Pregnant nurse fired for refusing flu shot

allnurses Guide · Apr 18, 2014

Why the crankiness? I'm trying to engage in honest debate on the subject. And in return this is what I get?
Almost all of those name "allergy to a vaccine component", a pretty vague catch-all. How would a HCP go about identifying such individuals? Or such components?
Before we can go requiring that the system becomes mandatory like you'd desire, we ALL have to agree that the system is imperfect and therefore needs more tweeking. I don't see why that would be such an outrageous thing to want for everyone. Why do you?

Do you realize that system has been in use for decades and is used on millions of Americans every year? Those Americans would be people in the military and VA beneficiaries.

You will find that most allergies that people list are not true allergies, but d/t the cost and trouble of allergy testing most allergies never go on to be verified.

By the way a major part of a debate is that you provide some kind of factual evidence to debate.

Nurseworks, ASN, RN · Apr 18, 2014

You identify allergy to the vaccine or it's components by identifying symptoms of allergy following previous vaccination OR by previously identified allergies which would automatically generate a contraindication to the vaccine.
You seem unfamiliar with some practice standards related to administration of vaccines.

I'm very unfamiliar with many practice standards as I am just a student. That said, what you quoted is stated quite clearly on the CDC site. I find that sort of approach to be counter-intuitive when it comes to a medical procedure, kind of cart-before-the-horse. Should someone suffer a reaction to a vaccine deemed significant enough to voluntarily report/have reported to VAERS, the damage may have already been done. Along with this we may also see the dismissal of such an association based on temporal prejudices or lack of follow-up care. How does that sort of practice do anything to help the public, improve the program or instill confidence in maintaining or exceeding vaccination uptake?

allnurses Guide · Apr 18, 2014

I'm very unfamiliar with many practice standards as I am just a student. That said, what you quoted is stated quite clearly on the CDC site. I find that sort of approach to be counter-intuitive when it comes to a medical procedure, kind of cart-before-the-horse. Should someone suffer a reaction to a vaccine deemed significant enough to voluntarily report/have reported to VAERS, the damage may have already been done. Along with this we may also see the dismissal of such an association based on temporal prejudices or lack of follow-up care. How does that sort of practice do anything to help the public, improve the program or instill confidence in maintaining or exceeding vaccination uptake?

Do you take over the counter medications? Have you ever taken prescription medications? Do you think those have a lower rate of adverse reactions than vaccines, if you do you would be sadly mistaken?.

Vaccines are incredibly safe and go through much more thorough testing than OTCs or Rx medications ever do.

There is no such thing as a 100% safe medication, food, cleaning product, chemical etc. Everything in our lives have certain amount of risk.

It is counter-intutitive to think you expect to develop a 100% safe product/vaccine (which doesn't exist in any other form that we ingest or are regularly exposed through in our daily lives) while millions die from vaccine preventable diseases.

Nurseworks, ASN, RN · Apr 19, 2014

Do you take over the counter medications? Have you ever taken prescription medications? Do you think those have a lower rate of adverse reactions than vaccines, if you do you would be sadly mistaken?.

That you posit that this is even remotely the same argument is disconcerting. Right person, right dose, right route. Or are vaccines exempt from that nursing adage?

Vaccines are incredibly safe and go through much more thorough testing than OTCs or Rx medications ever do.

Statistically so is air travel as compared to automobile travel. But if you get in a car accident you're more likely to survive versus a plane crash. While crude, I'm sure you understand the analogy I am making.

There is no such thing as a 100% safe medication, food, cleaning product, chemical etc. Everything in our lives have certain amount of risk.

Couldn't agree more. But if something is to mandated, it needs to be as close to 100% safe as possible, yes? This is eerily reminiscent of the arguments on the legality of the death penalty. Not trying to be dramatic, but there are some parallels. Either way, there should be respectful debate on the topic as it will lead to improved outcomes for all involved.

It is counter-intutitive to think you expect to develop a 100% safe product/vaccine (which doesn't exist in any other form that we ingest or are regularly exposed through in our daily lives) while millions die from vaccine preventable diseases.

