Should the H1N1 Vaccine be mandatory for Healthcare Professionals?

lamazeteacher · Nov 7, 2009

As a nursing student, I was told to get the shot or drop out. I am not happy with that of course but what can I do? I have worked very hard and put a lot of time and money into my schooling. The CDC says "it is not mandatory", but they are not regulating this statement. Also they are not testing for the H1N1 anymore, does that mean they are also not keeping track of adverse effects? This may be just like the flu shots. The CDC list possible reactions, yet who really reports them if you say you have had a reaction? I had mentioned to a few nurses that I had developed flu symptoms from the vaccine,and all I got was "you can't get the flu from a shot." I am sure they did not report my adverse reactions.

You might be interested to know that Canadian research with 2,000 people in 4 different studies revealed that receiving seasonal flu vaccine prior to H1N1 vaccine, results in greater susceptibility to having H1N1 flu. So if you caught a flu after receiving seasonal flu vaccine...... as I did.......it most probably was H1N1 flu...... The Canadians have focused on giving H1N1 flu vaccine now, rather than seasonal flu vaccine, to avoid that because seasonal flu comes in late December, January, February, and March. American and UK microbiologists have said that the Canadian findings couldn't be replicated, but the seasonal flu vaccine hasn't been around long enough this year for any credible study to be done to invalidate the Canadian study here or elsewhere.

Ahhhh, I have so much medical history to share with you!

The problem with Dr. Sabin's oral polio vaccine discovered by him in the USA, is that it used the attenuated virus, which capriciously was "enlivened", horrifying those who were proponents of it. (Flumist for prevention of H1N1 used a similar process, without that drawback. Live polio virus mutated occasionally, and therefore was much too labile to use in a vaccine. Unfortunately that polio virus got all too live for a very small percent of those given it, and they got an "attenuated" version of the disease.

Worse yet, as those who have had polio and fortunately lived to find out, the debilitating effects of their disease returned to taunt them, with advancing age when they were around 50 years old. Lest that ever happen again, its use was discontinued, except in developing countries (? cheaper) and the original injected vaccine which contains dead virus is the only approved polio vaccine used in the USA. That had been discovered by Dr. Salk at Connaught Laboratories in Toronto, Canada and is the only vaccine for polio used in the USA today. Hence the use of the name Sabin for the oral vaccine, and Salk for the injectable one.

Those two American scientists were fiercely competitive, and brought their vaccines to other countries to do their research, for financial and political reasons. However neither scientist patented their discoveries. The Smithsonian has several interesting articles about that, which are available online.

I remember the closed public swimming pools of my childhood, in Canada and the sheer panic of parents for their children, who seemed more susceptible to polio (harks of H1N1, doesn't it?). I began my student nursing in 1957 in Canada, working with patients in "iron lungs" (a challenge if ever there was one, for patients and nurses) at an Infectious Diseases Hospital

in Montreal. Many Eskimo people who were extremely vulnerable to polio and Tb were transported by the government, down to Montreal for treatment there. That was an exercise in ethnic shock for both cultures!

The Eskimo toddlers weren't used to wearing any clothes inside their heated homes up north, and were "Houdinis" at escaping their restraints (without them, they were out of their cribs in a few seconds) during the night; and were to be found bouncing on the metal springs, having tossed the mattress, bedding and nightclothes on the floor and grinning widely at us as we came on duty in the morning. they adapted pretty well to being in a strange place, without anyone there that they knew. I wonder, though, what happened psychologically the rest of their lives.....

Canada reveled in the presence of Dr. Salk there, having sponsored his research leading to his discovery of the first vaccine that successfully combated polio. Early in the 1960s, I worked in pediatrics in the USA and gave the pink Sabin oral vaccine drops on white sugar cubes. Many years later, in 1987 while designing the home I built, the architect suffered the return with a vengeance of his painful childhood symptoms.

ACRN06 · Nov 8, 2009

No. It should not be mandatory.

As far as pple who are comparing this to other vaccinations, we are not talking about those vaccinations, we are talking about this brand-spankin-new H1N1 vaccine.

