Mandatory Flu shots

[CathyLew]

sooooo...what are your thoughts of mandatory Flu shots for health care workers? we got the ultimatum....get the shot or get the ax. So I got my first ever flu shot yesterday. just sitting arround waiting to get sick now!!!!!

[DuluthMike]

"I will pose this question, does a symptomatic nurse have a right to work with a vulnerable population?"

Now Mike, you have introduced a red herring here...I don't think anyone for a nurses right to refuse this new, untested vaccine is arguing that that nurse should go into work if he/she is symtomatic! But, nice try, though...

I will not take this new and untested vaccine, not this year, anyway. If the vaccine truly does no harm, then we will soon know that, won't we? If, on the other hand, it causes problems, like the swine flu vaccine of the 70's did, then we will also know that. But just because someone works in health care, does not mean they should be unwilling guinea pigs for a drug manufacturer who MAY have been convinced to release a vaccine quickly for political reasons. (And who, I understand, may have been released from liability...)

Yes, political reasons. Anyone who honestly believes that this hurried vaccine is being produced for strictly altruistic reasons is simply naive! Our "hard-working" politicians are desperately trying to avoid the fallout that a nasty flu season will produce, especially after all the hoopla over this new flu. So, a vaccine MUST be made available. Whether it is safe or not, or even actually WORKS is irrelevant at this point. Students of influenza history will perhaps remember that during the great pandemic of 1918, a 'faux vaccine' was made available in Boston and Philadelphia, simply to avert panic and convince the populace that "something" was being done! Thanks, but no thanks!

As things stand with this flu right now, it seems that it has greater effects on the young and healthy. The classic signs of a new infection. The younger ones have not been exposed to this type of virus, so it runs wild. Older ones have been exposed to more viruses, and so have greater immunity. This is the way that infections work. No need to go "nuts" and start calling for "mandatory" anything!

I guess my point here is that infection will ALWAYS be with us. How we react to it will determine how effective any course of action will be. Our "hurry" to DO SOMETHING ends up causing more problems than it solves. How many of us are old enough to remember trips to the pediatrician when we were young...taken there by Moms who didn't think the doctor was DOING ANYTHING about their child's illness unless they went home with the ubiquitous bottle of pink medicine? You know, that antibiotic you had to keep in the fridge? Even though most respiratory infections are viral in nature, you got the antibiotic anyway...Today, we have bacterial infections on steroids, MRSA, VRE, and others, who basically laugh at whatever we throw at 'em, cause they have "been there, done that, got the tee-shirt..."

The doctor's at my nursing home still do this. Prescribe an antibiotic BEFORE the culture even comes back, just in case. How frickin' STUPID! There are residents where I work who basically have NO immune systems left after years of this crap! They should be living in plastic bubbles, for chrissakes! Any nasty virus or bacteria comes around, these folks are TOAST!

Infection will always be with us, some will get sick and recover, some will die. The ones that survive have a "body memory" of the agent, and develop immunities, and the illnesses that cause horrible death today will become the minor childhood illnesses of the future. Those are the FACTS people! But, if medicine continues to try and prevent EVERY illness, we will soon end up with a VERY BIG PROBLEM that the most advanced medicine will not be able to solve.

So, no vaccine for me. I am older, and I know I have been exposed to numerous flu agents over my lifetime. I rarely get sick. But when I do, I ride it out. At the age of 50, I can count the number of times I have "needed" an antibiotic on the fingers of one hand. No, I will NOT go to work if I am sick, and hope that others will make this wise choice. But I will NOT be forcibly injected with ANYTHING that I am not 100% comfortable with, period. If that means I can't work as a nurse, then do without me.

You have misread my posts. I have only advocated for a mandatory Influenza A vaccine. Moderators moved an Influenza A vaccination thread into the pandemic forum for some unknown reason. Please reread my post and then if you would like to post some constructive argument try again.

[DuluthMike]

Your "infected nurse" is shedding virus and etc every day. Our emphasis should be on helping the individuals effected by illness, instead of trying to prevent it altogether. Infection is a fact of life. There is actually a school of thought that thinks our cellular mitochondria may be signs of primordial infection. Mitochondria is an invasive agent in the animal cell, has it's own DNA, but is necessary for the cell to sustain complex life. Just like chloroplasts in plant cells that do photosynthesis. You can treat certain plant cells with streptomycin and "cure" them of their chloroplasts, but they will be unable to photosynthesize, and die. The old infectious agent has become necessary for survival.

Medicine should be more focused on our living with infectious agents. They don't WANT to kill us...they NEED us to survive. And we/they can survive much better if we understand the rules...

Again, simply reading the research will change your point of view. Peer reviewed, non-pharma funded, unbiased research shows that preventing infection by immunizing drops death rates of our patients. Our goal is to prevent, first, treat last. Influenza A infection is not simply a fact of life. It is a needless killer.

