Should the H1N1 Vaccine be mandatory for Healthcare Professionals? - page 12

This is a hot topic, so I thought I'd ask all your opinion of allnurses.com community. According a survey linked below, 87% of the public think we should? What do you as a healthcare provider... Read More

  1. by   JennyPNurse2B
    i am very concerned about this vaccine because from what i have read a similar vaccine administered in the 1970s caused a marked increase in post vaccine incidents of "guillan barre"...not good. that is enough to scare me.i have taken care of someone with this. it is horrible..so no thanks ..not for me.
  2. by   Pfiesty
    jenny, me too. it is horrible.

    indigo, i did not want to leave without giving you at least a few of the citiations. here they are:

    http://www.scientificamerican.com/article.cfm?id=pandemic-payoff

    citing new england journal of medicine
    http://www.scientificamerican.com/article.cfm?id=single-vaccine-dose-even

    nejm:
    http://content.nejm.org/cgi/content/full/nejmra0904322

    the small variation in the 1977 strain is best explained in ken alibek’s book, biohazard. he was the director of the russian ddpartment overseeing russian biological labs at the time. i read it about ten years ago. it is a great and enlightening read!


    enjoy!

    "see" you when i get back!
    Last edit by Pfiesty on Nov 5, '09 : Reason: add
  3. by   Pfiesty
    Yikes Indigo, I forgot to address your question about the vaccine additives as the possible culprit of induction of autoimmune response. Sorry!

    Here is a quick one - gotta catch my plane!

    Through a link at the NIH website and from the Journal of Autoimmunity....
    http://www.ncbi.nlm.nih.gov/pubmed/10648110

    Excerpt: ".....The findings could also represent a polyclonal activation (adjuvant reaction). The mechanism (or mechanisms) of autoimmune reactions following immunization has not yet been elucidated. One of the possibilities is molecular mimicry; when a structural similarity exists between some viral antigen (or other component of the vaccine) and a self-antigen. This similarity may be the trigger to the autoimmune reaction....."
  4. by   DolceVita
    Quote from pfiesty
    jenny, me too. it is horrible.

    indigo, i did not want to leave without giving you at least a few of the citiations. here they are:

    http://www.scientificamerican.com/article.cfm?id=pandemic-payoff

    citing new england journal of medicine
    http://www.scientificamerican.com/article.cfm?id=single-vaccine-dose-even

    nejm:
    http://content.nejm.org/cgi/content/full/nejmra0904322

    the small variation in the 1977 strain is best explained in ken alibek’s book, biohazard. he was the director of the russian ddpartment overseeing russian biological labs at the time. i read it about ten years ago. it is a great and enlightening read!


    enjoy!

    "see" you when i get back!
    well i just read the nejm article and it says "it is not known whether low levels of cross-immunity against historically remote shared epitopes might confer some clinical protection against the newly emerging virus". it also goes to some length to describe the differences between the current and previous strains.

    also, vis the 1976 vaccine issues, do we really think that no progress has been made on vaccine safety or lessons learned?

    i hesitate to post this lest people seize on it as some proof of vaccine not working... i got the h1n1 vaccination but before i was a maximum immunity i actually got h1n1 from my niece and sister. i was exposed 5 days post vaccination. consider that it is possible that similar happened to some in 1976. entirely feasible. now, consider that gb is a potential complication of influenza. could it be that some of those folks in 1976 got gb from the flu rather than the vaccination? could it be they might have been incubating the flu before the vaccination? or contracted flu shortly after the vaccination before they were at full immunity.

    just some thoughts.
    Last edit by DolceVita on Nov 5, '09
  5. by   Pfiesty
    thanks for your thoughts.

    that same nejm also said, "analysis of full genome sequences of representative influenza a (h1n1) viruses from 17 countries and five continents that were sampled between 1918 and 2006 shows that all eight segments of the virus have had generally congruent patterns of evolution over time.14 "

    so we could argue how alike and how similar these viruses are; how much or how little they have evolved or merged, but that is all relative. or we could concentrate on why there are complications and how to prevent them.

