Is your Facility 'forcing' you to get the Flu Vaccine?

[madwife2002]

My company have a new policy that if you do not want to receive the flu vaccine this year by end November, then you have to wear a mask within 6 feet of all patients.

So they are not saying you have to have the flu vaccine but if you don't then you have to wear a mask at all times!

The local hospital was on the news this week saying if staff refuse to get the flu shot then their contract will be terminated. As we work in an at will state then this apparently is legal.

I chose to take the flu shot, but the rest of the staff feel they are being bullied into doing it. For me it is just not possible to wear a mask 24/7 when with the patients.

[Samael]

Whether you receive the flu vaccine or not is protected health information. It could be argued that by requiring you to mask if you have not had the vaccine, your employer is violating your privacy.

Some facilities agree. They'll simply fire employees who refuse.

I must be the odd one here. I get a flu shot every year even if no one tells me to. Evidence-based medicine persuades me to.

[Samael]

How well the flu vaccine works (or its ability to prevent influenza illness) can range widely from season to season and also can vary depending on who is being vaccinated.

No medical therapy is 100% effective, though the HPV vaccine is pretty close.

I used to get the flu periodically, as many people do. In the 10+ years since I've been getting the flu vaccine, I only had the flu once: H1N1, for which I hadn't gotten a vaccine.

I'm much happier not getting the flu every (approximately) third winter. I'm also pretty sure I haven't infected anyone else with the flu since I haven't been infected with it myself.

[Anna Flaxis, BSN, RN]

Some facilities agree. They'll simply fire employees who refuse.

Unless there is a collective bargaining agreement in place. Then they can't. Yet another mark in the "plus" column for unions.

I must be the odd one here. I get a flu shot every year even if no one tells me to. Evidence-based medicine persuades me to.

Nobody here is advocating for taking away your right to receive a flu vaccination if you wish. In fact, I completely support employee education programs that provide objective, factual information about the flu vaccine and easy access to the vaccine for those who choose to get it.

What I do not support is my employer being allowed to mandate what I put into my body. I'm happy to get the flu vaccine if, after being educated about it, I decide it's right for me. But once you tell me I have no choice, that's where I draw the line.

Since 90% of flu deaths are in people over age 65, perhaps we ought to focus our attention on making the flu vaccine easily available to that patient population. Oh wait, we're doing that already. And yet, I still don't see little old ladies being told they have to get the flu shot or lose their Medicare. After all, they know the risks and so if they choose not to get the vaccine and then get sick, why should society pay?

No. They are being educated about the risks and benefits and being allowed to make their own informed decision like autonomous adults in our society are allowed to do. This same courtesy is all I ask as a health care worker.

If you really want to make a dent in flu transmission, then school aged children should be the ones getting the vaccination. According to the National Institute of Allergy and Infectious Diseases, children are 2-3 times more likely to get sick with the flu and are frequent transmitters of the flu. Households with school aged children are the most likely to acquire the flu.

I have no children in my household, and have very little contact with children at all. My elderly patients are more likely to get the flu from their grandchildren than they are from me.

Mandatory vaccination of health care workers is evidence based? I don't think so.

[Brightfuture4us]

Although I am just preparing to enter nursing school, I have been in the medical field in different aspects for years. There are many people who feel vaccines are bad for you. I do not think it is right to require any vaccine. I feel it should be my choice as to what risk I am exposed to. If the people who get vaccines believe so strongly that they work then those people are not affected by my chosing not have said vaccine. It is me who assumes the risk of whatever it may be. There is a recent study that found flu vaccine increases risk of Alzheimer. Another example is that since our children are vaccinated against chicken pox...Shingles out breaks are much worse. This is because once a person had CP their immune system would protect them against it and as they were exposed to others with CP they got a boost in immunity against it. Now that hardly anyone gets CP that boost never comes hence later here comes the shingles worse than ever. Then here comes another vaccine for shingles. I just believe that your immune system has to be exercised. I won't get on my soap box...my point is just that a facility would never make a policy stating that to enter as a patient you HAD to have X Y and Z vaccines. I have never gotten the flu shot nor have my children and none of us have had the flu. I think this is an issue people just have to agree to disagree on...You do what you have to do to keep your job. It just doesn't seem right to me.

