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.
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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
Your own experience is subjective and not measurable.ETA: I am glad you are feeling better!
Ty :) I just wanted to say, it's not measurable because it's true, everyone is different. Different diets, habits, etc. But, everyone needs vitamins. That's what's in food that the body uses for health and healing. It can help heal itself if it get's enough of them. How much works for one or the other is not clear, but, it is clear, they are what works with the body best. Someone may well get enough vitamin C in their 2 fruits a day. But, others may need more. Since we're not in perfect climates and health conditions to begin with, it varies person to person. Just one thing, I know, respiratory problems like the one who had the flu 4 years in a row, is in poor shape, and she obviously needs more than what she's getting in her food.
No idea what this case is secondary to, but it should suffice.[ATTACH]20039[/ATTACH]
This one is relatively mild, too. Not quite as bad in the left lung, and certainly is capable of getting worse than the right.
Rusti, in case you aren't comfortable reading X-rays, the photo on the left has blackened areas within the lungs that show where air exchange is capable of happening. In other words, when you breath, that's where the air ends up. On the right, as you can see, there is very little blackened space by comparison. All of the white is space where air is not going. It is being stopped by fluid. The brighter the white, the less that air can fill. This person will feel like they can't breathe, literally. For lack of a better way of explaining it, they are drowning in their own body fluids. They may be gasping for breath, and will often be intubated (given a breathing tube) because they just can't get rid of carbon dioxide or get enough oxygen in.
This is a life-threatening complication of the flu. Even the young, healthy adult is at risk for this.
ixchel...why did you change your pic? :)...and thank you for that lesson. I would like to say, Vitamin C is a natural antihistamine, and it has bein used on very serious cases (like your x-ray there) in one dying of influenza, and actually saved his life. C is what the body uses naturally to clear out fluids, and is a strong antiviral itself.
Just met another (there are many) patient who got Guillain Barre Syndrome (severe peripheral neuropathy) shortly after getting a flu shot. None of the patient's doctors ever recommended oral Vitamin B complex, plus extra sublingual (under the tongue, to promote absorption into bloodstream, bypassing any digestive issues) Vitamin B-12 (MethylCobalAmin type), to help patient's injured peripheral nerves heal their damaged myelin sheaths.
Patients' docs also never told pt. about how flu shots can cause Guillain Barre Syndrome).
Reminds me of the Emperor's Clothes tale. Naked emperor (myth--Emperor is wearing clothes--and myth is spread by Emperor and all adults in his kingdom) seen by a youngster to be naked, and youngster hollers the truth, out loud--"but he's naked!"
Analogy: Flu shots can cause Guillain Barre Syndrome.
Myth--no way can flu shots cause Guillain Barre Syndrome.
Patient had to figure out the cause and effect, and patient now says patient will NEVER again get a flu shot.
In my opinion: Nurses and anyone should be able to make their own decisions, and not ever be FORCED to get a flu shot.
I have had an Experience, and for years (not a "belief"). I understand the difference.I didn't have a remedy from asthma with medication. Obviously, it helped me temporarily, but, asthma didn't stop returning. Only got more occurrences actually. Vitamin C not only has stopped asthma attacks, but, it's a very rare occurrence (not in 7 years or so) since a mold condition in the rural area we live at this time. What I question is how and what vitamin C was used in those studies. Ascorbic acid alone does not work as well as one with bioflavanoids. Not only did I realize it for myself, I then read it online as well. So, there again, I know my experience, and it's not a "belief". I know conventionals dismiss what people say easily regarding vitamins, but, I wouldn't have found out how well they worked till I tried them for myself. I like giving others the chance to look into things for themselves too, for their sake. I'm scared of conventional meds. more so. I used to think we were all on the same page, wanting people to get healthy. I really don't think that anymore. sorry.
Just to add. The fact that she got the flu 4 out of the 5 last years despite getting the vaccine, if that's not clear evidence that the flu vaccine is NOT working, I don't know what is. There are far safer preventatives than that.
Your EXPERIENCE is what we science folk call ANECDOTE, which basically means your belief based on your experience. It is not fact. It is not science. It is, when it stands alone, opinion only.
I am going to guess you are in your 20s, based on the fact that sometimes, childhood asthma changes into adulthood. In severity, in triggers. Children also outgrow allergies into adulthood, so if an allergen triggered your asthma, it may very well go away.
