Vaccination Mandating

[Ariemay82]

I'm in NY. Wonder how other NURSES are feeling about mandatory COVID vaccination?

[hppygr8ful, ASN, RN, EMT-I]

12 hours ago, 2BS Nurse said:

We would never administer IV pain meds in urgent care. We didn't even stock narcotics. IM sumatriptan and IM ketorolac were the only meds we administered for migraines. Sometimes IV fluids. 

I was about to say the same thing - Iwas having a problem with migraines a few years ago and when I went to ER I got IV Phenergan with a very low dose of Ativam 0.5 mg. Straightened things right out but the dogs told me to take Benadryl at home at the first sign of a migraine and It worked.

[Sciencedude1, BSN, RN]

On 12/29/2021 at 5:15 AM, toomuchbaloney said:

The only zealots in these threads are those pretending that vaccination isn't the pathway out of a covid pandemic.  They've been convinced to push against vaccination because their political beliefs have consumed their ability to reason or think critically...assuming that they could do those things prior to submitting to the wiles of the rhetoric. No, we've been unable to find common ground with them. 

 I have never said that vaccines should not be used. I have always held a position of being pro-vaccine. However I disagree with the majority of posters stating that we should mandate vaccines. I still think we should use education as a means of convincing people in order to get vaccinated.

Not only should we utilize vaccines but we should also be treating patients on an outpatient basis in order to reduce viral loads within patients. The virus replicates within the first 10 days of infection and afterwards only debris of the virus remains. The immune system can't tell the difference between live viruses and viral debris which leads to a cytokine storm and subsequently ARDS and DIC. If we can reduce viral loads of patients within the first 10 days with antivirals then we would reduce the rates of cytokine storms and subsequent ARDS. So not only should we educate the population of the benefits of vaccines but we should also be pushing antivirals on an outpatient basis. We should also be talking to the population about nutrient deficiencies which leads to higher rates of cytokine storms and DIC such as vitamin D/Magnesium.  

I wanted to point out another study that came out on Dec 14, 2021. It's a publication in Nature by Oxford University. In this study it shows Moderna has higher rates of myocarditis in men under 40 after the second dose compared to COVID19 infection. Dr. Vinay Prassad MD MPH from the University of California at San Francisco stated that we should be promoting men under 40 to be utilizing pfizer which has a better safety profile, and he recommends that we not rush the booster campaign for until more data is acquired. 

Patone, M., Mei, X.W., Handunnetthi, L. et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med (2021). https://doi.org/10.1038/s41591-021-01630-0

DiNicolantonio JJ, O'Keefe JH. Magnesium and Vitamin D Deficiency as a Potential Cause of Immune Dysfunction, Cytokine Storm and Disseminated Intravascular Coagulation in covid-19 patients. Mo Med. 2021 Jan-Feb;118(1):68-73. PMID: 33551489; PMCID: PMC7861592.

 

[Sciencedude1, BSN, RN]

On 12/29/2021 at 9:14 AM, subee said:

 What do you think we should do with unvaccinated patients if it comes to that?

Treat them. The omicron variant has less mortality compared to previous variants but is more infectious. The omicron variant is out competing the delta variant so omicron is going to become the prevalent variant in the population. We should see less ICU admission's with the omicron variants considering the lower mortality rate of the omicron variant, having FDA approved antivirals, and  a large portion of our population is vaccinated or has natural immunity. The vast majority of people who will require ICU admission are those that are not vaccinated or no natural immunity and did not seek outpatient care.

As per the article below it seems that the burden on hospitals is due to people going to ER's just to get tested for COVID19 which is increasing the wait times at ER's.  Maybe the long wait times at the ER contributed to patients not seeking care at your facility? It sounds like some of these hospitals with congested ER's should setup tents outside just for testing for covid. Like we did at the start of the pandemic instead of having people wait in the ER's. 

At my particular facility the  EV-ICU which treated specifically covid patients was shut down. Now the few covid19 patients which require an ICU admission are cared for in the MICU. 

https://pennstatehealthnews.org/2021/12/penn-state-health-advises-patients-not-to-head-to-emergency-department-for-covid-19-testing/

[toomuchbaloney]

Sciencedude1 said:

 I have never said that vaccines should not be used. I have always held a position of being pro-vaccine. However I disagree with the majority of posters stating that we should mandate vaccines. I still think we should use education as a means of convincing people in order to get vaccinated.