[turnforthenurse, MSN, NP]

Last year was nothing; we just had to sign a waiver if we didn't want a flu shot. I have never gotten a flu shot and I have been fine. This year, my hospital is implementing the flu shot or else wear a mask within 6 feet of patients, which I think is ridiculous. I haven't gotten my flu shot yet but I do feel like I'm being "bullied" into it. I agree, it's ridiculous.

[Anna Flaxis, BSN, RN]

Also, most states do not require immunizations for hospital workers. Check your individual state here:

NCIRD: Immunization Laws

Additionally, and I hope I'm not overstepping the TOS regarding legal advice, it is my understanding that even if your state doesn't have a medical or religious exemption statute, if your employer is an equal opportunity employer, then they are obligated to make reasonable accommodations for religious objections to vaccinations, without placing undue requirements on "proof" of your religious beliefs.

[NRSKarenRN, BSN, RN]

Our East Coast corporate health system announced Mandatory vaccination policy this week.

Home health agency already had immunization program in place with my staff RN's providing injections at our business operations headquarters. Hey, it's the one time of year I get to jab the CEO and CFO. :)

What is behind mandatory vaccination? $$$ and best healthcare practice recommendations.

• Laws encouraging the prevention and reduction of healthcare-associated infections (HAIs), infections acquired during the course of receiving treatment for other health conditions, have emerged and expanded in US since 2004. Thusly, a health care facility can establish a hiring policy that requires evidence of flu immunization along with other immunizations as fitness for duty to prevent HAI.
  
• The Joint Commission standard is to achieve 90% health care personnel vaccination rate by 2020 supporting US HHS Healthy People 2020 Annual Influenza Vaccine Coverage Goal for Health Care Personnel,
  
• Medicare IPPS regs require public reporting of health care worker vaccination rates starting in 2013. They will most likely include the expectation of 90% immunization rate as part of their value based purchasing plan taking back monies from facilities with lower than recommended rates.
  
• PA Health Department noted that during the 2010/11 flu season, only 5 hospital systems and 18 nursing homes had vaccinated more than 90% of their staff against influenza. The Hospital Association of PA best practice paper released September 2011 Universal Flu Immunization Programs for Health Care Personnel encourages hospitals to work toward influenza vaccination as condition of employment by 2013.
  
• On Feb. 8^th 2012, the US Dept. of Health and Human Services' National Vaccine Advisory Committee voted 12-2 to recommend that health facilities failing to achieve a 90% flu-vaccination rate using voluntary approaches "strongly consider a policy of employer requirement for influenza vaccination."
  
• There is increased concern for litigation from patients who can prove they acquired a HAI while inpatient.
  

What health care workers are getting flu shots?

Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States shows the nationwide flu immunization rate among people working in health facilities was 63.5%. Physicians had higher immunization rates than nurses.

[TABLE]

[TR]

[TD]Type of health worker[/TD]

[TD]2010-11 immunization rate[/TD]

[/TR]

[TR]

[TD]Physician or dentist[/TD]

[TD]84.2%[/TD]

[/TR]

[TR]

[TD]Nurse practitioner or physician assistant[/TD]

[TD]82.6%[/TD]

[/TR]

[TR]

[TD]Nurse[/TD]

[TD]69.8%[/TD]

[/TR]

[TR]

[TD]Allied health professional[/TD]

[TD]64.4%[/TD]

[/TR]

[TR]

[TD]Technician[/TD]

[TD]64.0%[/TD]

[/TR]

[TR]

[TD]Nonclinical support[/TD]

[TD]66.2%[/TD]

[/TR]

[TR]

[TD]Administrative[/TD]

[TD]57.2%[/TD]

[/TR]

[TR]

[TD]Assistant or aide[/TD]

[TD]55.9%[/TD]

[/TR]

[/TABLE]

Some healthcare workers don't realize they had the flu, thus can pass it onto patients.

HHS Action Plan to Prevent Healthcare-Associated Infections

Influenza transmission to patients by healthcare personnel (HCP) is well documented.^1-8 HCP can acquire and transmit influenza from patients or transmit influenza to patients and other staff. Vaccination remains the single most effective preventive measure available against influenza, and can prevent many illnesses, deaths, and losses in productivity

Several studies have documented serologic evidence of influenza infection after a mild influenza season. One study showed that among 23% of HCP with serologic evidence of influenza infection, 59% did not remember having influenza, and 28% could not recall any respiratory infection, suggesting a high proportion of asymptomatic illness. Thus, HCP who are clinically or sub-clinically infected can transmit influenza virus to other persons at high risk for complications from influenza.