Vitamin C decreases inflammation, generally when taken chronically. If you are at the onset of an asthma "attack", you pop a Vitamin C, and the attack goes away, I believe you should be assessed for anxiety. Anxiety can present similarly and will respond to placebo (which the vitamin C would be at that point), whereas bronchospasm/constriction will not.
A site to present a balanced and researched summary of effectiveness and methods of treatment uses (https://umm.edu/health/medical/altmed/condition/asthma):
Vitamin C (1 g per day). One preliminary study suggested that children with asthma had significantly less wheezing when they ate a diet rich in fruits with vitamin C. Vitamin C does have anti-inflammatory and antioxidant properties, which may help you maintain good health. Some studies suggest that taking a vitamin C supplement (1 g per day) may help keep airways open, but other studies show no benefit.
Now, the person who was flu positive for 4 years out of 5, I'm sure you'll say yes regardless of what really happened, but did she have nasal swabs every time to confirm? It's a frustrating truth that people tend to say they have had the flu without ever testing to confirm, and often they can't tell the difference between the flu and a different virus. If they did have the flu, I guarantee they had a less severe illness than they would have. (And yes, that is only my opinion, based only on my experience.)
NOT ONE OF US dismisses the value of vitamins. We just usually know what each one REALLY does, not what random quacks like to tell you on the Internet.
ixchel...why did you change your pic?:)...and thank you for that lesson. I would like to say, Vitamin C is a natural antihistamine, and it has bein used on very serious cases (like your x-ray there) in one dying of influenza, and actually saved his life. C is what the body uses naturally to clear out fluids, and is a strong antiviral itself.
To answer your question, it was time for a change.
To the rest of it, where do you get this stuff?! None of it is true. It does not clear out fluids, it is not an anti-viral, and it is not an antihistamine. I read the story about the magic influenza guy, but what you fail to recognize is that this is ONE PERSON who scientifically can not be ruled out as simply getting over the flu.
Just met another (there are many) patient who got Guillain Barre Syndrome (severe peripheral neuropathy) shortly after getting a flu shot. None of the patient's doctors ever recommended oral Vitamin B complex, plus extra sublingual (under the tongue, to promote absorption into bloodstream, bypassing any digestive issues) Vitamin B-12 (MethylCobalAmin type), to help patient's injured peripheral nerves heal their damaged myelin sheaths.(Patients' docs also never told pt. about how flu shots can cause Guillain Barre Syndrome).
Paragraph 1 - do you have any idea how fast GBS hits a person, from first foot tingle to lung paralysis? I'm pretty sure they are too busy stabilizing the person on sedation and vents to worry about vit B and B-12. Supplements can be discussed outpatient.
Paragraph 2 - docs don't tell patients they can get GBS from the flu vaccine because it is more likely a person will get GBS from the flu than from the vaccine. (Guillain-Barr)
Your EXPERIENCE is what we science folk call ANECDOTE, which basically means your belief based on your experience. It is not fact. It is not science. It is, when it stands alone, opinion only.I am going to guess you are in your 20s, based on the fact that sometimes, childhood asthma changes into adulthood. In severity, in triggers. Children also outgrow allergies into adulthood, so if an allergen triggered your asthma, it may very well go away.
Vitamin C decreases inflammation, generally when taken chronically. If you are at the onset of an asthma "attack", you pop a Vitamin C, and the attack goes away, I believe you should be assessed for anxiety. Anxiety can present similarly and will respond to placebo (which the vitamin C would be at that point), whereas bronchospasm/constriction will not.
A site to present a balanced and researched summary of effectiveness and methods of treatment uses (https://umm.edu/health/medical/altmed/condition/asthma):
Now, the person who was flu positive for 4 years out of 5, I'm sure you'll say yes regardless of what really happened, but did she have nasal swabs every time to confirm? It's a frustrating truth that people tend to say they have had the flu without ever testing to confirm, and often they can't tell the difference between the flu and a different virus. If they did have the flu, I guarantee they had a less severe illness than they would have. (And yes, that is only my opinion, based only on my experience.)
NOT ONE OF US dismisses the value of vitamins. We just usually know what each one REALLY does, not what random quacks like to tell you on the Internet.
