. Interesting that I think research may support that most Covid deaths occurred in those who had been flu vaccinated.
          I am wondering if their may be a relationship between Shringrix and Covid deaths in the elderly.

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      Laura January 18, 2021 at 6:29 pm - Reply

      Hi, I am a student and Soon this year I will start my clinicals. I am a Christian and I hate that the government is stripping away our Religious exemptions. I respect those who are willing to receive flu shots, but I also want the same respect towards people like me who do not trust it. Over the past years, I have heard the slogan “My body, my choice” Why can’t we have the choice to reject mandatory vaccinations. It is sad that I have to choose between my faith and my dream job.
      What can a nurse or a nurse student do to be exempt from these immunization shots?

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    Wanda December 7, 2018 at 11:34 am - Reply

    I would like to know the states that do not require the flu vaccine and if they have multi state licensure. I do not want the flu vaccine and respect those who do but I should not be forced to put something in my body I feel is harmful. Sadly these facilities that require us to wear mask just cause the patients to question if the flu vaccine is harmful when they ask why we are wearing the mask and we tell them we did not want to receive the flu vaccine.

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    Elsa Monroe January 15, 2019 at 6:40 am - Reply

    Give us the evidence base on vaccines being effective against the 2018-2019 Flu. How can anyone demand a person to get vaccinated without proof that this vaccination will prevent this year’s flu? Do these vaccinations come with the list of ingredients of the serum being injected? How many attenuated live viruses are in one vaccination? And if it’s a multi=dosage vial, what preservatives are in it? Mercury? Aluminum? Anti-freeze is normal used in Dilantin IM,

    I wish you would comment on the acceptance of vaccinated employees getting a Pass to come into work coughing and sneezing knowing that they will not be blamed or considered as a source of contaminating the herd without any evidence.

    Is it ethical for CDC to purchase millions of vaccinations from Big Pharma after accepting only pharmaceutical private studies without demanding another study by an independent research institution that is not economically vested in?

    Are the states that mandate Flu Vaccinations provide a full list of Vaccination Injuries and side effects at any time before administering the vaccinations or when doing a drive to recruit consumers for the Flu Vaccination?


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    pat johnson January 24, 2019 at 2:28 pm - Reply

    The flu vaccine might be just the beginning. What’s next – – the HPV vaccine, the shingles vaccine, etc. etc. etc.? How many more vaccines are in the pipeline? And since the CDC holds the patent on the flu vaccine, (and maybe others) that should raise a red flag.

    • Avatar
      Robert EV March 11, 2019 at 3:12 pm - Reply

      Could you please cite where the CDC holds a patent on any flu vaccine?

      And if so, why should anyone care, as the CDC is part of the US government, funded and controlled by US taxpayers and Congress.

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    Dorothy June 28, 2019 at 3:37 pm - Reply

    I am a nurse educator and am expected to sing praises of vaccines. Yet as autism and Alzheimer’s rates rise we are expected to believe it is caused by genetics and stress. Stress might be more like it. Stress from toxins! As we drink water contaminated with glycophates. Flu shots continue to contain mercury and aluminum. You cannot even sue the companies making the vaccines for damages. Research is not being done correcly or is hidden. Where is the research showing mandated vaccines have slowed the flu occurrences? I am at a loss to explain this irrational mandate to patients and students.

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      Nursurcher101 May 31, 2020 at 12:01 am - Reply

      HI. I’m a nurse working in Australia. The mandatory Flu Vaccination band wagon has only recently reached out shores with some states mandating the annnual Flu vaccination in high risk areas such as ICU, PICU, ED, Oncology and Age Care Nursing since 2018 and the State of Victoria mandating Flu Vaccination for all heathcare workers by law in May 2020.

      Personally I never had an issue with the other vaccinations as when weighing the risks vs benefits however I have a massive problem with vaccines against RNA virus with low to very low evidence of efficacy.

      I want to find out the stories of any RN’s in the USA who were sacked or decided to leave Nursing after the onset of Mandatory Flu vaccinations and what they did after. Happy to be contacted by any interested parties

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        Christi Wilson July 23, 2020 at 5:06 pm - Reply

        I haven’t been sacked but I’m a nurse who is in graduate school to receive my nurse practitioner license and I’m against the flu shot. They are about to force me to get the flu shot to continue in school. I’m now at the point to decide if I quit or I sue. It’s ridiculous that people are forced to put things in our bodies that we don’t agree with. And let me just say I’m not anti vaccine. I’m anti a vaccine that must be taken yearly and may not work.

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    Courtney July 10, 2019 at 10:42 pm - Reply

    Thank you for those nurses who have spoken up and spoken out. It is very refreshing to hear. Keep your rights.

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    connie wissbaum September 29, 2019 at 7:50 pm - Reply

    I would like to know how valid the research is behind the statement “Not getting a flu shot can result in serious risk to patients, to co-workers and to yourself.” There is no valid, reliable research behind that statement. Nor does the ANA statement in any way “force” nurses to take the flu vaccination that is rarely effective in preventing influenza. Some of the weak studies that were stating the influenza vaccine would prevent patients from contracting influenza from staff were based in nursing home residents that needed 24-hour care. They are one of the most vulnerable populations. NO single RN should be twisting the ANA Code of Ethics for Nurses with Interpretive Statements to match the agenda of pharmaceutical companies who have obviously won this fight using their marketing tactics. We, as nurses are sworn to do no harm, but we should have free choice where the inadequate influenza vaccine is concerned. I have taken care of many, many patients over the years with the diagnosis of influenza; and guess what…they had the shot. Keep standing up for what you believe, and please become educated over the topic before just giving in to what your organization and the pharmaceutical giants want.