Influenza Vaccination Information for Health Care Workers

What Does the Research Say?

• Health care workers who get vaccinated help to reduce the following:
  
  • transmission of influenza
    
  • staff illness and absenteeism
    
  • influenza-related illness and death, especially among people at increased risk for severe influenza illness
    

  [*]Higher vaccination levels among staff have been associated with a lower risk of nosocomial (hospital-acquired) influenza cases.

  [*]Influenza outbreaks in hospitals and long-term care facilities have been attributed to low influenza vaccination coverage among health care workers in those facilities.

  [*]Higher influenza vaccination levels among health care workers can reduce influenza-related illness, and even deaths, in settings like nursing homes.

Flu Vaccine Facts

• The 2011-12 flu vaccine provides protection against the three main viruses that research indicates will cause the most illness this season. The 2011-12 flu vaccine will protect against an influenza A (H3N2) virus, an influenza B virus, and the 2009 H1N1 virus that caused so much illness during the 2009-10 influenza season.
  
• Flu vaccines CANNOT cause the flu. The viruses in flu vaccines are either killed (the flu shot) or weakened (the nasal-spray vaccine).
  
• Flu vaccines are safe. Serious problems from the flu vaccine are very rare. The most common side effect that a person is likely to experience is soreness where the injection was given. This is generally mild and usually goes away after a day or two.
  

In at will states, employers can terminate staff for any reason unless under individual contract, have a union contract or religious objection under civil rights.

Forcing Flu Shots, Employees and Health at Work - Lawyers.com

[JZ_RN]

I don't think it's fair to force workers to get a flu vaccine. Do they force all cashiers, bus drivers, anyone else who deals with people to get it? We can't force our patients to get it so they don't infect us. We can't force our patients to get anything for our protection, heck, we can't even force them to bathe so they don't stink us out sometimes.

We are people with rights. And while I chose to get the flu vaccine this year (I had the flu last spring and it was the most miserable time I've had in a long time, mind you, I had the flu vaccine last year as well) I would not be forced to. They can't force you to consent to a medical procedure or medication to work there. If parents of children can refuse VITAL vaccines, why can't we refuse a flu vaccine if that's our prerogative?

[imjustme123]

I wrote this on another thread......I was in nursing school and they changed the rules mid-semester and said we all had to get the flu vaccine. I asked for my options because I signed off at the beginning of the semester and I was told I must get it or "not continue with your nursing education". I think this is an outrage.

[llg, PhD, RN]

I wrote this on another thread......I was in nursing school and they changed the rules mid-semester and said we all had to get the flu vaccine. I asked for my options because I signed off at the beginning of the semester and I was told I must get it or "not continue with your nursing education". I think this is an outrage.

It may not have been your school's decision. The facilities where you will be doing your clinicals may have started requiring it. Your school would have no say in that. If you can't go to clinical, then you can't take the required courses.

[Savedbygrace1]

Just one more suttle loss of our freedom. What about the hospitals not hiring unless you have a BSN. Being forced to go back to school when tuition has tripled since I graduated, at almost 50 when I have 19 years of experience. Most of the hospitals dont admit to this however it is happening. Seems like discrimination to me.

[TheAmazingMrsA]

This is one of those arguments that will never end and will always have people on both sides of the fence. I'm still in NS, and was required to get the flu vaccine to even participate in a clinical setting. However, once graduated there is no way I'd consent to continue getting it. Forced immunizations is a really scary prospect, and something every single person should be crying foul about. This goes above "patient safety" and "sucking it up", this is about freedom of choice and freedom to decide what goes into your body.

A few years back I read a journal article that the first H1N1 vaccine in Canada was only tested on a little over 200 people before being mass produced for the public. Out of those 200 people, 4 had severe reactions that required hospitalization. Even worse, the vaccine had never been tested on pregnant women (which doctors push to vaccinate) and was tested on less than 12 children before being deemed "safe". Sure, the CDC can tout the safety of vaccines all they want, but sometimes I wonder if the pharmaceutical companies don't have their hands in the pockets of the CDC and other agencies that are pushing for forced immunizations.

I'll keep the freedom over my body, thank you very much.