Hospital and other healthcare workers are at the front of the line to get the new swine flu vaccine, but many are resisting and even fighting vaccination requirements.

The U.S. Centers for Disease Control and Prevention cannot yet say how many are reluctant to have the shots because the campaign has just started. But the number may be significant given that only about 40 percent of U.S. healthcare workers ever get vaccinated against seasonal influenza.

A vaccination requirement sparked protests in New York this month, and already one lawyer has filed suit to allow staffers to opt out.

Healthcare workers, at high risk of infection with influenza, includingswine flu, were the first offered the vaccine against H1N1 in many states that have started vaccinating campaigns over the past two weeks.

It is extremely important that healthcare workers, as well as all hospital staff, get vaccinated for both H1N1 and seasonal flu, said Lynnae Mahaney, president of the American Society of Health-System Pharmacists.

Mahaney's organization surveyed pharmacy directors at 341 hospitals across the country and found only 37 percent could report vaccination rates of more than 70 percent at their hospitals.

That's too low, said Mahaney.

Healthcare workers such as nurses and technicians often have the same fears the general public has about vaccines -- are they tested, can they give you the flu and can they cause side-effects?

The CDC says these fears are based on myths, but doubts persist.

MANDATORY SHOTS

The Infectious Diseases Society of America has asked for all states to mandate vaccinations for healthcare workers.

Decades of scientific data demonstrate Food and Drug Administration-approved influenza vaccines to be safe, effective, and cost-saving, the group said in a statement.

But the U.S. Health and Human Services Department is stressing that the vaccination campaign is voluntary.

Hospital Corp. of America is requiring healthcare workers to get vaccinated, while MedStar, which operates hospitals in the Baltimore-Washington area, requires all staff, including clerical workers, to be immunized.

New York state requires healthcare workers to be vaccinated against flu, but this week attorney Patricia Finn of Piermont, New York, filed for a temporary restraining order against Health Commissioner Dr. Richard Daines.

Finn, whose practice specializes in clients who want to be exempt from vaccine requirements, said her suit represents 60,000 healthcare workers.

Last month some healthcare workers protested in the state capital, Albany. Let's unite to oppose mandatory H1N1 vaccinations, organizers wrote in a Facebook announcement.

British officials are battling similar resistance.

We all know that uptake of the seasonal flu vaccine among NHS staff is traditionally low, Ian Dalton, director of flu resilience at the National Health Service, wrote in a letter to chief executives and boards of hospitals quoted by the Guardian newspaper.

It is an NHS board responsibility that we do not find ourselves in this position with the swine flu vaccine.

Medicine