Many hospitals are moving towards creating mandatory influenza vaccination policies as a condition of employment. Such mandates are causing surefire responses on both sides of the fence. What is the push behind the movement, and what is causing the pushback?
Updated:
First, let me just go over some of the symptoms of the flu, and then we will get down to business on the controversy surrounding the push to create mandatory flu vaccines for healthcare workers:
I can't think of anyone who wants any of these symptoms, or to come down with the flu, can you?
Influenza vaccination research has clearly documented the benefits of receiving the flu vaccine (Google it - you will find a plethora of information...however, I will list some links at the end of this article for your information). However, even though there is sufficient evidence to prove the benefits of receiving the flu vaccine, vaccination rates among healthcare workers are pitifully low. In 2013, only 55% of nurses in the frontlines were vaccinated.
Organizations such as The Joint Commission, the American Nurses Association, the American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the Centers for Medicare & Medicaid Services, the Centers for Disease Control, Healthy People 2020, etc., etc., have stated their position on recommending the flu vaccine for healthcare workers in order to decrease the risk of exposure and reduce deaths. Due to this recommendation, many healthcare facilities are now creating mandatory flu vaccine policies as a condition of employment.
Employers who create mandatory policies will have exemptions, of course. Exemptions are made for medical and religious exceptions. For places that do not have a mandatory flu vaccine, they may "strongly recommend" the vaccination and may have a declination form for employees to submit if they refuse the vaccine. Additionally, some employers will enforce refusers to wear a mask during flu season while they are at work in order to protect the patients and the employee.
Evidence has shown that there are more than 36,000 deaths in the US each year related to influenza, and more than 200,000 hospitalizations. Influenza is the 6th leading cause of death. Healthcare workers are the leading cause of influenza outbreaks in the healthcare system. up to 50% of people who are infected by the flu virus do not fill ill for several days and can spread the virus to people at risk of complications and death from the flu. Additionally, evidence shows vaccination decreases mortality by 40%, decreases the spread of nosocomial infections by 43%, and decreases absenteeism by 20-30%.
Additionally, there is the ethics to consider. As healthcare workers, we have all taken an oath to "do no harm". As a nurse caring for patients who are not in their most physically healthy state, do we take the vaccination in order to prevent spreading the flu to our vulnerable patients, in order to "do no harm"? We must consider this when we make our decision to take or refuse the vaccination.
I have the names of a few hospitals, and this is by no means a comprehensive list. This is based on a ListServe survey of hospitals and these are the responses received:
Refusal may be largely due to misconceptions related to the vaccine. Fears that the immune system will cause them to get the flu, beliefs that hygiene and better nutrition are more helpful than the vaccine, fear of needles, beliefs that the vaccine does not work, and fear of side effects. Others believe that they have a constitutional right to refuse the vaccine and that mandatory policies are violating these rights.
(taken from the Los Angeles County Department of Public Health outline of flu vaccine talking points for managers)
The flu shot does not give people the flu. It uses inactivated ("dead") virus. People may still catch a cold or other virus that the vaccine is not designed match.
Studies have shown that flu vaccination prevents flu in 70% to 90% of healthy adults younger than 65 years old.
You need a new vaccine every year - the virus changes over time.
Serious adverse reactions are very rare. They are explained on the CDC's Vaccine Information Statement, which is distributed when the vaccine is administered.
Local short-term reactions - such soreness at the vaccination site, slight fever, achy feeling - may occur but usually do not last long. Over the counter medicines are helpful. Even short-term reactions are much less bothersome than catching the flu and feeling very sick for days.
Your patients are at-risk, and possibly some friends and family members. You can be infected with the flu virus but not feel ill - and can still transmit flu to at-risk patients.
Inactivated influenza vaccine is effective in preventing transmission and reducing complications of the flu. In years when there is a close match between the vaccine and circulating virus strains, the vaccine prevents illness among approximately 70%--90% of healthy adults under 65 years of age. Vaccinating healthy adults also has been proven to lead to decreased work absenteeism and use of health-care resources, including use of antibiotics. Strong protection is also expected when the vaccine is not a close match with circulating strains, with 50%--77% effectiveness in these instances. In addition, effectiveness against influenza-related hospitalization for healthy adults from inactivated vaccine is estimated at 90%.
All healthcare facilities will be facing the choice of creating a mandatory influenza vaccination in the near future, if they have not already. In order to make an informed decision on the topic, we must have information. Knowledge is power. Before you make a blanket statement on pros or cons, have the information you need, know the research, and make an educated decision.