    and yes, i am very hopeful and i do think (hope) there have been lessons learned and changes to the vaccines and safety. that brings me to my original question: does anybody know -or can find information about what these changes/improvements are? those facts remain mia!

    be safe!
    and hope there is no traffic enroute to airport today!
    Last edit by Pfiesty on Nov 5, '09 : Reason: add
  6. by   indigo girl
    Quote from Pfiesty
    Certain pathogens and the immune responses they trigger have a higher rate of producing inappropriate immune responses in susceptible individuals. And certain additives can act as a catalyst to that response.
    Thank you for the link to the abstract: http://www.ncbi.nlm.nih.gov/pubmed/10648110

    Because it is an abstract, we don't get to see the conclusions which is unfortunate. It makes mention of many vaccines including other influenza vaccines, & seems to ask more questions but provides no real answers.

    The adjuvant issue (which is your concern but not mine just to be clear) is not
    really answered in this abstract. Adjuvants are substances that together with
    antigen (Ag) increases antibody (Ab) production, to produce a greater immune
    response thus enabling the use of less antigen. The use of adjuvants with flu
    vaccine in the US has never been approved but the Canadians and the Europeans
    are using adjuvants. So, I am wondering why adjuvants are being brought up as
    an issue. And, again what adjuvant could you be referring to?

    Why are you questioning the 2009 swine flu vaccine in particular, Pfiesty? What
    makes this vaccine an issue for you rather than the seasonal vaccine or do you
    have concerns about other vaccines as well that you have not mentioned?

    Quote from www.ncbi.nlm.nih.gov
    Vaccination and autoimmunity-'vaccinosis': a dangerous liaison?
    Shoenfeld Y, Aron-Maor A.

    Department of Internal Medicine B, Sheba Medical Center, Tel Hashomer, Israel. shoefel@post.tau.ac.il
    The question of a connection between vaccination and autoimmune illness (or phenomena) is surrounded by controversy. A heated debate is going on regarding the causality between vaccines, such as measles and anti-hepatitis B virus (HBV), and multiple sclerosis (MS). Brain antibodies as well as clinical symptoms have been found in patients vaccinated against those diseases. Other autoimmune illnesses have been associated with vaccinations. Tetanus toxoid, influenza vaccines, polio vaccine, and others, have been related to phenomena ranging from autoantibodies production to full-blown illness (such as rheumatoid arthritis (RA)). Conflicting data exists regarding also the connection between autism and vaccination with measles vaccine. So far only one controlled study of an experimental animal model has been published, in which the possible causal relation between vaccines and autoimmune findings has been examined: in healthy puppies immunized with a variety of commonly given vaccines, a variety of autoantibodies have been documented but no frank autoimmune illness was recorded. The findings could also represent a polyclonal activation (adjuvant reaction). The mechanism (or mechanisms) of autoimmune reactions following immunization has not yet been elucidated. One of the possibilities is molecular mimicry; when a structural similarity exists between some viral antigen (or other component of the vaccine) and a self-antigen. This similarity may be the trigger to the autoimmune reaction. Other possible mechanisms are discussed. Even though the data regarding the relation between vaccination and autoimmune disease is conflicting, it seems that some autoimmune phenomena are clearly related to immunization (e.g. Guillain-Barre syndrome). The issue of the risk of vaccination remains a philosophical one, since to date the advantages of this policy have not been refuted, while the risk for autoimmune disease has not been irrevocably proved. We discuss the pros and cons of this issue (although the temporal relationship (i.e. always 2-3 months following immunization) is impressive).
  7. by   MarynRN
    Quote from shrinky
    No I do not get yearly TB tests, I am allergic to them after all these years in nursing. If they promise me, which they can't, that I won't have an allergic reaction then maybe. But to make it mandatory, no way, I will retire first.
    what is the reaction you have that makes you think you're allergic vs being a positive?
  8. by   MarynRN
    Quote from lamazeteacher
    There must have been a problem getting HCWs to take the HepB series of vaccinations, as anyone who doesn't want to do that, signs a release saying they either had the series previously, or refuse to have it. The Employee Health Nurse can order (with consent of a new employee), a test for HbSAb. If the result is HbSAg +, he/she will have to work where the danger of exposing patients to their carrier state isn't a potential risk.

