Flu Vac, should it be mandatory

[hagler2011]

I work for a facility that is thinking about making the Flu vaccine mandatory in order to work. I personally do not like this idea. I have never gotten the Flu, Pneumonia, or H1N1 for myself or my family. I think that this kind of act is forceful against my free will. It should be my decision not anyone elses. Any thoughts?

[DizzyLizzyNurse]

My hospital givs us a choice. Take the shot or wear a mask every minute you are in the building. If you are cought without the mask before the end of respiratory season you may be terminated. Simple and your autonomy is still intact.

This is what the hospital I did clinicals in last year did.

[rn/writer, RN]

I think it should be mandatory, but with an option for refusal for religious or philosophical reasons. However if you opt out, you have to attend a seminar/class about flu prevention that is mandatory. If you don't do one or the other you lose your job. I think if you provide free shots and state that they are mandatory, most people will get them, especially if it means they have to do more than just sign a waiver. The people who refuse and are willing to go in for "flu education" on their day off are most likely serious enough about their position that it should be respected.

And the class should be on your own time, i.e., not paid. I am not paid to stand in line to get the shot.

I also think the mask idea is a good one.

I've heard conflicting reports on whether or not it actually protects other's from getting the flu, but even if it did the flu shot is a guessing game based on last year's strain! So I don't see the reason to force it into my body.

I just read an long article on the development of the first H1N1 vaccine in 2009. This story explained a lot about how crazy fast pandemics can spread and how the CDC and the disease folks in other countries arrive at what they think is the best vaccine.

Vaccines don't prevent every case of the flu, but supposedly, they mitigate the effects. They also knock out enough of the disease that their effect is like removing manly pieces from a domino chain. Yes, people may still become ill, but they'll have milder cases and the disease won't spread like wildfire.

I'm also reading a book by a well-known author who lost her husband d/t a secondary infection he acquired while he was hospitalized with pneumonia. After being in the hospital for a week, he was due to go home on a Tuesday, when his wife was called in the wee hours of Monday morning. She was told he had take a serious turn for the worse. But the time she got to the hospital, he was gone. Maybe nothing would have changed the outcome of this case, but caretakers who get flu shots might make a difference for some patients or their visitors.

I am happy to get the shot if it mean helping to protect my patients and others who are immuno-compromised.

[tahitianmoon]

I don't think it should be mandatory. You should be able to choose whether or not you want something injected into your body. If someone in health care is sick they should not be at work anyways. Also an adult can be very healthy without getting immunization. Washing hands or general good health hygiene and healthy lifestyle ward off most contagious illness, so I do not think it is unethical for it to be a personal choice.

[siafulinux]

I just read an long article on the development of the first H1N1 vaccine in 2009. This story explained a lot about how crazy fast pandemics can spread and how the CDC and the disease folks in other countries arrive at what they think is the best vaccine.

Even so, it doesn't mean they're going to get it right. It's still just a guess. You have a high chance of them not getting it right. "While there are many different flu viruses, the flu vaccine protects against the three viruses that research suggests will be most common." - CDC

Vaccines don't prevent every case of the flu, but supposedly, they mitigate the effects. They also knock out enough of the disease that their effect is like removing manly pieces from a domino chain. Yes, people may still become ill, but they'll have milder cases and the disease won't spread like wildfire.

I'm not sure I agree with this, though you could be correct. Here's why I'm not sure about it... if I get the flu shot and it's for flu A, but then I get infected with flu B... how is the vaccine for A supposed to help me with B? If so, then there would be just ONE flu shot for all flu's right and no need for all this guessing business? But I could be wrong of course.

I'm also reading a book by a well-known author who lost her husband d/t a secondary infection he acquired while he was hospitalized with pneumonia. After being in the hospital for a week, he was due to go home on a Tuesday, when his wife was called in the wee hours of Monday morning. She was told he had take a serious turn for the worse. But the time she got to the hospital, he was gone. Maybe nothing would have changed the outcome of this case, but caretakers who get flu shots might make a difference for some patients or their visitors.

Edit: Was his death due to the Pneumonia or the flu? What secondary infection did he get? I remember reading and hope I can find, an article about how pneumonia is actually the main culprit for "flu" related deaths, but it isn't the flu in and of itself.

I am happy to get the shot if it mean helping to protect my patients and others who are immuno-compromised.

Sure, but there's no guarantee that you will be protecting anyone. In fact, according to some medical University studies the mortality rates for elderly who actually take the shot hasn't reduced. So, if that's the case, then me taking the shot is certainly not going to protect them if them taking the shot doesn't!

"

The research group pointed out that most evidence on the benefit of influenza vaccines in older patients is based on observational studies that suggest a 50% mortality rate reduction. However, they said many experts have suspected that such a high benefit is implausible.

For example, they wrote that though vaccination rates in the United States' elderly population have risen from 15% to 65% over the over the past 20 years the increase has not been matched by decreasing hospitalization and mortality rates.

"

"Also, the researchers wrote that other studies have detected similar mortality reductions during the times of year when influenza viruses aren't circulating, which cast further doubt on the size of the vaccination benefit."

