Ethical Issue- Nurses not getting flu vaccine when they could!

[Aaron86]

hey everyone,

i'm a recent graduate and got my first job as a prn flu shot nurse. anyone involved with flu shots this year is probably aware of the high public turnout and the issues with low supplies, but has anyone been involved with healthcare worker vaccination?

i have and, quite frankly, i'm disgusted!

nurses and other educated medical professionals are declining to be vaccinated and most of them really have no good excuse for putting their patients at risk. at a time when people are standing outside clinics before sunrise for the chance to get an h1n1 vaccination, i find myself sitting in a hospital (and more recently taking the vaccine to the actual units) with a large amount of h1n1 flumist and no one will take it!

in case you haven’t had a chance to look into it, the flumist is a live attenuated influenza virus (laiv). it is only approved for use in healthy people ages 2 - 49 years. no pregnant women, no asthmatics, no diabetics, and no one who is taking anything that suppresses their immune system.

in short: none of the people at highest risk for influenza complications.

so why then does a healthy 30 year old mother in a critical care unit or emergency dept. decline? why does the 22 year old perfectly healthy phlebotomist that visits hundreds of patients each day decline?

the most common thing i hear from people when i roll my cart onto the unit? "i'll wait for the injectible"

that is, except for the > 50 crowd who almost all seem to want the vaccine but can't get the nasal. from them i usually hear "oh i see how it is, over 50 and left to die!" =)

i get the fears about it being a live attenuated virus, but i would expect these fears from the general public and not other nurses or healthcare professionals! i have the information from the cdc, i've educated myself on the various clinical studies and results and i share this with the employees and they still insist on waiting for the injectible.

what do you all think? should these people even be allowed to have the injectible when they are otherwise good candidates for the much more widely available, but also more restrictive, nasal vaccine?

i say, save the injections for those that *really* need it and can't have anything else. not the paranoid and uninformed.

[CrunchyMama, ASN, RN]

Haha, you'd think that would make it better for those healthcare workers who are afraid of needles!

If I could pick between the two, all things being equal, I would probably choose the h1n1 shot too. It so much manlier to bear the arm and take it.

But if my getting the shot means a pregnant woman and her child go unprotected? I'll take the runny nose for a few days.

Also, kind of off topic here but going back on your previous post: those diseases are rare *because* of the vaccine. Untill it becomes erradicated in the wild (small pox) the risks of the vaccine still must be compared to the risks of the disease.

DTaP or MMR and polio may seem like rare and exotic diseases in the U.S. but they are endemic in many countries that tourists visit and people immigrate from.

It may be hard to think of it like this, but less than a death in a million due to a vaccine reaction is immensely preferable to thousands of deaths per million from the disease.

I make sure to go through any contraindications and ask for questions before administering vaccine even to someone who absolutely wants it. Because you know what? that 1 death in a million might be better than thousands but you still try to rule it out at every possible chance.

Actually....these diseases were on the decline just before vaccines were introduced. So it seemed like vaccines did the world good. I ran across a chart awhile ago and it showed the rate of diseases and the decline, then vaccines were introduced. And depending on what side of the fence you're on...you'd either think the decline was natural (considering the rates were declining anyway) or the decline continued because of the vaccines. Just depends on how you look at it. I understand why some people give every vaccine under the sun because I've looked into these diseases and know what they can cause. But I also know, there's a slim chance my kids (or myself) will ever come in contact with polio or measles. I also know that vaccines can kill...rare but it does happen. I feel more comfortable taking the extremely rare chance of my kid coming in contact with polio, then purposely giving the vaccine and something happening....all for a disease that rare where it does exist.

[CrunchyMama, ASN, RN]

i know that we deal with people and not just facts and figures.

this is mainly why i was driven to even post (which won't be happening again soon)

any seasonal flu clinic i go to i get hundreds of questions from anxious parents asking when we will give out the h1n1 vaccine.

what do i tell them? we do, in fact, have over 6,000 doses of h1n1 sitting in a fridge reserved for healthcare providers who are holding out. i'm sorry mam, your kid might end up in a picu because resources are being tied up like this rather than getting to the people most at risk.

i put myself in her shoes and see how rediculous it is that i am twiddling my thumbs trying to get healthcare workers vaccinated with the alloted vaccine. meanwhile the public is driving from doctor's office to doctor's office trying to find it.

let me put it this way:

someone is at a pizza party.

there are 10 pizzas with meat, and 1 that is cheese only.

of course, this is a stupid way to hold a pizza party because there are a lot of vegetarians there.

this person knows damn well there are vegetarians at the party but they insist on holding off on the meat and eating the whole cheese pizza themselves.

because, you know, that meat has more cholesterol in it.

why is it the healthcare workers fault that the vaccine manufactors haven't made enough vaccines? the cdc and all these other halfwits have scared anybody that watches tv or reads the paper into thinking that it's a pandemic....so hello?....if you're going to put a disease out in the environment (this is my belief) and cause hysteria, then make enough vaccines! it's not the fault a healthcare workers because they don't want to put a live virus into their body (yeah, that sounds smart and promising).

