What to do about DNP and flu shot?

subee, MSN, CRNA · Feb 2, 2020

First, masks are bogus. Anyone who ever worked in an OR knows their limitations.

Check out this story on USATODAY.com: https://www.usatoday.com/story/news/health/2020/01/31/coronavirus-flu-prevention-face-masks-offer-little-protection/4620463002/

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I had the swine flu in the 70's when I was in college. Sick enough to have lost track of time for a few days...but on the flip side, it was a time when you could buy codeine cough syrup without a prescription and my mother was generous:) Seriously, though, I understand the flu can cull young, healthy people.

brownbook · Feb 2, 2020

3 hours ago, Emergent said:
That might be something worth investigating. I haven't had the flu in over 30 years. I had it once at age 17, and twice in my 20s. All 3 cases were knock you on your orifice, 103+ fevers, in bed for a week cases, bad respiratory symptoms. Now I appear to be immune. I've been exposed many many times.
Now, I daresay, I'm likely healthier and more vigorous than most posting on this thread. The proofs in the pudding. There have been studies, by the way, giving evidence that fighting off illnesses is beneficial to the body. It lowers cancer rates and autoimmune problems. The immune system likes to keep busy.
I do feel vaccines and antibiotics have their place and have obviously saved many lives. But, the rise in allergies and autoimmune diseases has been exponential in the last forty or fifty years. I think these things should be used more judiciously.

I've never had the flu. I can't claim to be healthier and more vigorous than anybody. Honestly I have a lousy diet, (I had Cool Ranch Doritos with my coffee this morning ?, am terrible about fresh fruits and veggies), never exercise, just kept busy as a bedside nurse and around the house and yard. I don't think my parents ever had the flu....I don't think my 3 brothers and 3 sisters ever had the flu. There are probably a lot of people who never had the flu. Doesn't mean they shouldn't get the flu vaccine.

I've never had a house fire, no one I know has ever had a house fire. Doesn't mean we shouldn't have fire insurance, pay taxes for fire departments, have a fire extinguisher, etc.

The key to good health is to carefully choose your parents.

SummitRN, BSN, RN · Feb 2, 2020

1 hour ago, subee said:
First, masks are bogus. Anyone who ever worked in an OR knows their limitations.
Check out this story on USATODAY.com: https://www.usatoday.com/story/news/health/2020/01/31/coronavirus-flu-prevention-face-masks-offer-little-protection/4620463002/

Seriously? You are a CRNA... would you please be good enough to not post misleading articles from USA Today? The purpose of that article was to stop everyone from panic buying all the masks for coronavirus, not to be guidance for healthcare workers!

Surgical masks are very effective for protecting the wearer against droplet borne disease including influenza.

Yes, surgical masks (all masks) lose their effectiveness when they wet out, and they need to be changed.

Surgical masks are not going to offer full protection against 2019-nCoV if it is airborne, and we are treating it as airborne.

Surgical masks help in the OR by keeping your spittle and coughs off of things and wounds.

And of course, there is no substitute for hand hygiene.

SummitRN, BSN, RN · Feb 2, 2020

4 hours ago, Emergent said:
That might be something worth investigating. I haven't had the flu in over 30 years. I had it once at age 17, and twice in my 20s. All 3 cases were knock you on your orifice, 103+ fevers, in bed for a week cases, bad respiratory symptoms. Now I appear to be immune. I've been exposed many many times.
Now, I daresay, I'm likely healthier and more vigorous than most posting on this thread. The proofs in the pudding. There have been studies, by the way, giving evidence that fighting off illnesses is beneficial to the body. It lowers cancer rates and autoimmune problems. The immune system likes to keep busy.

I'm going to be blunt. You don't know what you don't know, both about basic immunology and influenza.

First, chances are that you are probably wrong about not having had the flu in 30 years. You probably have had flu, and you didn't realize it. Most flu cases are subclinical. You can still spread it. That is why we make healthcare workers mask who are not vaccinated. That is why we ask healthcare workers to mask if they are slightly under the weather, because what is mild in them may be deadly if spread to a patient.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(14)70034-7/fulltext

Second, you probably aren't immune to flu. Flu is not a a fixed monolith. It is a mutating swarm. There are multiple strains and subtypes circulating at any one time, and those change year to year. The antigens are so different that exposure to one subtype does not confer improved immune response to another. Flu is a segmented RNA virus with antigens that maintain function despite mutations sufficient to fool the immune system (unlike say measles) which means that you could catch 2 or 3 strains of flu in one season because they are different enough that the immune system won't recognize them, and then mutations between seasons have enough difference to for you to catch each subtype again (although with some improved response). That is why the flu vaccine "changes" every year, to cover the 4 most likely sets of presenting antigens.