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      Debi November 10, 2019 at 9:50 pm - Reply

      Connie thank you for your encouragement. I am amazed how many people just blindly ask for the flu shot because they have been told to do so without even finding out if all the fear tactics about the upcoming flu season have been substantiated. I also dont like being told that I have to get the shot or else wear a mask for 4 months.

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    Annue November 16, 2019 at 5:19 pm - Reply

    Question, I have a two yr contract as an RN case manager. I was hired with 2doctors stating medical reasons why I should not have vaccines. They agreed. Then this last July, changed policy. Yesterday was told, get the vaccine before Dec 2, or you will be volunteering to resign. Then they said, that they were not going to place me in another position that I would have to find one within primary care clinic myself and interview and possibly get hired. So, now I am without a job based upon discrimination of allergic reactions to vaccines. My career in nursing is over. Any ideas for a nursing career for a nurse without pt care. If companies are now firing nurses because they changed their policy at least they should place them someplace else. It should be the law. But, since “at will” state it allows them to treat us like garbage.

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    Dorothy May 27, 2020 at 9:39 am - Reply

    Let us talk about our immune systems. I remember having to allow my 8 month old daughter to have a fever, rather than treat her with antibiotics. She had had a fever every month starting at 2 months of age. She was anemic from the constant antibiotics. The doctor had no answers except to give her immunoglobulin. A human blood product for an 8 month old? Really?

    I went to my fellow nurse cohorts who were parents for advice. They said her immune system is immature and has to be allowed to activate. So, rather than use yet another invasive procedure to support her immune system I let her infection ride awhile. The fever cycle stopped and never returned.

    There are many ways to support and strengthen our immune systems. We experience herd immunity every time we go out. Otherwise we will ALL need our own personal bubble (hopefully with Oxygen versus rebreathing our own CO2[masks]). We will begin living like we are on the moon.

    FYI- my student nurses really task my immune system all the time. They do not get sleep, food, etc. They burn the candle at both ends, remember that? Rather than be sickly with them I have taken high C and B For years. Why are OTC and energy drinks full of this?

    There are MANY natural ways to support the immune system. They even give high dose IV vitamin C in the ICU along with early enteral feedings (food!) to critical patients to increase their survival. This is called progress in our understanding, something we were clueless about before.

    Apparently, 70% of the immune system is in the gut. We keep bypassing the MAIN IMMUNE SYSTEM constantly with poorly researched mandated immunizations. I am tired of being a research participant wo giving my permission.

    Nurses, do no harm to yourself. If that does not affect you; what about defenseless newborns who do NOT need Hep B shots yet! How about 5 immunization shots per visit for children with immature immune systems and immature brains?

    Do you realize the massive increase in numbers of immunizations for children? Did you know parents can no longer sue for disability/death for harm with immunizations? I do, I am a pediatric nurse and pediatric nurse educator for 4 decades which is why I am shockingly aware.

    Now the elderly are being asked to take more and more. Perhaps soon to be mandated like the nurse. If the flu vaccine only covers 10% of the current flu dt mutation, then why? A mask all shift? Rebreathing CO2? Is this mandated for doctors?

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    Harolyn Harris July 29, 2020 at 9:33 am - Reply

    My daughter is going to rn school to fi ish and the school just sent her paperwork to get a flu shot she is already working in a hospital as a nurses aide for 6 years a and weres a mask at flu season she does not want to take flu shot what can she do
    Clinical starts in the fall

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    MStar March 20, 2021 at 11:44 am - Reply

    Hello, the flu shot doesn’t work. When it became mandatory at my hospital, I watched as coworkers became sick after taking the vaccine. I haven’t had the flu for 30 years I had it once before after I took the flu shot at work. It was bad. The flu shot was not mandatory at that time. So I never took it again. When it became mandatory I’d get a letter from my allergy doctor to use for exemption. For all of you people who say, “Oh, we need to protect the patients. The health care workers are the ones making the patients sic with the flu.” That’s BS.

    Flu season comes and the people are the ones who bring the flu into the hospital. But now, since the mandatory flu shot the employees are increasingly sick now after taking the shot. None of the genesis are realizing this or care I might say. They just want 100 percent cooperation in the hospitals. I believe this was all orchestrated by the pharmaceutical companies. That shot doesn’t work.

    I was in the elevator one day I heard a nurse saying five of her nurses took the flu shot, now all five of them are out sick with the flu. How much more obvious can it be that this shot doesn’t help? They always start with healthcare workers. We are the guinea pigs. Because, if we want our jobs we can be made to take anything. I had to wear a mask for eight hours for six months of flu season. Which I thought was a bit over the top. I can see wearing it around the patient that’s what was done in the beginning, but then some genius got the idea to suffocate us all day. Therefore, I’m happy to say that I’m glad everyone have to wear a mask now. All day long everyday, everywhere. Now all the ones who talked so much crap about us not wanting to take the flu shot get to see how we felt about not being able to breath properly and getting dizzy and anxious wearing the mask all day. I’m happy

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