As Maine battles the COVID-19 pandemic, the Maine Center for Disease Control and Prevention is proposing a new rule that would require health care workers to get a seasonal flu shot in addition to other mandatory vaccinations.

But the proposal, which aims to boost immunity in health care settings to protect workers and patients, ran into opposition from some nurses who argued during a public hearing Monday that they should get to choose whether to be immunized for the flu.

Rebecca Begin believes many health care workers will quit rather than take the flu vaccine.

“Free will cannot be taken away from health care workers,” said Begin, a nurse. “This move will be a tipping point to many leaving the health care workforce.”

Malissa Wildes holds a dose of this year’s flu shot at Maine Medical Partners – Pediatrics in September. Brianna Soukup/Staff Photographer

Cokie Giles, president of the Maine State Nurses Association, said the union supports flu vaccinations but not the state rule making them mandatory, and that employees should still be able to choose whether to get the shot.

But another nurse, Brandie Rubin, said health employees have an ethical duty to protect their patients, and getting the flu shot is one of those duties.

The Maine CDC already requires health care workers to be immunized for measles, mumps, rubella, varicella and hepatitis B. Influenza would be added to the list if the agency approves the rule. Maine would join at least nine other states, including Massachusetts, Rhode Island and New York, that mandate flu vaccinations for health care workers, according to the U.S. Centers for Disease Control and Prevention.

Dr. Nirav Shah, director of the Maine CDC, said at a media briefing on COVID-19 cases Monday that having more people immunized for influenza is “good public health practice.”

“Every health care worker we can keep healthy and not affected by flu is a health care worker that can take care of COVID-19 patients and other patients as we go into the winter months,” Shah said.

MaineHealth, the parent company of Maine Medical Center in Portland and a network of hospitals and health care services in Maine, required the flu shot for its 23,000 employees this year after having it be voluntary in previous years. Public health experts have emphasized the importance of the flu vaccine during the pandemic to avoid hospitals becoming overwhelmed with flu and COVID-19 patients at the same time.

Cara Sacks, spokeswoman for Mainers for Health and Parental Rights, a group that led an unsuccessful campaign to overturn a new Maine law that eliminated religious and philosophical opt-outs to school-required vaccines, said the Maine CDC is overstepping its authority.

“Maine CDC has the authority to make rules within the process of implementing existing laws. However, this proposed rule change abuses that authority and usurps the role of the Legislature by blatantly attempting to create new law under the guise of a rule change,” Sacks said in a statement.

Caitlin Gilmet, spokeswoman for Maine Families for Vaccines, which supported the school vaccine requirements, said that the “flu vaccine plays an important role” in public health.

“We trust the experts that are recommending this measure,” Gilmet said.

The proposed rule change could also pave the way for mandatory immunization of health care employees for COVID-19. But Shah said that it’s “too early to predict” whether the new flu rule, which could go into effect early in 2021, would apply to the COVID-19 vaccines.

“Our focus is on the logistics and rollout of the new COVID-19 vaccines,” Shah said.

Some health care workers could start receiving COVID-19 vaccinations as early as December, as two vaccines are in late stages of development and could be approved for emergency use by the FDA at a Dec. 10 meeting.

COVID-19 is surging in Maine and throughout the country this fall. Hospitalizations have also increased, and Maine currently has 103 people hospitalized.

The proposed new Maine CDC rule says that “in the event of a public health emergency or extreme public health emergency declared by the governor, the department may impose control measures” for health care workers “including, but not limited to, mass vaccinations and exclusions from the workforce.”

Dan Morin, spokesman for the Maine Medical Association, a group that represents doctors before the Maine Legislature, said that “there’s no question that reduced rates of healthcare-associated influenza improves patient safety, and health care worker seasonal flu mandates work.”

“We support mandating the seasonal flu vaccine for health care workers,” Morin said.

But Morin also said that because COVID-19 vaccines are new, even if an emergency use is approved for the vaccines in December, “we are not yet at the point where we have convincing evidence to make recommendations for a mandate (of the COVID-19 vaccine).