Mandates work to increase vaccination rates.  Increasing vaccination rates is a good thing when the world is still struggling with a pandemic.  

[Sciencedude1, BSN, RN]

10 minutes ago, toomuchbaloney said:

Mandates work to increase vaccination rates.  Increasing vaccination rates is a good thing when the world is still struggling with a pandemic.  

So should we mandate men under 40 to get vaccinated with Moderna if that is the only vaccine that is available? Yes covid19 is still an issue and it appears that it will become endemic but are death rates in this omicron variant wave the same as previous waves? Also we have fda approved PO antivirals for this wave which was not available for previous waves. 

[toomuchbaloney]

1 hour ago, Sciencedude1 said:

So should we mandate men under 40 to get vaccinated with Moderna if that is the only vaccine that is available? Yes covid19 is still an issue and it appears that it will become endemic but are death rates in this omicron variant wave the same as previous waves? Also we have fda approved PO antivirals for this wave which was not available for previous waves. 

Vaccine mandates work to increase vaccinating rates which is a desirable outcome when trying to get to the end of a pandemic. The fiscally responsible choice is to vaccinate with an inexpensive vaccine rather than gamble with a virus and depend upon expensive treatments which are less effective at reducing serious illness or death than are the vaccines. 

[Sciencedude1, BSN, RN]

13 minutes ago, toomuchbaloney said:

Vaccine mandates work to increase vaccinating rates which is a desirable outcome when trying to get to the end of a pandemic. The fiscally responsible choice is to vaccinate with an inexpensive vaccine rather than gamble with a virus and depend upon expensive treatments which are less effective at reducing serious illness or death than are the vaccines. 

You didn't answer my question instead you deflected the question like a politician. However I will ask you again. Should we mandate men under 40 to get vaccinated with Moderna if that is the only vaccine that is available? It's either yes or no. 

[subee, MSN, CRNA]

Sciencedude1 said:

 I have never said that vaccines should not be used. I have always held a position of being pro-vaccine. However I disagree with the majority of posters stating that we should mandate vaccines. I still think we should use education as a means of convincing people in order to get vaccinated.

Not only should we utilize vaccines but we should also be treating patients on an outpatient basis in order to reduce viral loads within patients. The virus replicates within the first 10 days of infection and afterwards only debris of the virus remains. The immune system can't tell the difference between live viruses and viral debris which leads to a cytokine storm and subsequently ARDS and DIC. If we can reduce viral loads of patients within the first 10 days with antivirals then we would reduce the rates of cytokine storms and subsequent ARDS. So not only should we educate the population of the benefits of vaccines but we should also be pushing antivirals on an outpatient basis. We should also be talking to the population about nutrient deficiencies which leads to higher rates of cytokine storms and DIC such as vitamin D/Magnesium.  

I wanted to point out another study that came out on Dec 14, 2021. It's a publication in Nature by Oxford University. In this study it shows Moderna has higher rates of myocarditis in men under 40 after the second dose compared to COVID19 infection. Dr. Vinay Prassad MD MPH from the University of California at San Francisco stated that we should be promoting men under 40 to be utilizing pfizer which has a better safety profile, and he recommends that we not rush the booster campaign for until more data is acquired. 

What you don't mention is that the myocarditis secondary to Covid is more problematic than the myocarditis from a vaccine.  And it occurs mostly in pubscent males which are a pretty healthy cohort.  You are okay with unvaccinated health care workers?  Yes, the idea of mandates in the general public does give me a little pause (but NOT much:).  However, they are promoting the pandemic, promoting varients, promoting economic insecurity, promoting societal division so yeah, they are a bunch of a-holes, but I know that we can't force people to be tied down and vaccinated.  We have to find another way and hurting them in the wallet is probably our best option.  It doesn't help when red states pay people unemployment to stay home because they don't want to get vaxxed or take two Covid tests a week.  Actually, it's insane.