[ghillbert, MSN, NP]

And, btw, NONE of the causes of death are 'preventable'...it happens to ALL of us, regardless of behavior, at some time or other. Our time will no doubt come at an inconvenient moment-unrelated to our behavior, or maybe not-maybe we will die of old age, maybe not...maybe quick, maybe not...but it will come.

I think I just prefer to be realistic. It may sound cold, but it's really not...

And, never mind the "Health Promotion Class" bs... if "Almost all of the leading actual causes of death are preventable", well then, MOST OF US WOULD BE ALIVE, wouldn't we!? And, we're not, are we? No...most of the people who have ever lived are dead... So, what does this tell you?...God!

I'm not sure if you're being silly or disingenuous, or perhaps reading comprehension is not your forte? As I stated, the leading actual causes of death ARE preventable. I did not claim, as you appear to misinterpret, that death itself it preventable.

The leading causes of death are tobacco, poor diet, physical inactivity and alcohol consumption. All preventable. Like a reference? See attachment.

Mokdad_et_al_2004_Actual causes of death in USA.pdf

[RuRnurse?]

Thanks, but Mike, I have a problem with the "mandatory" part, as do many others. We who refuse do so for a variety of reasons, some are allergic, some oppose on religious grounds, and some like me, for more philosophical reasons.

And I agree with you in that immunization DOES cut back on illness and death in general. I am routinely vaccinated each year against the common flu, it is an old and tested vaccine, and have received the other time-tested immunizations.. But this "swine flu" vaccine is not time-tested, and in my opinion, is being very hastily introduced because people want "something" done. Do we know if this will not cause more problems than it solves, down the line?

So, I am not anti-immunization per se, just this one particular one. (I'm sorry they moved your post, I interpreted it as relating to a global pandemic, not just the regular seasonal flu...)

[RuRnurse?]

"I'm not sure if you're being silly or disingenuous, or perhaps reading comprehension is not your forte? As I stated, the leading actual causes of death ARE preventable. I did not claim, as you appear to misinterpret, that death itself it preventable.

The leading causes of death are tobacco, poor diet, physical inactivity and alcohol consumption. All preventable. Like a reference? See attachment."

I was being somewhat facetious, sorry...It's just that the idea implies that if someone does die of these causes, they basically committed suicide. It's their fault. And I disagree. Plenty of folks who indulge in the above-mentioned practices live long, happy lives. And plenty who don't die of the same illnesses anyway. Not smoking greatly reduces your chances of dying of lung cancer, but you may die of pancreatic cancer instead. Or, maybe even lung cancer, like Andy Kaufman, who never smoked and died of aggressive lung cancer at a young age.

I don't mean that one shouldn't do their best to live healthy. Whatever time you have on this earth, it's better to live it well, and good habits can only enhance your life. But death comes to us all, at some time or another, for this reason or that...It cannot be prevented. The CAUSE may be preventable, but not the inevitability of it.

[DuluthMike]

Thanks, but Mike, I have a problem with the "mandatory" part, as do many others. We who refuse do so for a variety of reasons, some are allergic, some oppose on religious grounds, and some like me, for more philosophical reasons.

And I agree with you in that immunization DOES cut back on illness and death in general. I am routinely vaccinated each year against the common flu, it is an old and tested vaccine, and have received the other time-tested immunizations.. But this "swine flu" vaccine is not time-tested, and in my opinion, is being very hastily introduced because people want "something" done. Do we know if this will not cause more problems than it solves, down the line?

So, I am not anti-immunization per se, just this one particular one. (I'm sorry they moved your post, I interpreted it as relating to a global pandemic, not just the regular seasonal flu...)

You have misread my posts. The confusion is likely due to the moving of this influenza a vaccination thread to the pandemic flu forum. I blame the moderators, not you. I have not advocated for mandatory H1N1 vaccinations (yet). This would be a rash, illogical, and dangerous policy. I have, and will continue to fight, aggressively, for the vaccination of HCPs with the Influenza A vaccination. It saves lives.

[auntstel]

Our hospital is requesting all direct patient care givers recieve the flu vaccine. If you do not, you will be required to wear a mask your whole shift. There is even talk that there will be a special room in the cafeteria for those who have not been vaccinated. It will be interesting to see what happens. Many nurses are saying they will not get the vaccine.

[MikeyBSN]

I have been thinking about this issue a lot lately. Partially because they are starting to mandate the flu shot in NYC and other areas, and partially because I've always been a legal-political minded person. First, let me say that I do believe that mandatory vaccinations, to some extent, are a good idea. That being said, I think there is a significant cost-benefit analysis that we should remember and apply. As for the regular flu shot, I do not believe it should be mandatory. They are requiring all school age children to get the flu shot in my state (a travesty of justice) and last year was the "pilot" year. What happened? Seasonal flu spread the second fastest in my state, and it spread faster than previous years, with more kids getting sicker. Why? The season flu vaccine is basically a giant guess, nobody can predict what strain of the flu will hit and whether the vaccine will be effective. Notice when speaking of the efficiency of the flu vaccine, the CDC says "in well-matched" vaccines. The flu vaccine may be a good investment if a person is at high risk for becoming very ill if they get the flu, but I don't think it should be mandated for all people/children. Personally, and call me a conspiracy theorist, I find it is ironic that the state with the most pharma companies is also the first to mandate a flu shot.

