Workers fired, but where did the guidance to fire them come from?

What is up with firing workers who don't get vaccinated for flu?  Indiana's Goshen Hospital just fired 8 workers for refusing the shots.  

Hospital spokeswoman Melanie McDonald told The Elkhart Truth the new requirements came as a recommendation from the U.S. Centers for Disease Control and Prevention, the American Medical Association and other major health agencies.

Did they really recommend firing refusers?  Of course not.  Not officially.  The actual ACIP / CDC recommendation is the following:

The most effective combination of approaches for achieving high influenza vaccination coverage among HCP likely varies by institution. Hospitals and health-care organizations in the United States traditionally have employed an immunization strategy that includes one or more of the following components: education about influenza, easy access to vaccine, incentives to encourage immunization, organized campaigns, institution of declination policies, and legislative and regulatory efforts (e.g., vaccination requirements)

 The latest AMA Code of Ethics (2011) states:

As professionals committed to promoting the welfare of individual patients and the health of the public and to safeguarding their own and their colleagues’ well-being, physicians have an ethical responsibility to take appropriate measures to prevent the spread of infectious disease in health care settings.  Conscientious participation in routine infection control practices, such as hand washing and respiratory precautions is a basic expectation of the profession.  In some situations, however, routine infection control is not sufficient to protect the interests of patients, the public, and fellow health care workers. 

In the context of a highly transmissible disease that poses significant medical risk for vulnerable patients or colleagues, or threatens the availability of the health care workforce, particularly a disease that has potential to become epidemic or pandemic, and for which there is an available, safe, and effective vaccine, physicians have an obligation to: 

(a) Accept immunization absent a recognized medical, religious, or philosophic reason to not be immunized. 

(b) Accept a decision of the medical staff leadership or health care institution, or other appropriate authority to adjust practice activities if not immunized (e.g., wear masks or refrain from direct patient care).  It may be appropriate in some circumstances to inform patients about immunization status. (I, II)

Issued June 2011 based on the report "Routine Universal Immunization of Physicians for Vaccine-Preventable Disease," adopted November 2010.