MissBrittanyRN · Nov 8, 2009

I am giving the flu shots as a temporary member of the employee health team at a hospital. I respect anyone's decision to refuse the H1N1 injection and our hospital does not require it for the employees. I do wonder why employees accept the mandatory PPD inj. MMR, Varicella, etc, but not the flu shot(s). Perhaps people are scared of the H1N1 inj. because it is a "brand new shot." Many do not realize that the seasonal flu shot is brand new every year. Trust me, I do not want to be a lab rat myself. I refused the gardasil shot that my MD encouraged me to get when it was brand new. I did not want to be the one who the kinks were being worked out on, and my refusing gardasil did not affect anyone else. However, I do not want to put those around me at risk by not getting the H1N1 inj. and I believe that it is as safe as any other flu shot

MissBrittanyRN · Nov 8, 2009

I do not believe that it is ethical to force any person to get any vaccine, as that would be against their free will. However, if your employment is "at-will" and your institution has a policy in place, then they could take action against those who do not adhere to the policy.

Laidback Al · Nov 8, 2009

Regarding the question -

"Should the H1N1 Vaccine be mandatory for Healthcare Professionals?" Yes, if your employer requires it.

"Do you have a right to refuse?" Yes, and then find another career more suitable to your nature.

Comment:

The lack of scientific understanding of vaccinations demonstrated in a number of posts here at allnurses.com is disconcerting to me. I am not a health care professional, but I have taken the time to educate myself about vaccinations.

Seasonal trivalent and the current monovalent H1N1 vaccines do not contain "live" viruses. Vaccinations from "dead" viruses can not give you influenza (the flu). The only thing different about the current H1N1 monovalent vaccine compared to the previous influenza vaccines is the genetic make up of the seed strain. That is, the novel H1N1 seed strain contains a different genetic sequence than H1N1 strains used in previous vaccines. An H1N1 strain has been present in influenza vaccines for decades, although the specific strain varies. Now the novel H1N1 pandemic strain has been added to the list of H1N1 strains to be used in vaccines.

In 2007, WHO recommended replacing the previous New Caledonia strain of H1N1 with the Solomon Island strain. (1) In 2008, WHO recommended replacing the H1N1 Solomon Island with the H1N1 Brisbane strain. (2) In early to mid 2009, The FDA approved the 2009-2010 trivalent seasonal flu vaccine with last year's H1N1 Brisbane strain. (3) Recently, WHO has recommended that the novel H1N1 pandemic strain replace last year's Brisbane strain for Southern Hemisphere. (4) Recommendations for the 2010-2011 influenza vaccine in the Northern Hemisphere have not yet been officially announced but will most certainly include the H1N1 pandemic strain in some form. Thus, there have been changes in the strain of H1N1 in the seasonal flu vaccines over the past couple of years. I don't recall any public complaints from HCWs when these changes in the H1N1 seed strains in the influenza vaccines took place. Why is it that today, a monovalent vaccine with the novel H1N1 pandemic strain is singled out as a dangerous and unproven vaccine? This strain is simply another H1N1 virus with a different genetic structure than previous strains used for years in vaccines. It is manufactured with the tried and true egg-based production process used for decades in the manufacture of seasonal influenza vaccines.

You can always chose to not get the H1N1 vaccination. But, whether you get the H1N1 vaccination this year or not, a novel H1N1 strain will be in the seasonal flu shot you get next year. So I guess those of you refusing to get the H1N1 vaccination now will also be refusing the seasonal influenza vaccine next year as well.

References

(1)

Feb 20, 2007 (CIDRAP News) - Because of changes in the influenza viruses now in circulation, the World Health Organization (WHO) has recommended changing one of the three viral strains to be used in flu vaccines in the Northern Hemisphere next fall and winter.
The WHO is recommending changing the influenza A/H1N1 strain in the vaccine for the first time since the 2000-01 season. The agency recommends a Solomon Islands strain of H1N1, replacing a New Caledonia strain. The New Caledonia strain of H1N1 had been recommended for the previous 7 years.
The other two recommended strains remain the same as last year. They are a Wisconsin strain of influenza A/H3N2 and a Malaysia strain of influenza B. The WHO had changed the H3N2 strain the past 3 years and changed the B strain last year.
http://id_center.apic.org/cidrap/content/influenza/general/news/feb2107vaccine.html

(2)

