Mandatory vaccination laws include Alabama, Arkansas, California, and Kentucky. However, in these states, the laws include exemptions through which healthcare workers can abstain from vaccination due to religious or medical reasons (eg, Alabama and Kentucky); in California, healthcare workers can decline for any reason if the refusal is made in writing. The New York requirement is, to date, the most stringent among the states.

The American Medical Association does not support mandatory vaccinations, but "we strongly encourage all healthcare professionals to protect their patients, their families, and themselves from the harmful effects of the flu by getting vaccinated," Rebecca J. Patchin, MD, a member of the Board of Trustees of the American Medical Association, told Medscape Infectious Diseases.