Anyway... back to the issue at hand. When speaking directly about that "swine" flu, it might be a well-matched vaccine because we already know what strain we are dealing with. However, I fail to see how mandating a vaccine at this point is a good idea. We are all health care professionals and we know the risks and benefits of a vaccine. I personally had several patient with "swine" flu, and I later spent an entire week with my younger brother who had a positive swine test (no I didn't give it to him). I never go sick, so either I slowly built up immunity to swine, I got it and didn't realize I had it or I am naturally immune. Either way, mandating the flu shot on me would do nothing but put toxic chemicals into my body and place me at risk for an allergic or other adverse reaction with zero potential benefit. Further, no one knows how well this swine flu shot will work (although pilot studies do confirm some efficacy). No one knows if the swine flu will come back, or how widespread it will be, or what the mortality rate will be (studies I've seen put it lower than the seasonal flu), or whether it will mutate into an form not susceptible to the flu vaccine, or whether this swine flu vaccine will give us Guillain Barre...

I see no evidence-based pratice here, I see no peer-reviewed studies. All I see is a bunch of hysteria and conjecture. That is certainly not a good reason to have the government and/or an employer mandate the risks we take with our personal health, and our private bodies. Where it is true that we want to protect patients, I don't think we will be doing our patients any type of positive service if we force each other to put our own health at risk (and thus decrease the number of total nurses who can take care of patients) by being vaccinated against a flu that we know little about with a vaccine that we know almost nothing about. I would conclude that madating this "swine" flu vaccine would clearly come out on the wrong side of a balancing test. There is simply no evidence that mandating the vaccine would greatly decrease the spread of the virus, and every vaccine carries a risk to our personal health.

[ozoneranger]

Again, simply reading the research will change your point of view. Peer reviewed, non-pharma funded, unbiased research shows that preventing infection by immunizing drops death rates of our patients. Our goal is to prevent, first, treat last. Influenza A infection is not simply a fact of life. It is a needless killer.

Really?

http://www.msnbc.msn.com/id/6969077/

[MikeyBSN]

Our hospital is requesting all direct patient care givers recieve the flu vaccine. If you do not, you will be required to wear a mask your whole shift. There is even talk that there will be a special room in the cafeteria for those who have not been vaccinated. It will be interesting to see what happens. Many nurses are saying they will not get the vaccine.

I would like see the evidence-based study showing that wearing a mask somehow reduce the transmission of flu from a person who doesn't have the flu to a patient. Sounds like the employer is trying to shame their nurses into making a personal health choice with their bodies. Nice...

[caroladybelle, BSN, RN]

I would like see the evidence-based study showing that wearing a mask somehow reduce the transmission of flu from a person who doesn't have the flu to a patient. Sounds like the employer is trying to shame their nurses into making a personal health choice with their bodies. Nice...

First, most people are infectious initially when there are few symptoms. How many times do people go to work, with "The sniffles", or an "allergy attack", when they truly have no clue what they have? Or they start to feel bad, but it is too late to call off, or they get guilted into working.

I currently work at a facility that utilizes evidence based research in developing most of their policies. Said facilty often sets the policies followed in many other major hospitals. Based on this research, the nurses on the immunosuppression units are required to wear masks in all patient rooms at the start of flu season, and until two weeks after the last reported case of the flu in the facility. Needs to say, we were "off masks" for about 10 days this year. And are pts wear surgical masks when walking out of rooms, and N95 if leaving the unit (the unit has special air flow). As to the actual studies, I do not know. But as virtually everything here is prefaced with, "Well, evidence-based research has shown, yada, yada".

I will see whether I can dig them up, but it is not my forte.

But when you consider our pt population, I am amazed that I almost never see any flu cases. And since most of them cannot be vaccinated during treatment, it really is remarkable.

Research with severely immunosuppressed cancer pts have not shown that the old "boy in the bubble - completely sterile" is all that necessary for most immunosuppressed pt care, but good handwashing, masking, careful infection control policies, and aseptic/sterile care of lines is much more important.

[RuRnurse?]

"I see no evidence-based practice here, I see no peer-reviewed studies. All I see is a bunch of hysteria and conjecture."

Absolutely! This whole thing bothers me so much because it is ALL about hysteria and conjecture! This vaccine, whether it is good, bad or indifferent, is being released when it is BECAUSE of political reasons, based on fear and panic. And that scares me worse than the stupid flu does.

With the flu, I have an idea of what I'm dealing with. With this vaccine, it's an open-ended question...If I have to wear a mask when I work, so be it. It is a minor inconvenience that can't hurt you. The vaccine MAY, or may not, we just don't know yet.