Feb 14, 2008 (CIDRAP News) - The World Health Organization (WHO) today reported evidence of a less-than-satisfactory match between all three components of this season's influenza vaccine and the flu strains currently making people sick.
Last week US health officials reported mismatches between the influenza A/H3N2 and influenza B components of this year's vaccine and the circulating H3N2 and B strains. Today the WHO reported that the majority of recent H1N1 virus isolates globally have not matched well with the H1N1 component of the vaccine.
As a result, the WHO today recommended replacing all three components in next year's flu vaccine for the northern hemisphere.
H1N1 is the flu subtype that has begun to show resistance to the antiviral drug oseltamivir (Tamiflu), one of the two neuraminidase inhibitors recommended for flu patients. In a separate update today, the WHO said H1N1 viruses with a resistance mutation have been found in 18 of 37 countries where the viruses have been analyzed. The mutation was observed in 14% of the isolates studied, including 8% of those in the United States.
Each February the WHO assesses the flu virus strains in circulation before picking the strains for the next northern hemisphere flu season. It takes about 6 months for vaccine manufacturers to grow the viruses in chicken eggs and formulate them into trivalent (three-strain) vaccines. Changing one or two strains is not unusual, but replacing all three is less common.
The WHO recommended the following for next season's vaccine:
For the H1N1 component, a strain similar to A/Brisbane/59/2007, replacing A/Solomon Islands/3/2006
For the H3N2 component, a strain similar to A/Brisbane/10/2007, replacing A/Wisconsin/67/2005
For the B component, a strain similar to B/Florida/4/2006, replacing B/Malaysia 2506/2004
http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/feb1408vaccine-jw.html

(3)

Jul 21, 2009 (CIDRAP News) - The Food and Drug Administration (FDA) yesterday announced its approval of seasonal influenza vaccines for this year, the annual step that clears the way for manufacturers to start marketing their vaccines.
Six manufacturers are making seasonal flu vaccines for the US market this year--five inactivated injectable vaccines and one live attenuated vaccine given as a nasal spray. The FDA recently sent all six companies letters approving their supplemental license applications for this year's version of the vaccine.
The seasonal vaccine targets three influenza subtypes; the specific strains are often changed from year to year as health authorities strive to keep up with the strains in circulation. This year's vaccine contains a different influenza B component than the 2008-09 vaccine. The type A/H1N1 and A/H3N2 components are the same as in last year's version.
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jul2109fda_mws.html

(4)

Sep 23, 2009 (CIDRAP News) - The World Health Organization (WHO) has recommended that seasonal influenza vaccines for use in the southern hemisphere next year contain the pandemic H1N1 virus instead of a current seasonal H1N1 strain, signaling that the pandemic strain is expected to push the older H1N1 strains aside.
The WHO also picked a new strain of influenza A/H3N2 for the 2010 Southern Hemisphere vaccine, while keeping the influenza B strain the same. The recommendation means that manufacturers will likely be changing two of the three strains used in the vaccine.
The WHO annually recommends one H1N1, one H3N2, and one B strain for use in seasonal flu vaccines, trying to match the current circulating strains. Because it takes months to grow millions of doses in eggs, the agency makes its choices for the southern hemisphere in September and those for the northern hemisphere in February.
The pandemic H1N1 was the predominant flu strain in much of the world by July of this year, the WHO's technical report on the strain recommendations notes. In a separate question-and-answer statement, the agency added, "The available data suggest that the pandemic influenza A (H1N1) viruses are becoming much more common than the current seasonal influenza A (H1N1) viruses.
http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/sep2309strains.html

tshores · Nov 8, 2009

The calling of nurses to accept H1N1 vaccine so that their patients will not get that flu from their caregivers; and to prevent deaths of those susceptible to lethal repercussions of it, along with demonstrating trust in the regulating agencies of pharmaceuticals' statement that the vaccine is safe. It tests everyone's capacity to place their health in line with their dedication to their patients' wellbeing.
It is very important that we pass this test and realize our place with legions of other health care providers, willing to stand up for the mission of being part of the solution of illness.