- From the

Center for Infectious Disease Research and Policy; University of Minnesota

.

[EmergencyNrse]

http://www.cdph.ca.gov/services/boards/Documents/DeclinationFluVaccine.pdf

Wow, so many of you with the put up with it or else position.

Take it or work elsewhere...

So eager to get your shot and make damn sure everyone around you gets it too. You have no clue what is in the vaccine. You didn't grow it. You didn't extract the antigen. Didn't label it, Didn't package it...Sooooo very trusting that you're receiving what they say is in the vial.

Oh, but coming soon to an ER near you: An UN-immunized nurse that could care less what you think should or shouldn't be mandatory. I decline once again...

http://www.cdph.ca.gov/services/boards/Documents/DeclinationFluVaccine.pdf

[rn/writer, RN]

The quotes in post #15 are attributed to the wrong person.

[MunoRN, RN]

I don't think it should be mandatory. You should be able to choose whether or not you want something injected into your body. If someone in health care is sick they should not be at work anyways. Also an adult can be very healthy without getting immunization. Washing hands or general good health hygiene and healthy lifestyle ward off most contagious illness, so I do not think it is unethical for it to be a personal choice.

People infected with influenza are contagious prior to having any symptoms, so not working when you are sick doesn't prevent the spread of the flu.

Hand washing is an important part of disease prevention, but there's no evidence that it can replace the need for immunizations particularly in diseases such as the flu that are spread primarily through the air, not by contact.

I think Nurses who work with at-risk patient populations should be obligated to take reasonable steps to protect their patients, whether it be hand washing, checking orders, etc. It's part of the job.

[MunoRN, RN]

I'm not sure I agree with this, though you could be correct. Here's why I'm not sure about it... if I get the flu shot and it's for flu A, but then I get infected with flu B... how is the vaccine for A supposed to help me with B? If so, then there would be just ONE flu shot for all flu's right and no need for all this guessing business? But I could be wrong of course.

Seasonal flu vaccines cover for three types: Flu B, Flu A (H1N1), and Flu A (H3N2), the three most common flu types. The Flu A portion won't really help you with Flu B (which is why it also contains Flu B).

Edit: Was his death due to the Pneumonia or the flu? What secondary infection did he get? I remember reading and hope I can find, an article about how pneumonia is actually the main culprit for "flu" related deaths, but it isn't the flu in and of itself.

Pneumonia is an inflammation of the lung, which you are correct is the common cause of flu deaths. But they aren't by any means unrelated, pneumonia is the life threatening condition that the flu causes. Just like nobody actually dies of tylenol overdose, they die of liver failure.

Sure, but there's no guarantee that you will be protecting anyone. In fact, according to some medical University studies the mortality rates for elderly who actually take the shot hasn't reduced. So, if that's the case, then me taking the shot is certainly not going to protect them if them taking the shot doesn't!

"

The research group pointed out that most evidence on the benefit of influenza vaccines in older patients is based on observational studies that suggest a 50% mortality rate reduction. However, they said many experts have suspected that such a high benefit is implausible.

For example, they wrote that though vaccination rates in the United States' elderly population have risen from 15% to 65% over the over the past 20 years the increase has not been matched by decreasing hospitalization and mortality rates.

"

"Also, the researchers wrote that other studies have detected similar mortality reductions during the times of year when influenza viruses aren't circulating, which cast further doubt on the size of the vaccination benefit."

- From the

Center for Infectious Disease Research and Policy; University of Minnesota

.

You are correct that the rate of effectiveness is much lower in the elderly, which is why it's so important that those of us for whom it is effective get vaccinated. Vaccines depend on a strong immune response to the vaccine, without that they don't work. Many elderly patients aren't capable of mustering the immune response required to build sufficient antibodies following vaccination, rather they depend on the vaccinated population's ability to fend off the virus so we don't pass it on to them.

[rn/writer, RN]

i just read an long article on the development of the first h1n1 vaccine in 2009. this story explained a lot about how crazy fast pandemics can spread and how the cdc and the disease folks in other countries arrive at what they think is the best vaccine.

even so, it doesn't mean they're going to get it right. it's still just a guess. you have a high chance of them not getting it right. "while there are many different flu viruses, the flu vaccine protects against the three viruses that research suggests will be most common." - cdc

it's a pretty well educated guess. the h1n1 flu that became worrisome in 2009 is thought to be the same as the epidemic in 1918 that killed millions of young, healthy people around the world. it took place during wwi and killed more than four years of war did.

---------

vaccines don't prevent every case of the flu, but supposedly, they mitigate the effects. they also knock out enough of the disease that their effect is like removing manly pieces from a domino chain. yes, people may still become ill, but they'll have milder cases and the disease won't spread like wildfire.

i'm not sure i agree with this, though you could be correct. here's why i'm not sure about it... if i get the flu shot and it's for flu a, but then i get infected with flu b... how is the vaccine for a supposed to help me with b? if so, then there would be just one flu shot for all flu's right and no need for all this guessing business? but i could be wrong of course.

last years flu shot combined both the seasonal flu and the h1n1 vaccines. the seasonal flu is the main one that they have to make an educated guess with. logically speaking, if you reduce the number of cases of any kind of flu, the population should be healthier over all.