[subee, MSN, CRNA]

3 hours ago, Sciencedude1 said:

Treat them. The omicron variant has less mortality compared to previous variants but is more infectious. The omicron variant is out competing the delta variant so omicron is going to become the prevalent variant in the population. We should see less ICU admission's with the omicron variants considering the lower mortality rate of the omicron variant, having FDA approved antivirals, and  a large portion of our population is vaccinated or has natural immunity. The vast majority of people who will require ICU admission are those that are not vaccinated or no natural immunity and did not seek outpatient care.

As per the article below it seems that the burden on hospitals is due to people going to ER's just to get tested for COVID19 which is increasing the wait times at ER's.  Maybe the long wait times at the ER contributed to patients not seeking care at your facility? It sounds like some of these hospitals with congested ER's should setup tents outside just for testing for covid. Like we did at the start of the pandemic instead of having people wait in the ER's. 

At my particular facility the  EV-ICU which treated specifically covid patients was shut down. Now the few covid19 patients which require an ICU admission are cared for in the MICU. 

https://pennstatehealthnews.org/2021/12/penn-state-health-advises-patients-not-to-head-to-emergency-department-for-covid-19-testing/

No one is suggesting they should not be treated.  It's hard to treat a patient in a tent when the temps are in the 20's.  You are not putting two and two together.  We don't have enough nurses to serve the patients indoors so who is going to volunteer to take care of patients in an outdoor tent in the snow?  The ER is not the place to do Covid testing on request. People are not waiting in line for a Covid test; they are waiting in line because they are already sick or injured.  

[toomuchbaloney]

3 hours ago, Sciencedude1 said:

You didn't answer my question instead you deflected the question like a politician. However I will ask you again. Should we mandate men under 40 to get vaccinated with Moderna if that is the only vaccine that is available? It's either yes or no. 

Yes.

Mandates work to increase vaccination rates.  The vaccines are safe and more effective than treatments after infection in reducing serious illness, hospitalization or death from covid.  That is the current public health guidance.  

[Sciencedude1, BSN, RN]

16 hours ago, subee said:

What you don't mention is that the myocarditis secondary to Covid is more problematic than the myocarditis from a vaccine.  And it occurs mostly in pubscent males which are a pretty healthy cohort.  You are okay with unvaccinated health care workers?  Yes, the idea of mandates in the general public does give me a little pause (but NOT much:).  However, they are promoting the pandemic, promoting varients, promoting economic insecurity, promoting societal division so yeah, they are a bunch of a-holes, but I know that we can't force people to be tied down and vaccinated.  We have to find another way and hurting them in the wallet is probably our best option.  It doesn't help when red states pay people unemployment to stay home because they don't want to get vaxxed or take two Covid tests a week.  Actually, it's insane.

OK so where is the reference so all of us on AN can see what you're talking about? I love how you make claims but are very scant on references. I never said I was OK with unvaccinated workers. I think we should promote the vaccine through education and let doctors and patients decide what is best for the patient. It's really not that complicated. You know we have been taking this approach for any procedure/medication because it's the safest and most ethical approach. That doesn't seem to matter anymore to a lot of posters on this thread. States that try to hurt the wallets of firemen, police officers, teachers,  nurses, doctors, and workers of all kind are only going to experience a mass exodus of said workers because people got to eat. You can't force poverty on individuals because you don't agree with them because..you know.. that is unethical.  Also what is that going to do to the shortage of nurses and doctors in states mandating the vaccines? I imagine it's going to make the shortage worse. So basic economic states when supplies are low and demand is high the cost of having a nurse will increase. So those states are going to have to pay higher fee's for vaccinated travel nurses to go to those states. Then what happens to the price of healthcare in states having to pay higher traveler fees? Its going to become more expensive and it will effect people of lower socio economic status regardless of vaccination status. 

[Sciencedude1, BSN, RN]

16 hours ago, subee said:

No one is suggesting they should not be treated.  It's hard to treat a patient in a tent when the temps are in the 20's.  You are not putting two and two together.  We don't have enough nurses to serve the patients indoors so who is going to volunteer to take care of patients in an outdoor tent in the snow?  The ER is not the place to do Covid testing on request. People are not waiting in line for a Covid test; they are waiting in line because they are already sick or injured.  

Maybe if you didn't fire your nurses for not being vaccinated you would have enough nurses to treat patients. Here in my state and facility we have plenty of nurses and all patients are being treated and not in tents. It sounds like your state and facility has a logistic/planning problem.