    Since there's nowhere a HCW can work as such without exposing others to H1N1, when he/she's communicable (notice that I wrote "when", not "if"), she/he shouldn't work at all until the risk is over! If I for any reason couldn't take the vaccine without risking my life, I'd leave nursing until the risk of acquiring it is over; and I'd stay away from crowded indoor spaces.

    Those who refuse to take the vaccine must be sure it could be lethal for them to take it. Therefore they should get as much information as they can, about the vaccine having been administered to many human volunteers during the research of it. I've read that online, and I'm convinced that a sufficient number of people have received the vaccine without ill effect, that I will take it. However, I believe HCWs have a right to refuse it, as mandatory administration of anything to employees is wrong - legally and morally. However employers can and should require anyone who hasn't taken the vaccine, to take an unpaid leave of absence.

    The reason I feel so strongly about that, is because I'd hate to see nurses as "Typhoid Marys" exposing the public to a disease that has been shown to be lethal, when a vaccine is available to render them immune. If people with active Tb refuse (or are unreliable) to take their meds, the court can, and does restrict them to their homes, sending HH nurses in to give the meds by injection forceably, if need be. It would be a real pity if an insufficient number of HCWs made that necessary with nurses. However the length of time it takes the vaccine to render immunity, would make it unrealistic to do that. So the public will have to get the vaccine so that unvaccinated nurses won't spread H1N1 to them!

    Now read about it, folks and believe what the CDC and WHO say about researching it sufficiently, before advising its use. It's shear paranoia to think that those agencies would intentionally mislead us and the public, for heaven's sake!!! I listened to a radio "talk show" this morning, which had a "neurosurgeon" speaking against vaccines in general, the one against H1N1 specifically, siting all the old and now unused substances that were in vaccines, such as formaldehyde. He talked about them having more than "a dose" of mercury in each dose of vaccine, while the program host gasped. Now is that idiotic? How much mercury is a dose, and why would it be considered that? :stone
    i understand your thinking but it's not the fact that the WHO or CDC would intentionally harm the public with a vaccination, but it has happened as a side effect. example, the public use to be given the oral vaccination for polio until it was discovered, after a period of time, that it was giving a number of people polio as a side effect. it was then changed to an im injection which is still used today... point proven, sometimes what seems safe and beneficial at first can be deemed quite the contrary after a period of time.

    also... this was the first year i opted for the flu vaccination, and just as some people, it gave me the flu... who's to say that the same can't occur with the h1n1 vaccination... and even if it's one in a hundred... that one peron has to count for something... the numbers are people, not just statistics...
  9. by   DDdove
    As a nursing student, I was told to get the shot or drop out. I am not happy with that of course but what can I do? I have worked very hard and put a lot of time and money into my schooling. The CDC says "it is not mandatory", but they are not regulating this statement. Also they are not testing for the H1N1 anymore, does that mean they are also not keeping track of adverse effects? This may be just like the flu shots. The CDC list possible reactions, yet who really reports them if you say you have had a reaction? I had mentioned to a few nurses that I had developed flu symptoms from the vaccine,and all I got was "you can't get the flu from a shot." I am sure they did not report my adverse reactions.
  10. by   lamazeteacher
    Quote from stnursee
    As a nursing student, I was told to get the shot or drop out. I am not happy with that of course but what can I do? I have worked very hard and put a lot of time and money into my schooling. The CDC says "it is not mandatory", but they are not regulating this statement. Also they are not testing for the H1N1 anymore, does that mean they are also not keeping track of adverse effects? This may be just like the flu shots. The CDC list possible reactions, yet who really reports them if you say you have had a reaction? I had mentioned to a few nurses that I had developed flu symptoms from the vaccine,and all I got was "you can't get the flu from a shot." I am sure they did not report my adverse reactions.
    The calling of nurses to accept H1N1 vaccine so that their patients will not get that flu from their caregivers; and to prevent deaths of those susceptible to lethal repercussions of it, along with demonstrating trust in the regulating agencies of pharmaceuticals' statement that the vaccine is safe. It tests everyone's capacity to place their health in line with their dedication to their patients' wellbeing.