:) I got asthma first as an adult, when 5 or 6 months pregnant with my first son. It wasn't too bad for years, just taking some theophyline (sp) once in a while, but, in my late 30s it progressed. On 4 medications, including steroids time to time. I had enough, and one time thought of how Vitamin C might be good for colds, so I thought (silly as it seems) "I wonder if it will help with asthma too?". So, I went out and bought some, very cheaply, and, for some amazing reason, within a few minutes an asthma attack would stop! I thought..."Nah" this can't be that easy". But, then I dared to try it again the next time, and, it happened again. Then again, over and over. Stupidly, I wasn't taking it daily not liking pills anyway, so that's how it went for quite a while. It was hit and miss sometimes, and I'd need my inhaler as well. Anyway, that went on for years. I finally got the idea maybe I'll take it daily, at least in the winter when I had the most problem (with colds and asthma). So, slowly, interestingly, I found I wasn't getting as sick as I used to. It's been years not having a cold or asthma attack as well. I shared earlier, it was only when I had a vaccine that I actually got sick (for 9 days of "flu-like" symptoms laying me out). That was the last. I'm sorry if it's gotten to mentioning vitamins now as being "dangerous" or "scary". It's funny to me.
:) I got asthma first as an adult, when 5 or 6 months pregnant with my first son. It wasn't too bad for years, just taking some theophyline (sp) once in a while, but, in my late 30s it progressed. On 4 medications, including steroids time to time. I had enough, and one time thought of how Vitamin C might be good for colds, so I thought (silly as it seems) "I wonder if it will help with asthma too?". So, I went out and bought some, very cheaply, and, for some amazing reason, within a few minutes an asthma attack would stop! I thought..."Nah" this can't be that easy". But, then I dared to try it again the next time, and, it happened again. Then again, over and over. Stupidly, I wasn't taking it daily not liking pills anyway, so that's how it went for quite a while. It was hit and miss sometimes, and I'd need my inhaler as well. Anyway, that went on for years. I finally got the idea maybe I'll take it daily, at least in the winter when I had the most problem (with colds and asthma). So, slowly, interestingly, I found I wasn't getting as sick as I used to. It's been years not having a cold or asthma attack as well. I shared earlier, it was only when I had a vaccine that I actually got sick (for 9 days of "flu-like" symptoms laying me out). That was the last. I'm sorry if it's gotten to mentioning vitamins now as being "dangerous" or "scary". It's funny to me.
Meanwhile, you clearly did not actually read the last paragraph of my post regarding vitamins being accepted by the nursing community.
You won't get a single one of us to believe vitamin C literally stopped your asthma taking it after onset of symptoms. Literally, that is not possible, it was placebo, and you need to get that checked out.
Taking it daily, long term, I do believe you could have a decrease in severity and frequency. But not immediately like that.
To answer your question, it was time for a change.To the rest of it, where do you get this stuff?! None of it is true. It does not clear out fluids, it is not an anti-viral, and it is not an antihistamine. I read the story about the magic influenza guy, but what you fail to recognize is that this is ONE PERSON who scientifically can not be ruled out as simply getting over the flu.
Of course his one experience doesn't "prove" anything to those who don't know how amazing Vitamin C is personally (as I do), but, nevertheless, I think it's worth mentioning. I've had many times the beginning of a cold, one time "flu-like" symptoms, and once again used Vitamin C along with honey, apple cider vinegar and cinnamon, and amazingly, they altogether apparently stopped the symptoms too! It does depend on how quickly one can catch them imo. So I found. This is years of experience speaking :) So, pardon me but, I think there's something very wrong with those "science" studies. Maybe how they're done. Maybe what they use. I just wouldn't wait for them to "prove" too much.
Maybe true, but, not in my experiences with "colds" and what I had that time...head ache, fever, chills, body ache, feeling of being hit by a truck all at once. Certainly not like any other beginning of a "cold" I've had. In any case, my fav vitamin "hero" C and "cold protocol" worked for me :).
Just want to say, it's only in the presence of "professional" medicals, do I feel like some kind of "enemy" mentioning natural remedies that work so well. As I said, I wonder how much we're on the same page of "health" concerns. Actually "warning" me to not say what I know. It is not writing out dangerous prescriptions, it's speaking of how well vitamins might work. There is a difference.
Farawyn
12,646 Posts
Your own experience is subjective and not measurable.
ETA: I am glad you are feeling better!