lots of people are wondering whats the big deal with getting vaccinated? maybe it wasnt such a big deal when we were kids but because of the job we do, there are other things to consider this time:
<<for immediate release
Smallpox Vaccinations: Weighing the Risks
New York State Nurses Association Urges Protections for Nurses Who Volunteer
by Nancy Webber
On December 13, 2002, the Bush administration announced that healthcare workers would be among the first to participate in a voluntary smallpox vaccination program.
By that time, county public health departments were already making plans to inoculate these volunteers, who would give vaccinations to other healthcare workers and to the general public in the event of a smallpox emergency. Acute-care facilities were designating smallpox response teams made up of a cross-section of hospital workers and specialties.
These fast-moving events left nurses facing the difficult decision whether to be vaccinated. There are many factors to be considered. As healthcare professionals, nurses recognize the need to prepare for a smallpox outbreak possibly generated by a bioterrorism attack. The risks of the vaccine itself, however, raise concerns about severe side effects, the possibility of endangering the health of family members and patients, and issues related to potential liability and compensation for lost time at work.
Responding to these concerns, the New York State Nurses Association (NYSNA) recently sent a letter to hospitals where the association represents RNs for collective bargaining, putting them on notice that they would have to negotiate certain aspects of the vaccination program.
"Being vaccinated could have a serious impact on a nurse's health and livelihood," said Lorraine Seidel, director of NYSNA's Economic and General Welfare (E&GW) Program. "Before facilities implement their vaccination programs, we must be assured that RNs will be protected in every way possible."
NYSNA outlined six major areas of concern, noting that more could arise as the program develops --
* Nurses must be properly educated about smallpox and the vaccine
nurses volunteer to be vaccinated, employers must provide complete and accurate information about the relative risks of contracting smallpox and the possible side effects of the vaccine both for nurses and for unvaccinated people with whom they come in contact.
* There must be no reprisal for refusing to volunteer
. Nurses should not be harassed or experience discrimination if they refuse to be vaccinated. They should not have to divulge the reason for their refusal.
Nurses should not be vaccinated, for example, if they have a history of eczema or atopic dermatitis, HIV infection, a compromised immune system, allergies to antibiotics used in development of the vaccine, and pregnancy. People with these conditions are more likely to experience severe reactions. Nurses also may be at risk if they have a history of dermatitis associated with latex allergy.
In the vaccination plan it submitted to the state, the New York City Department of Health will require all volunteers in the city to receive confidential HIV testing before being vaccinated.
* Specific pre-vaccination information must be provided for those who do volunteer
. If nurses do decide to volunteer, they must be fully informed about their rights as workers
, possible side effects, the treatment available in the event of a severe reaction, care of the inoculation site, and precautions to prevent accidental inoculation of patients and household members.
* Nurses must be paid for lost time from work due to reaction to the vaccine
. The smallpox vaccine contains a live vaccinia virus. Vaccinia, known as cowpox in earlier centuries, is a weaker relative of smallpox and provides immunity from the more deadly disease. In fact, it is the source of the word "vaccination" (the Latin word for "cow" is "vacca"). Typically, a person vaccinated against smallpox for the first time may experience flu-like symptoms: fever, malaise, and swollen lymph nodes. In clinical trials at the University of Iowa, about a quarter of those vaccinated missed at least one day of work or school.
The smallpox vaccine can cause more severe side effects in a small percentage of cases, which were outlined in the December 2002 issue of Report. It is estimated that 15 people out of a million will experience life-threatening complications and one or two out of a million will die.
* NYSNA is telling employers that if nurses volunteer to be vaccinated as part of a public health initiative, they should not have to use sick time or other personal time for missed workdays
. In addition, treatment for severe side effects must be provided at no additional cost
to the nurse volunteer.
* Nurses must not be held liable for accidental inoculation of patients or others
. Because the smallpox vaccine contains a live virus, the virus can be shed from the vaccination site for up to three weeks
. There are measures that can be taken to minimize the risk of accidentally inoculating others. Special care must be taken to cover the sore that develops after vaccination. Frequent handwashing also will prevent the vaccinia virus from being passed on. But despite these precautions, potential liability remains.
* Facility vaccination plans must address the risks of having recently vaccinated employees care for patients
. Hospitals have already expressed concern about their liability
if employees or patients are harmed by the vaccine. As Report went to press, many of these legal questions had not been resolved.
* Plans must be provided for staffing support and coverage for staff who may be absent from work following vaccination
. NYSNA proposes that vaccinations be administered on a staggered basis
to minimize impact on staffing levels, with a group being vaccinated every three weeks. Most absences due to typical vaccine reactions will occur eight to ten days after inoculation.
If you are represented by NYSNA for collective bargaining and have questions or concerns about how your facility is implementing its smallpox vaccination program, contact your NYSNA nursing representative. Information is also available at NYSNA's Web site, www.nysna.org,
and at www.smallpox.gov.