---------

i'm also reading a book by a well-known author who lost her husband d/t a secondary infection he acquired while he was hospitalized with pneumonia. after being in the hospital for a week, he was due to go home on a tuesday, when his wife was called in the wee hours of monday morning. she was told he had taken a serious turn for the worse. by the time she got to the hospital, he was gone. maybe nothing would have changed the outcome of this case, but caretakers who get flu shots might make a difference for some patients or their visitors.

edit: was his death due to the pneumonia or the flu? what secondary infection did he get? i remember reading and hope i can find, an article about how pneumonia is actually the main culprit for "flu" related deaths, but it isn't the flu in and of itself.

i don't know if the secondary infection was ever definitively identified. my main point with this paragraph was that some of our patients are so immunologically fragile that i am willing to do whatever i can to reduce that risk. people can die if they get the flu. caregivers can transmit the disease before symptoms appear. i would think that the vaccine(s) should be mandatory in the newborn, geriatric and critical care areas at least.

---------

i am happy to get the shot if it mean helping to protect my patients and others who are immuno-compromised.

sure, but there's no guarantee that you will be protecting anyone. in fact, according to some medical university studies the mortality rates for elderly who actually take the shot hasn't reduced. so, if that's the case, then me taking the shot is certainly not going to protect them if them taking the shot doesn't!

maybe their mortality rate wasn't reduced, but i don't think the last word is in on that. at any rate, i'm willing to experience a little discomfort and inconvenience to avoid, not only the flu, but also the thought that i might be transmitting it to my patients. if i had a condition that made the flu vaccine dangerous for me, i'd be willing to wear the mask. i don't want to give a disease like this one that has such a high mortality rate to anyone i care for or about.

[tahitianmoon]

People infected with influenza are contagious prior to having any symptoms, so not working when you are sick doesn't prevent the spread of the flu.

Hand washing is an important part of disease prevention, but there's no evidence that it can replace the need for immunizations particularly in diseases such as the flu that are spread primarily through the air, not by contact.

I think Nurses who work with at-risk patient populations should be obligated to take reasonable steps to protect their patients, whether it be hand washing, checking orders, etc. It's part of the job.

As far as a know influenza is spread through droplet. According to the CDC, "Influenza viruses are spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets do not remain suspended in the air and generally travel only a short distance (less than or equal to 1 meter) through the air. Contact with respiratory-droplet contaminated surfaces is another possible source of transmission. Airborne transmission (via small-particle residue [less than or equal to 5µm] of evaporated droplets that might remain suspended in the air for long periods of time) also is thought to be possible, although data supporting airborne transmission are limited." Source: http://www.cdc.gov/flu/professionals/acip/clinical.htm

You really have to be coughing near/on the patient in which case you should be wearing a mask at that point and if sick, staying home. I do agree though if your job is working with at risk patients then you would heavily consider your choice and wear a mask when required. Personally I haven't had the flu shot in 4 years and have been sick once since then with regular rhino virus.

At the end of the day I still believe it should be a personal choice as to whether or not you want to get the flu shot or any other immunization for that matter. Most people will get the shot, but not making it a choice to me is the wrong answer. I could contiune on with the whys and why nots of my position but I just wanted to quickly weigh in on the topic.

[MunoRN, RN]

As far as a know influenza is spread through droplet. According to the CDC, "Influenza viruses are spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets do not remain suspended in the air and generally travel only a short distance (less than or equal to 1 meter) through the air. Contact with respiratory-droplet contaminated surfaces is another possible source of transmission. Airborne transmission (via small-particle residue [less than or equal to 5µm] of evaporated droplets that might remain suspended in the air for long periods of time) also is thought to be possible, although data supporting airborne transmission are limited." Source: http://www.cdc.gov/flu/professionals/acip/clinical.htm

You really have to be coughing near/on the patient in which case you should be wearing a mask at that point and if sick, staying home. I do agree though if your job is working with at risk patients then you would heavily consider your choice and wear a mask when required. Personally I haven't had the flu shot in 4 years and have been sick once since then with regular rhino virus.

At the end of the day I still believe it should be a personal choice as to whether or not you want to get the flu shot or any other immunization for that matter. Most people will get the shot, but not making it a choice to me is the wrong answer. I could contiune on with the whys and why nots of my position but I just wanted to quickly weigh in on the topic.

Transmission is not limited to coughing and sneezing, from the CDC: "Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk."

You can thank the rest of us who do get immunized for not getting the flu in 4 years, it's called herd immunity, you're welcome.

[tahitianmoon]

Transmission is not limited to coughing and sneezing, from the CDC: "Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk."

You can thank the rest of us who do get immunized for not getting the flu in 4 years, it's called herd immunity, you're welcome.

thats another argument as to why you don't need to be forced to take it.