Millions? There are not millions of people dying in this country from vaccine preventable diseases. There aren't even thousands (please don't quote the awful data from the CDC on influenza, we both know it's not all influenza related). There's something to be said for how this country does things beyond vaccines when it comes to preventing illnesses, particularly something as simple as basic sanitation and access to viable food and water, to say nothing of the healthcare industry. Naturally, vaccines have a part in that, but they aren't the sole savior that's for sure.

Some vaccines are necessary. Some are less so. Some don't do as good a job as the natural illness in affording future immunity.

allnurses Guide · Apr 19, 2014

That you posit that this is even remotely the same argument is disconcerting. Right person, right dose, right route. Or are vaccines exempt from that nursing adage?
Statistically so is air travel as compared to automobile travel. But if you get in a car accident you're more likely to survive versus a plane crash. While crude, I'm sure you understand the analogy I am making.
Couldn't agree more. But if something is to mandated, it needs to be as close to 100% safe as possible, yes? This is eerily reminiscent of the arguments on the legality of the death penalty. Not trying to be dramatic, but there are some parallels. Either way, there should be respectful debate on the topic as it will lead to improved outcomes for all involved.
Millions? There are not millions of people dying in this country from vaccine preventable diseases. There aren't even thousands (please don't quote the awful data from the CDC on influenza, we both know it's not all influenza related). There's something to be said for how this country does things beyond vaccines when it comes to preventing illnesses, particularly something as simple as basic sanitation and access to viable food and water, to say nothing of the healthcare industry. Naturally, vaccines have a part in that, but they aren't the sole savior that's for sure.
Some vaccines are necessary. Some are less so. Some don't do as good a job as the natural illness in affording future immunity.

There is no debate here just your rabbling on and on. You have yet to provide any scientific evidence of any sort. You are still suggesting that vaccines are unsafe, and still provide no proof that vaccines might have some conspiracy theory behind them.

Right dose, right route, etc. is a silly comment. I would counter by saying what person is not susceptible to vaccine-preventable diseases, and what health care professionals is not able to spread these vaccine preventable diseases to patients?.

Vaccines should be mandated because of the proven health risks vaccine-preventable diseases are to every person throughout the world.

Vaccine Preventable Deaths and the Global Immunization Vision and Strategy, 2006--2015 Here is the list of estimates of mortality of vaccine preventable diseases.

Also, if you want to counter the "awful" data from CDC on influenza mortality then you need to provide some peer-reviewed scientific evidence.

Jory, MSN, APRN, CNM · Apr 19, 2014

I agree with the decision to fire her, but I am adamantly pro-vaccine.
I personally would require everyone, without a legitimate medical reason (verifiable allergy, rare immune problems etc.), to be vaccinated just as everyone in the military is required to do.

I am pro-vaccine, but the flu shot is not one of those vaccines. It is not every strain, it is not even accurate every year and it's a false sense of security for the hospital.

Hospitals are selling a bill of goods to the general public, even ADVERTISING "100% of our staff is vaccinated for the flu"...which gives many of the uneducated the distinct impression that if you come to "Memorial Hospital" that we can assure you that your family member will not get the flu from our staff members.

What a joke.

Why don't they require visitors to be vaccinated and show proof of vaccination? Especially on the ICU floors? After all, they are walking around the hospital, into the patient's room, possibly bringing in diseases, etc.

The military is not even the same animal as the nursing profession...an enlistment is not an simple employment situation..you are literally, handing your life and BODY over to the gov't. That isn't true when you take a job as a nurse.

I agree with requiring the other vaccinations but the flu-shot isn't one of them. I believe it should be illegal to fire a nurse for refusing to take one..especially if the policy was implemented AFTER the nurse was hired.

Jory, MSN, APRN, CNM · Apr 19, 2014

She was notified and given her options either take the flu vaccine per hospital policy that she was well aware or resign. She decided without any medical recommendation, medical exemption and/or religious exemption to go against the hospital policy. She decided to effectively resign her position by voluntarily not following hospital policy, so how is that being "nasty" on the part of the hospital? It is the hospitals job to protect the patients first not advocate conspiracy theories.

The hospitals also need to be taking care of their employees. If you want to rest on that theory then I don't think someone that doesn't take vaccinations or flu shots for religious reasons should be permitted to work in the hospital at all...but they do. You know why? BECAUSE THEY DO NOT POST A SIGNIFICANT THREAT.

