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As many states focus the start of H1N1 influenza virus vaccination efforts on health care workers, those are increasingly mounting objections to vaccine mandates in a growing number of facilities, as well as in New York State, ABC News reports. Although the Centers for Disease Control and Prevention (CDC) has assured Americans that the H1N1 vaccine is safe and effective, and a poll conducted by C.S. Mott Children's Hospital in August shows that 87 percent of U.S. adults support the requirement and expect health care workers to be vaccinated, current rates for voluntary vaccination among health care workers average approximately 50 percent. To increase this rate, many hospitals and health systems are making vaccination compulsory. In addition, the state of New York became the first to mandate that all health care workers who interact with patients receive the H1N1 vaccine or face job loss. According to ABC News, hundreds of people recently gathered in the state's capital to protest the state regulation making both the H1N1 and seasonal flu vaccines required for state health care workers, prompting the state's health commissioner to issue an open letter saying "high rates of staff immunity can only be achieved with mandatory influenza vaccination." Meanwhile, the California Nurses Association and the National Nurses Organizing Committee (CNA/NNOC) has issued a formal opposition to the H1N1 vaccine mandate, citing the individual right of each nurse to refuse vaccination for personal reasons. CNA's president adds that the flu vaccine may provide a "false sense of security," as its efficacy ranges from 60 percent to 90 percent. However, a law professor from Drexel University in Philadelphia casts doubt on the right of health care workers to object to vaccine mandates, noting that in most states, employers possess the right to require vaccination unless there is a specific exception in the contract (Cox, ABC News, 10/2/09; Fox, Reuters, 10/6/09; AHA News Now, 10/6/09; AHA News Now, 10/6/09).