But I don't blindly trust the pharmaceutical companies nor their regulating agencies--they've had to recall too many medications they said were "safe"; usually after a lot of people died. There are lawsuits right now because the pharmaceutical companies hid harmful side effects from those regulating agencies and the public. Some FDA officials are monetarily tied to those pharma companies. WHO changed its definition of a pandemic--from causing a lot of deaths to just being widespread. They admit that they sometimes mix other vaccinations (for diseases that haven't been around in a while to vaccinate against them, too) with the yearly flu shots without our knowledge. Why do they insist on using mercury and aluminum-based adjuvents in much higher doses than the safety recommendations of the FDA, known toxins to the human body? Why have they stockpiled squalene to mix in the shots--something normal around your nerves, but injected can cause your body to form antibodies against the normal squalene in your body causing MS-like diseases. Thankfully, the US won't let them use it--unless an Emergency Use Authorization is issued, but Europe uses it.

So I'd like to know why I should trust them?!? This is not a test or a call to arms to "stand up for the mission." It's about being politically correct and the control of others. Nowadays, it's PC to say the government and I think that's bad for you, so you can't have or do that--or we'll raise the taxes on that. The government and I think this is good for you, so we're making it mandatory for you to do this. As long as we're Americans, we should have the choices and freedom of all Americans--no matter what we do for a living, and it should be illegal for employers to mandate differently.

kcksk · Nov 8, 2009

So many different opinions on this. I got my vaccine because I believe I have an obligation to protect the ones who can't be protected. I work in a pedi office and am in contact with kids with flu one minute and newborns the next. I would not want it on me that I passed it along to someone too little to be protected. Yes H1N1 is the flu, so many think no big deal. I have a healthy 21 yr old child who ended up hospitalized this week as a result of H1N1 which turned into pericarditis, myocarditis. Drs said as a result of H1N1. Thankfully everything is Ok and we just need to follow up with cardiology but she wasn't considered a high risk group other than she is a college student.

I had to have vaccines in order to go to nursing school or to work in a hospital. Why should this be any different? Or if you choose not to be vaccinated, work you shift with a mask on so you don't infect others.

Also, two of our nurses are out sick this week with the flu--oh yeah, they didn't get vaccinated so now everyone else needs to step up, cover their shifts, work twice as hard to cover their absence etc. Not just no big deal if your sick you are out sick. Maybe that could've been prevented if they had gotten vaccinated with everyone else.

CuriousMe · Nov 8, 2009

No. It should not be mandatory.
As far as pple who are comparing this to other vaccinations, we are not talking about those vaccinations, we are talking about this brand-spankin-new H1N1 vaccine.

Do you consider the seasonal flu shot to be "brand spankin new?"

The H1N1 shot is EXACTLY the same as the seasonal flu shot....it just has one dead virus particle in it instead of three.

The seasonal flu shot always has a version of H1N1 in it....next year, the pandemic H1N1 from this year will likely be in the seasonal flu shot.

It really is the same thing.

Bonnie Chung · Nov 8, 2009

Brian,

I believe that the H1N1 vaccine should not be mandatory for healthcare professional because they should give us the option to choose to receive it or not. I think that healthcare professionals are smart enough to stay home if they have flu-like symptoms so patients would not be at risk. I feel that everyone, including healthcare workers should have teh option to choose.

CuriousMe · Nov 8, 2009

Brian,
I believe that the H1N1 vaccine should not be mandatory for healthcare professional because they should give us the option to choose to receive it or not. I think that healthcare professionals are smart enough to stay home if they have flu-like symptoms so patients would not be at risk. I feel that everyone, including healthcare workers should have teh option to choose.

What about the 1-2 days the HCW is infected and shedding virus, before they get symptoms?

Bonnie Chung · Nov 8, 2009

Areyou talking about the time that the flu virus is dormant?

tshores · Nov 8, 2009

I DO understand the reasons for taking the flu vaccinations; I just don't think they should make them mandatory because there are just as many good reasons not to take them. They could make them safer for people to take without all the extraneous garbage they put in them to manufacture them more cheaply.

We've had to cover for nurses out with the flu, too--and--oh yeah, most of them had the flu shots 2-4 weeks ago. How does that protect their patients any better? Most of the nurses I work with get vaccinated every year, and a lot of them get the flu anyway. I'm sure I'm not the only one seeing that.