The hospital had options...they just thought it would be easier to fire a pregnant nurse so they wouldn't have to worry about FMLA and use the flu shot as an excuse. I can tell you right now...you couldn't put a gun to my head and get me to take ANY vaccination while pregnant and I don't care how many journal articles you have that state otherwise.

LIMITED RESEARCH EXISTS for ANY vaccine on pregnant women. Keyword: Limited. I am pro-vaccine all the way, but NOT while currently pregnant.

Jory, MSN, APRN, CNM · Apr 19, 2014

She got two notes from different medical providers a CNM and a physician trying to get medical release from getting the flu shot and neither one stated any reason to not get the flu shot.
That study contains a review of over 19 years of reported adverse events in pregnancies after the flu vaccine. The report of incidence was 1 in 1.9 million of spontaneous abortion after the flu vaccine (not caused by but reported after the flu vaccine). The overall rate of spontaneous abortion is reported at 31%. With millions of pregnant women having been given the flu vaccine it would be safe to conclude at this point that the flu vaccine is safe during pregnancy.
Miscarriage
She had apparently gotten the flu shot without objections all her other years of employment and presumably without reaction, so again there wasn't any reason for her not to get the flu shot other than her personal objection.

Do you have a study that shows what the spontaneous abortion rate is of a woman that has a history of recurrent pregnancy loss after they receive the flu shot? I would wager you do not.

I don't consider two recent miscarriages a "personal objection". Considering we don't know with 100% certainty what causes ALL miscarriages, her objection was completely medically justified.

The vaccine has a pregnancy risk category, interestingly enough, of B...if it was 100% safe, it would have a risk category of A.

allnurses Guide · Apr 19, 2014

I am pro-vaccine, but the flu shot is not one of those vaccines. It is not every strain, it is not even accurate every year and it's a false sense of security for the hospital.
Hospitals are selling a bill of goods to the general public, even ADVERTISING "100% of our staff is vaccinated for the flu"...which gives many of the uneducated the distinct impression that if you come to "Memorial Hospital" that we can assure you that your family member will not get the flu from our staff members.
What a joke.
Why don't they require visitors to be vaccinated and show proof of vaccination? Especially on the ICU floors? After all, they are walking around the hospital, into the patient's room, possibly bringing in diseases, etc.
The military is not even the same animal as the nursing profession...an enlistment is not an simple employment situation..you are literally, handing your life and BODY over to the gov't. That isn't true when you take a job as a nurse.
I agree with requiring the other vaccinations but the flu-shot isn't one of them. I believe it should be illegal to fire a nurse for refusing to take one..especially if the policy was implemented AFTER the nurse was hired.

So, please provide the efficacy of the annual influenza vaccines over the last decade and show how it is not been effective in the treatment for the prevention of influenza. Also, provide some proof that healthcare workers who receive the influenza vaccine are not also an effective treatment in reducing transmission of influenza throughout the hospital. I will be waiting any peer-reviewed scientific statements you can find to prove your beliefs that flu vaccine is not effective preventive measure against influenza.

The military is a great test subject for comparisons on all sorts of health matters. The US military members are required to be vaccinated against a variety of illnesses and yet they show no higher complication rates than what is reported in the overall general public. This is essentially an annual sample size of over million persons, and that doesn't even include military retirees and dependents.

As as a nurse we are taught two important ethical principles of beneficence and nonmalfinacence. In my honest educated opinion nurses that refuse to get their annual flu based on a personal beliefs that go against the scientific literature should not be allowed to practice nursing.

allnurses Guide · Apr 19, 2014

Do you have a study that shows what the spontaneous abortion rate is of a woman that has a history of recurrent pregnancy loss after they receive the flu shot? I would wager you do not.
I don't consider two recent miscarriages a "personal objection". Considering we don't know with 100% certainty what causes ALL miscarriages, her objection was completely medically justified.
The vaccine has a pregnancy risk category, interestingly enough, of B...if it was 100% safe, it would have a risk category of A.