Please respond to this article by answering the following questions:
References
American Association of Family Practitioners. (2011). AAFP supports mandatory flu vaccinations for healthcare personnel. Retrieved from: AAFP Supports Mandatory Flu Vaccinations for Health Care Personnel
ATrain. (2014). To accept or refuse the flu vaccine. Retrieved from: ZZZ_133_Influenza: Module 7
CDC. (2014). Vaccination: Who should do it, who should not and who should take precautions. Retrieved from: Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions | Seasonal Influenza (Flu) | CDC
Influenza Action Coalition. (2015). Influenza vaccination honor roll. Retrieved from: Honor Roll: Mandatory Influenza Vaccination Policies for Healthcare Personnel
Los Angeles County Department of Public Health. (2014). Talking points for managers. Retrieved from: http://tinyurl.com/p6nbg2u
National adult and influenza immunization summit. (2015). Vaccinating healthcare personnel. Retrieved from: Vaccinating Healthcare Personnel - National Adult and Influenza Immunization Summit
NursingTimes. (2014). Why do health workers decline flu vaccination? Retrieved from: http://www.nursingtimes.net/Journals/2014/11/28/y/k/x/031214-Why-do-health-workers-decline-flu-vaccination.pdf
TJC. (2012). R3 Report: Requirement, rationale, reference. Retrieved from: http://www.jointcommission.org/assets/1/18/R3_Report_Issue_3_5_18_12_final.pdf
concerned lady said:Spidey's Mom wrote this, and I agree with her, as her quote applies to allopathic as well as to holistic and complementary medicine, regarding vaccine safety and efficacy, etc.:"Human beings are poor examiners, subject to superstition, bias, prejudice, and a PROFOUND tendency to see what they want to see rather than what is really there. M. Scott Peck"
AND ALL THE YELLING doesn't negate those wise words. As NVIC (Nat'l Vaccine Information Center) says, Ask 8 questions before you vaccinate. Anyone can look up those 8 (also wise) questions, at National Vaccine Information Center - Your Health. Your Family. Your Choice.
Here's the link to those 8 questions: Ask 8 Questions Before You Vaccinate NVIC
Ah yes well pretty funny to use my own sig line against those of us who are in favor of scientific facts instead of the wacko NVIC, Mercola, VacTruth crapola.
Sorry - not buying it.
Edited to add . . . . . actually NOT sorry.
Is it that people *can't* get it - or that they *choose* not to get it?
@concernedlady
I feel as though you are purposely misunderstanding the information and questions posed to you.
While you are entitled to your own opinion, you cannot have your own facts.
Please reread what these very educated and informed members have posted throughout these pages. Try not to use your default setting of a filter that won't let the scientific evidence through.
Lets address each of these "8 questions" created by a pesudoscience site. Most of them seem to be the same question asked in the same way....
Am I or my child sick right now?
Well we vaccinate to prevent illness, so unsure what this question relates to. Actually, an individual is NOT sick there is a reasonable chance it's because of vaccination.
Have I or my child had a bad reaction to a vaccination before?
The incidence of "bad reactions" is well less than 1%. In fact, the risk of complication from disease far exceeds that of vaccination.
Do I or my child have a personal or family history of vaccine reactions, neurological disorders, severe allergies or immune system problems?
If you have "immune system problems" you should be vaccinations biggest advocate.
Do I know the disease and vaccine risks for myself or my child?
This is a great question because I bet the vast majority of people have no idea what the disease risks are. Vaccine risks are easy to find, see next question.
Do I have full information about the vaccine's side effects?
Everyone who receives a vaccine gets a list of the potential side effects. They are also readily available from the WHO.
Do I know how to identify and report a vaccine reaction?
Everyone who receives a vaccine gets information about how to report an adverse reaction to the VAERS system. Less than 3% of reported reactions to the VAERS system is related to the vaccine.
Do I know I need to keep a written record, including the vaccine manufacturer's name and lot number, for all vaccinations?
Luckily where ever you get your vaccination keeps that info for you.
Do I know I have the right to make an informed choice?
Can you truly say you are informed?
Dear Nurse Leigh,
I think you are right, and I stand corrected. Your kind post got me to thinking. I actually was not in favor of doing "nothing" for cancer patients or for diabetic patients.
For those who are strictly into allopathic medicine, I do agree that using an actual placebo for cancer patients and diabetic patients would not be ethical.
My original point was that new vaccine efficacy can be proven or disproven by the methods described in a link, in a previous post I made.
I would also like to see even ONE example of a new flu vaccine clinical trial, that uses an actual (real) placebo, such as saline.
If this were to be done, then, if the placebo group has no more than a 20% flu prevention rate, compared with the new flu shot's 20% flu prevention rate, then, it would be true that the new flu shot is no more effective than a real placebo.