[Aaron86]

http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#risk

http://www.who.int/features/factfiles/immunization/facts/en/index.html

i think those are two reputable sources on the subject of vaccination in general.

and that is all the more i will say on that. it is not my intention to argue that everyone needs to be vaccinated. if someone objects to receiving the vaccine, it is their decision about their body and i have to respect that - any thing related to that deserves its own thread.

-----

my issue was with healthcare workers eligible for a more the widely available vaccine (which is not licensed for use on those who have the highest risk for death and hospitalization) insisting on waiting for the trivalent inactivated version.

these are healthy people at low risk for h1n1 complications taking the inactivated instead while the people that really need the inactivated can't get it.

meanwhile the laiv allocated to those healthy healthcare workers under the age of 50 is hoarded in a hospital doing no good at all.

if the trivalent inactivated h1n1 vaccine was as widely available as everyone was lead to believe this wouldn't be an issue. but it is an issue.

the ethics in question here isn't the decision to vaccinate or not to vaccinate.

it is unnecessary consuming limited resources that are badly needed by those people most likely to *die* if they get the flu.

[CrunchyMama, ASN, RN]

http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#risk

http://www.who.int/features/factfiles/immunization/facts/en/index.html

i think those are two reputable sources on the subject of vaccination in general.

and that is all the more i will say on that. it is not my intention to argue that everyone needs to be vaccinated. if someone objects to receiving the vaccine, it is their decision about their body and i have to respect that - any thing related to that deserves its own thread.

-----

my issue was with healthcare workers eligible for a more the widely available vaccine (which is not licensed for use on those who have the highest risk for death and hospitalization) insisting on waiting for the trivalent inactivated version.

these are healthy people at low risk for h1n1 complications taking the inactivated instead while the people that really need the inactivated can't get it.

meanwhile the laiv allocated to those healthy healthcare workers under the age of 50 is hoarded in a hospital doing no good at all.

if the trivalent inactivated h1n1 vaccine was as widely available as everyone was lead to believe this wouldn't be an issue. but it is an issue.

the ethics in question here isn't the decision to vaccinate or not to vaccinate.

it is unnecessary consuming limited resources that are badly needed by those people most likely to *die* if they get the flu.

thank you for posting the link to prove my point, lol. btw, do you really think a multibillion dollar business is going to come down on what they make and promote...vaccines? lol ok, now i don't feel like discussing this anymore. no offense, but you live in the typical bubble of thinking vaccines save lives and they're 100% safe. why don't you do some research on the ingredients and the harmful effects of these vaccines and people who have had to live with it?

~~~~~

ok....if you say you respect peoples decisions, then why care if someone would rather get the vaccine rather then the nasal spray? they have every right to decide what does and doesn't go in their body. if that's your main concern....then it is a valid issue. just like we all choose what to eat and what not to, why should vaccine be any different? you think these resources are badly needed because of tv....it'll brainwash anyone. no offense really....this hysteria is just annoying. like i said before....get on the vaccine makers, no your fellow healthcare workers. :)

[CrunchyMama, ASN, RN]

Sorry Aaron, I sounded like a b**** in my last post. Lets stop this conversation before it gets out of hand. :cheers:

[spider11]

The hospital where I work did not offer the mist to the employees. Anyone admitted to the hospital has a compromised immune system. Our hospital chose to only administer the injectible virus for those reasons.

As for the original poster....the great thing about America is that we are able to choose.

[elkpark]

Ah, yes -- I remember back when I was a new graduate and thought I knew all the answers, too.

I won't be having the nasal spray version or the injection.

[dcampbell]

The OP makes it sound so easy to just wear a mask for the next 48 hours at work. But I would feel that I should also wear a mask at home too and whenever I am out so that I don't infect my family members or others with the LIVE virus that I just had shot up my nose. Many of us don't just come around immunocompromised people at work but we are also with many different people in our everyday lives. We have pregnant friends, neighbors who are receiving cancer treatments, and we spend time with infants at church. Plus we ALL go to the grocery store:)

[cpkRN]

are either of you sensitive to MSG?

I know I'm not. Not sure about my friend.

[Aaron86]

Well I got my Live Attenuated virus a week ago and no ill effects so far. Not even so much as a runny nose.

Personally, I liked it better. When I got my seasonal flu shot my arm hurt as if someone had been punching me for nearly a week. I'm also more than happy to have saved a dose of the injectible for someone who really needed (and wanted) it. Someone like the nurse who posted earlier saying they had asthma.

Our hospital system implimeted a new policy this week saying that, untill all forms of the vaccine become widely available, anyone wanting a vaccine will go through the full screening and only be given the shot if they have some condition that rules out the mist.

We also just opened up the flumist to families and children of employees. In 3 hours on a Sunday we got nearly 800 family members along with a few of "lower risk group" workers (environmental services, maintenance, etc.).

To put that number in perspective. I spent nearly 12 hours over the course of the last few weeks offering the vaccine to the various units on the hospitals. I only administered about 25 intranasal doses in all that time.

I recognised one nurse who didn't want to take the flumist bring in 3 of her children for the mist. So I don't think the major concern is the safety and more the stigma of wearing a mask.

[CrunchRN, ADN, RN]

Ok, I will fess up. I just do not want anything to do with non-killed virus. I hate feeling sick and I just hate the idea of a live virus. I just want the injection. Itis just a personal thing with me.