Here is one of many research articles that found no correlation between abortions and/or birth defects and flu vaccine. This article addresses H1N1 specifically. You can easily find more in the reference section of this article. Risks and safety of pandemic h1n1 influenza vaccine in pregnancy: Birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants

You should actually try surveying the literature before posting ill formed opinions.

allnurses Guide · Apr 19, 2014

The hospitals also need to be taking care of their employees. If you want to rest on that theory then I don't think someone that doesn't take vaccinations or flu shots for religious reasons should be permitted to work in the hospital at all...but they do. You know why? BECAUSE THEY DO NOT POST A SIGNIFICANT THREAT.
The hospital had options...they just thought it would be easier to fire a pregnant nurse so they wouldn't have to worry about FMLA and use the flu shot as an excuse. I can tell you right now...you couldn't put a gun to my head and get me to take ANY vaccination while pregnant and I don't care how many journal articles you have that state otherwise.
LIMITED RESEARCH EXISTS for ANY vaccine on pregnant women. Keyword: Limited. I am pro-vaccine all the way, but NOT while currently pregnant.

The hospitals like anyone else has to follow state laws about religious objectors just like anyone else even if it goes against scientific theory.

Again post one peer-reviewed scientific article that states your opinions on flu vaccines are correct.

No one is forcing anyone to get vaccines, but as a part of your employment you either get the vaccine or find another job. It is that simple. It is unfortunate that you wouldn't even consider protecting your newborn's life by getting a pertussis vaccine while pregnant. https://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Update_on_Immunization_and_Pregnancy_Tetorifice_Diphtheria_and_Pertussis_Vaccination

It is funny that ACOG disagrees with you about vaccines during pregnancy, but hey what does ACOG know anyways...

Jory, MSN, APRN, CNM · Apr 19, 2014

Here is one of many research articles that found no correlation between abortions and/or birth defects and flu vaccine. This article addresses H1N1 specifically. You can easily find more in the reference section of this article. Risks and safety of pandemic h1n1 influenza vaccine in pregnancy: Birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants
You should actually try surveying the literature before posting ill formed opinions.

Are you familiar with pregnancy risk categories? I am wagering you do not. Considering you skipped right over that section and didn't even address it. Allow me to redirect you to the elephant in the room that you refuse to acknowledge.

A--means 100% safe. No documented association with any birth defect.

B--probably safe. This means that it carries a risk...a risk a mother of recurrent pregnancy losses wasn't willing to take a chance on or there is not enough documentation to say if it does or does not.

If it was 100% safe it would be category A. Again, notice it is not.

I work in an area where women have moved heaven and earth to be able to conceive and carry a baby to term..and even when everything is done right, still don't make it. If you do not work in that area of nursing, then you are SERIOUSLY out of touch with how emotionally draining it is to keep getting pregnant, only to end up losing the baby. EVERYTHING MATTERS when it keeps happening.

FACT: We don't know what causes miscarriage 100% of the time. Therefore, you cannot sit there and say with 100% certainty that "this didn't cause your miscarriage" because anything is possible.

FACT: If you have two miscarriages, your chances of having a third are significantly increased.

FACT: No vaccine is 100% effective against ANY disease.

FACT: No flu vaccine contains every strain that is going around...that is what I meant by a false sense of security.

You didn't read my post. This happened in the early part of the flu season this year....in certain geographical areas, the strain that was going around wasn't in the vaccine. A vaccinated child near where I lived died of one. She had no other health issues, other than the strain didn't match the vaccine she got.

FACT: Unvaccinated visitors puts patient's at risk as well. It is not just employees.

FACT: If unvaccinated nurses would put patients at risk, this is equally true, even if nurses refuse due to religious reasons.

I think you need to pick up your grade-school skills and read what I posted. You are on such a pro-military, pro-vaccine high horse and blindly post articles, but you are not engaging in critical thinking...critical thinking is putting knowledge with the patient's individual medical history to come up with a solution. If it was just a matter of pure statistics, they wouldn't need nurses, they could train any monkey to just pull up a protocol.

I NEVER STATED that vaccines didn't reduce the risk....yet you posted that I didn't believe they did...don't make it up as you go along.

I ONLY stated that there was no literature on the safety of the flu vaccines in women WITH A HISTORY OF REPEATED MISCARRIAGE!!!!!....

You also didn't apparently research the women's situation very well...the flu vaccine was not mandatory when she took the job, it was a NEW POLICY that started last fall. To me, that legally changes the terms of her employment. The state recommendation also stated that if a flu shot was refused, a mask was acceptable...a policy that the hospital did not wish to offer her.