I would also like to see clinical trials with full participants' consent, comparing allopathic and holistic treatments for both cancer and diabetes, etc. Haven't seen any, yet.
concerned lady said:Dear Nurse Leigh,I think you are right, and I stand corrected. Your kind post got me to thinking. I actually was not in favor of doing "nothing" for cancer patients or for diabetic patients
I would also like to see clinical trials with full participants' consent, comparing allopathic and holistic treatments for both cancer and diabetes, etc. Haven't seen any, yet.
And yet you posted in such a way that a non- medical person reading your posts and assuming you knew what you were talking about would think this was actually happening. Totally irresponsible and if anybody is harmed by your words you are responsible for their fate. How does that sit with you?
Fortunately, you will never see this because no reputable scientist or physician would risk another human being's life to do this.
concerned lady said:For those who are strictly into allopathic medicine, I do agree that using an actual placebo for cancer patients and diabetic patients would not be ethical.
I'm relieved that you realize and acknowledge that much.
QuoteI would also like to see clinical trials with full participants' consent, comparing allopathic and holistic treatments for both cancer and diabetes, etc. Haven't seen any, yet.
I wonder if you understand that pretty much every healthcare professional would be overjoyed if a safe, few side effects cure for cancer was discovered. If I thought that a few apricot kernels could accomplish that feat, I'd be jumping for joy.
The reason that you haven't seen, and likely won't see, a study where evidence-based medicine is compared to a holistic method is that there has to be a resonable expectation that the new method works at least as well as the established treatment and is safe enough to try on human beings.
The more serious the disease is, the more important it is that the trial method/medication has a good expectation to pass muster. You can't attempt new treatments based on no more than a hunch, hope or belief knowing that a very serious, life-threatening illness will progress while you're conducting the experiment. If you did, you'd be gambling with people's lives. That would be unconscionable.
The apricot kernels (amygdalin) that you mentioned hundreds of posts back has been touted as a cancer cure by holistic/alternative medicine supporters since the late 1800's. In all these years, laetrile (which is the synthetic form of amygdalin, a cyanogen compound) hasn't been shown to be able to treat or cure cancer or be safe. It's not because of some Big Pharma conspiracy to squash a viable cancer cure to protect their own income. Laetrile as a cancer cure simply doesn't work. It's. not. safe. It's. not. effective.
Another holistic method that will never receive ethical approval for a cancer treatment study is homeopathy. I'll use it as an example of why something won't be considered by a medical professional for a study done on actual human beings. It has no plausible mechanism of action.
Ignoring for a moment the ridiculous premise that "like cures like", homeopathy is just severly traumatized water. Water with a headache, if such a thing was possible. Homeopathic remedies are a drop of some substance dilluted so many times that mathematically the chance is great that not a single molecule of the "active ingredient" remains in the solution. Between the dillutions the water (or rather the container that it's in) has been forcefully struck against a surface in order to "potentiate" it in some magical, unexplained way. Hence the headache.
In order to believe the above can result in an effective medication, a person would have to ignore the knowledge gained in pretty much every single science class they've ever attended.
No plausible mechanism of action. No reason to include it in a trial and compare it against a proven treatment. It would be deeply unethical to do so.
In third world countries, there is not the reporting system for adverse effects from vaccines, like there is in the United States. So, when babies and children get vaccinated in the 3rd world countries, and some develop autism or die, nobody here in the U.S., who got their free concert tickets, will ever know about those unfortunate babies and children.Sleep well, before your free concert.
I will, thank you; because I've done a clinical rotation for community health in a third world country, where TB, polio, typhoid, yellow fever, measles, etc are still prevalent. I've seen the effects of these diseases. We've managed to eradicate many of these, but I'm still protected because when I went overseas I received a typhoid VACCINE.
I hope YOU sleep well when YOUR unvaccinated children spread these diseases to others and cause either permanent damage or end innocent lives, because of your selfish ignorance.
I thought RNs are supposed to be well educated? Hasn't the "vaccines cause autism" argument been beaten to death already?! Look at the EVIDENCE, which is something you should be doing in your practice!
This is too funny not to share.
A cancer quackfest – Respectful InsolenceRespectful Insolence; A cancer quackfest . . .
.......The same way that antivaccinationists have their yearly antivaccine quackfest known as Autism One, cancer quacks apparently like to have their quackfests, too....
macawake, MSN
2,141 Posts
Granted, this is wikipedia but I'm curious to know if you think that they got their facts wrong or if this is actually a correct description of this "information source" you're recommending that we read.
https://en.wikipedia.org/wiki/National_Vaccine_Information_Center
(quote from Wikipedia, my bold)
Concerned lady, I don't find your sources credible.