Could you be fired for refusing a flu shot?

Horizons Healthcare Services fired pregnant nurse Dreonna Breton for refusing a flu shot. Sounds harsh, right? But the flu is no laughing matter, and people who are receiving health services should expect to get better, not worse. The Center for Disease Controls (CDC) estimates that last year 381,000 Americans were hospitalized due to the flu. They also estimate that, even though only half of Americans receive a flu shot, 79,000 hospitalizations and 6.6 million illnesses were prevented by the vaccine.

Breton is a nurse and certainly had access to that information, as well as information that the CDC recommends that pregnant women receive a flu shot (but not the nasal version of the vaccine). But, she had had previous miscarriages and didn't want to take any chances. Certainly, that is her right. (Although, she needs to acknowledge that she's taking a chance in not getting a flu shot as well.)

But, her employer fired her. Breton says she has no desire to take legal action, but that's not necessarily even a choice, according to employment attorney Bryan Cavanaugh. He says:

From a workplace perspective, the employer can require its employees to get flu shots as a condition of employment. A couple of possible exceptions would be an employee's (1) religious objections to getting shots or vaccines, or (2) a disability that would render it dangerous to get shots or vaccines.  A religious objection or disability would not automatically exempt an employee from the requirement to get a flu shot, but it would start a dialogue and determination whether an accommodation existed short of forcing the employee to get the flu shot or be fired.

Does this mean that you could be fired for refusing the flu shot as well? For most of us, it's a moot point, as most employers don't require flu shots. While your boss would love it if you never had to take a sick day (which  most of us don't use enough -- 90 percent of us come to work when sick), most won't follow up with you to see if you got a shot. Some businesses make it easy to get flu shots by offering them onsite, while others never bring it up. But, if you're in healthcare it's a different story.

In healthcare settings with vaccination requirements, 96.5 percent of health care workers were vaccinated last year. That leaves just 3.5 percent who didn't -- which, undoubtedly, consists largely of those who have religious objections or disabilities that make getting the flu shot unwise. Overall, 72 percent of health care workers received the flu shot last year.

So, what if your employer wants you to get a flu shot and you don't want one? Are you stuck?

First of all, what are your reasons for not getting one? If it's for religious reasons, and your employer can "reasonably accommodate" your request, then you'll be off the hook. (What is reasonable differs from employer to employer and situation to situation.) If you have a disability or have had a bad reaction to the flu shot in the past, that's another issue where a reasonable accommodation comes into play.

But, if  neither of those situations apply, and your employer is enforcing the rule evenly across the board, you either need to roll up your sleeve or find a new job. (For instance, Attorney Cavanaugh warns that if Horizons Healthcare Services fired only Breton but allowed other, non-pregnant employees to keep their jobs without getting flu shots, then there would be legal trouble -- provided the other employees didn't have religious or disability objections. Then the firing would be because she was pregnant, and not because she refused the flu shot.)

So, in other words, your personal opinions regarding vaccines, and even if your personal physician backs you up, doesn't exempt you from an employer requirement for vaccinations. (Flu shots are not the only vaccines required in some workplaces.) If you feel strongly, then consider that when looking for a job. Most jobs don't require vaccinations, and not even all medical ones do.