Ethical issues with vaccination for the obstetrician-gynecologist.

Because of the growing importance of infectious disease prevention in the individual patient and the larger community, it is vital that Fellows of the American College of Obstetricians and Gynecologists be prepared to navigate the practical and ethical challenges that come with vaccination. Health care professionals have an ethical obligation to keep their patients' best interests in mind by following evidence-based guidelines to encourage patients to be vaccinated and to be vaccinated themselves. College Fellows should counsel their patients about vaccination in an evidence-based manner that allows patients to make an informed decision about the use of these agents in their health care. The Centers for Disease Control and Prevention reports that no evi-dence exists of risk to the fetus from vaccinating pregnant women with noninfectious virus or bacterial vaccines or toxoids. Mandatory vaccination of health care professionals may be an ethically justified strategy in cases in which the harm to patients and the general population is believed to outweigh the autonomy of individual physicians.