Third, you are wrong about thoroughly testing flu vaccine because it is "new" each year. It is not a whole new vaccine every year. Just the antigens change.

jobellestarr · Feb 2, 2020

4 minutes ago, SummitRN said:
I'm going to be blunt. You don't know what you don't know, both about basic immunology and influenza.
First, chances are that you are probably wrong about not having had the flu in 30 years. You probably have had flu, and you didn't realize it. Most cases are subclinical. You can still spread it. That is why we make healthcare workers mask who are not vaccinated. That is why we ask healthcare workers to mask if they are slightly under the weather, because what is mild in them may be deadly if spread to a patient.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(14)70034-7/fulltext
Second, you probably aren't immune to flu. Flu is not a a fixed monolith. It is a mutating swarm. There are multiple strains and subtypes circulating at any one time, and those change year to year. The antigens are so different that exposure to one subtype does not confer improved immune response to another. Flu is a segmented RNA virus with antigens not heavily fixed to function (unlike say measles) which means that you could catch 2 or 3 strains of flu in one season because they are different enough that the immune system won't recognize them, and then enough difference is present the next seasons to catch them all again. That is why the flu vaccine "changes" every year, to cover the 4 most likely sets of presenting antigens.
Third, you are wrong about thoroughly testing flu vaccine because it is new each year. It is not a whole new vaccine every year. Just the antigens change.

Excellent post. Thank you

CTtoRN, ADN, BSN, RN · Feb 2, 2020

Enjoy your new career!

Emergent, RN · Feb 2, 2020

LOL, @SummitRN

What you say about subclinical cases of the flu is exactly what proponents of the vaccine claim, that if it doesn't prevent the flu, it will lessen the severity of it.

I propose that you don't know what you don't know?

KatieMI, BSN, MSN, RN · Feb 2, 2020

On 2/2/2020 at 1:09 PM, Emergent said:
LOL, @SummitRN
What you say about subclinical cases of the flu is exactly what proponents of the vaccine claim, that if it doesn't prevent the flu, it will lessen the severity of it.

1). "Lessening the severity" of symptoms (plus decreasing the shedding of the virus, thus lessening the possibility to spread the virus to others, even if just somewhat) saves billions of $ of economic losses. Workers should work for economy growth and prosperity, not hybernate in bed sneezing or watch their sick little ones.

2). The main effect of "lessening the severity" of flu is decrease in rates of hospital admissions, ICU admissions and deaths, primarily among children aged 6 to 48 months and middle-aged adults. The effects on very young and very old are much less pronounced, although they are still there. The check price for these admissions is enormous, both short- and long term.

Flu is "economic" and "societal" disease. It is not a killer or debilitator like rabies or diphtheria or polio, it just makes society literally thrown money out in the cold wind because so many people get sick in a short period of time. Like rubella, which is fairly well tolerated at most but dangerous for not yet born children. If we stop rubella vaccinations, many parents will abandon workforce to care for their maimed children who, in their turn, will never become productive members of society.

Some things we do in First World society are really not about us but about benefits to others. This is how civilization works. If someone is not happy about it, there are about 110 other countries beyond the First World and Gold Billion which live by all kinds of different rules. It is a whole plenty to choose from.

Bumex, DNP, NP · Feb 2, 2020

Unless this is for health reasons like allergies to the flu shot, you should take your career elsewhere, for our patient’s sake.

Megarline, CNA · Feb 2, 2020

I've been receiving flu shots since I relocated here in the US (14years). Flu was rare where I came from because it was tropics. I had no flu until recently. It wasn't fun being bed bound for a few days and was about two weeks recuperation. Weird though because I had no runny nose or anything... but dry cough, fever, muscle and joint pains. It still made me miserable. Now, I wonder if I want a gallbladder attack again for an hour or two weeks of flu.

BSNbound21, BSN, RN · Feb 2, 2020

On 1/29/2020 at 6:49 PM, Dachshundmom said:
I am finishing my MSN soon, and had thought that I would get my DNP. However, I am second guessing this after a big ordeal from my school about me not taking a flu shot. My hospital does not require it if I wear a mask. I hate to put the time and money into getting a DNP, and at some point be required to take a flu shot to work in nursing. I WILL NOT. I will change careers. I’m not looking for pro flu shot comments here. However, I am looking for advice and useful information on what you think the future holds in this matter. I also have an MBA, and can just as easily go into a DBA program.

Getting a flu shot isn't about YOU- it's about not giving patients with compromised immune systems the flu. Nursing also should not be about YOU- it's about the patients. If you don't care enough to not give them the flu then yes, you should change careers.

Ilargia99, LVN, RN · Feb 2, 2020

I just lost my aunt to a nasty strain of the flu and she was a healthy lady before that. She wasn’t that old either. Please change careers if you aren’t willing to sacrifice Your personal “beliefs” for the safety and well-being of others.