    It is very important that we pass this test and realize our place with legions of other health care providers, willing to stand up for the mission of being part of the solution of illness.
  11. by   RNsRWe
    Quote from MarynRN
    also... this was the first year i opted for the flu vaccination, and just as some people, it gave me the flu... who's to say that the same can't occur with the h1n1 vaccination... and even if it's one in a hundred... that one peron has to count for something... the numbers are people, not just statistics...
    Your flu shot didn't give you the flu, period. An inactivated virus (read: dead virus) doesn't proliferate a flu. You might have had a side effect of the other materials in the shot, but that IS NOT THE SAME as having the flu. I wonder how we as nurses can educate the public when obviously there are those teaching who don't understand how the things work??

    You can't get H1N1 from having the vaccine for the same reasons. You might be sensitive to stuff in the shot (MIGHT be, but statistically there are WAY MORE people who claim this happened than actually happened, btw). But that doesn't mean you have contracted a virus. You didn't.

    People also choose to forget that the incubation period of the seasonal flu can be from a couple of days to a week or so. Meaning that you were ALREADY ILL with the flu and therefore the symptoms conveniently showed just after your shot. Or, you had a cold (NOT the flu) and have blamed a vaccination that couldn't have given it to you for that illness. Kinda like saying red jelly beans must have given you the flu, because you never ate red jelly beans before, and the day after you ate red jelly beans--WHAM!--you have the flu. So it was the candy.

    And btw, since you say statistics have to count for something, where does that "one in a hundred" people get the flu from the flu vaccine come from? Do you really think this?

    Misinformation abounds.
    Last edit by RNsRWe on Nov 7, '09
  12. by   RNsRWe
    In response to the original question, I don't think it should be a mandatory vaccine simply because it is not something that the vast majority of us are at risk of death for. It's not a life-long illness (such as contracting Hepatitis might be). It's the flu, for goodness' sake, and if you choose to not have the shot and get yourself good and sick, it's YOU who gets to lose time from work by staying home. You penalize yourself, IMO.

    I am in favor of voluntary vaccinations, primarily because I'm at risk of contracting the illness because of what I do, and I don't happen to like the idea of being sick myself or giving it to my family because I stuck my head in the sand and said "can't happen to me". But not in favor of making it a mandatory vaccination for reasons stated.
  13. by   RNsRWe
    Quote from stnursee
    The CDC list possible reactions, yet who really reports them if you say you have had a reaction? I had mentioned to a few nurses that I had developed flu symptoms from the vaccine,and all I got was "you can't get the flu from a shot." I am sure they did not report my adverse reactions.
    THEY weren't supposed to report an adverse reaction, YOU WERE. In answer to your question "Who really reports them if you say you have had a reaction?" that would be YOU.

    It's your responsiblity, not the nurses who you "mentioned it to". It doesn't become my business or responsibility to go to the place you got the shot and tell them YOU had issues with it, LOL....that's your job!

    You might be a student, but you're also an adult, and this would be one of those times in which you can't just complain to someone else (who is not involved) and expect you're now done with the situation. In fact, at the time you got the shot, you were told that if you had any adverse reactions you were to report them to the office where you got the shot. So whose fault is it if numbers aren't accurate?

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