Yes, Employer Can Require Covid Vaccine

[TheMoonisMyLantern]

Apparently per the EEOC's guidelines employers (not just healthcare related) can mandate vaccination of workers. The exception is a "sincerely held religious belief" or a covered disability. Just found out this morning that a chain of for profit LTC/SNF's are rolling out a Covid vaccine mandate for all direct care staff or face indefinite unpaid administrative leave. I am a heavy supporter of vaccination and of the new COVID vaccine and in fact am due to get one in early January. But I am doing so of my own volition. My facility encouraged all workers to sign up for a vaccine and provided information sessions and it's been really effective at getting people to sign up. 

Even though I would disagree with someone's choice to not vaccinate, I don't believe they should be mandated at this point.

Yes, your employer can require you to get a COVID-19 vaccine, the EEOC says

[myoglobin, ASN, BSN, MSN]

21 hours ago, MunoRN said:

You are far more likely to have GB after an influenza illness than you are after getting a flu vaccine (depending on the source, 15 to 40 times more likely).  If you don't want GB then getting the flu vaccine is one of the best ways to avoid getting it.

That may be true, but the influenza vaccine is historically only between 19 and 60% effective in actually preventing the flu https://www.CDC.gov/flu/vaccines-work/effectiveness-studies.htm  .

The vaccine may modify your  immunological response in a manner so as to make you less likely to develop GB if you do get the flu. However, other sources indicate that the vaccine can significantly elevate the risk of experiencing GB https://www.disabledveterans.org/2020/03/11/flu-vaccine-increases-coronavirus-risk/ .

[toomuchbaloney]

44 minutes ago, myoglobin said:

That may be true, but the influenza vaccine is historically only between 19 and 60% effective in actually preventing the flu https://www.CDC.gov/flu/vaccines-work/effectiveness-studies.htm  .

The vaccine may modify your  immunological response in a manner so as to make you less likely to develop GB if you do get the flu. However, other sources indicate that the vaccine can significantly elevate the risk of experiencing GB https://www.disabledveterans.org/2020/03/11/flu-vaccine-increases-coronavirus-risk/ .

Claim that flu vaccine increases coronavirus infection is unsupported, misinterprets scientific studies

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In summary, the question of whether the flu vaccine causes an increased risk of coronavirus infection requires more scientific studies to answer. While the studies by Wolff and Cowling et al. suggest a potential increase in the risk of viral respiratory infections after receipt of the flu vaccine, another much larger study found no significant difference in risk between vaccinated and unvaccinated groups[4]. This study monitored individuals over six influenza seasons, whereas the two studies cited in the claim covered only one influenza season.

To be clear, despite suggestions even from top politicians that the flu vaccine protects against COVID-19, this has not been substantiated. However, the vaccine can provide several indirect benefits during this pandemic, such as reducing the risk of flu infections, thereby reducing cases of flu complications like pneumonia that require hospitalization. This “will reduce the burden on hospitals and ensure that facilities are available for patients in need,” said Rouers. This is the same goal driving the popular “flatten the curve” catchphrase: preventing the healthcare system capacity from being overloaded.

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In addition, it is also possible to be infected with both influenza and SARS-CoV-2 at the same time, as this case report from China shows, although how common this is and whether co-infection would affect a patient’s clinical outcome is still unclear.

“We definitely want to avoid people having a flu at the same time as potentially having coronavirus—so having two infections and the body becoming overwhelmed,” said Holly Seale, a senior lecturer in the School of Public Health and Community Medicine at the University of New South Wales, in this ABC News report. She added that “health authorities wanted to avoid people presenting to their local hospital or GP with seasonal flu, which could put them at increased risk of catching another virus, including coronavirus.”

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The article and the facebook posts claim that the flu vaccine increases the risk of infection by other respiratory viruses, such as coronavirus. This is based on a recent scientific article published in the journal Vaccine in January 2020[1]. However the scientific publication itself is not so definitive in its conclusions. We just have to read the Highlights at the top of the article: “Vaccinated personnel did not have significant odds of respiratory illnesses” and “Odds of virus interference by vaccination varied for individual respiratory viruses”.

The associated risk of infection by other respiratory viruses in the vaccinated group does exist, but it remains low and limited to human metapneumovirus and coronavirus according to this study. Coronavirus is a family of viruses but this study did not look at COVID-19 specifically, so it can be misleading for readers in the current context. Also good to highlight that it’s difficult to establish a direct link between this observation and the vaccine.

 

[chare]

45 minutes ago, myoglobin said:

[...]

The vaccine may modify your  immunological response in a manner so as to make you less likely to develop GB if you do get the flu. However, other sources indicate that the vaccine can significantly elevate the risk of experiencing GB https://www.disabledveterans.org/2020/03/11/flu-vaccine-increases-coronavirus-risk/ . [Emphasis added]

As this was an interpretation of another article, and not actually research, how exactly did you come to this conclusion?

The referenced article is available free on Pub Med Central.  

[speedynurse, ADN, BSN, RN, EMT-P]

On 12/26/2020 at 8:16 AM, TheMoonisMyLantern said:

As hypocritical as this is going to sound, I agree with that. Even though that vaccine carries risk with it, due to how vulnerable the patient population is in the NICU I can see the reason for mandation. That being said we have a lot more information on the MMR that to me invokes a higher level of trust.

Hmm.. I don't know, maybe I'm just ornery or a hypocrite. 

But MMR vaccines has been around for quite some time and weren’t authorized under emergency use. Not agreeing or disagreeing but pointing out the difference. Also, the technology used in the covid vaccine is something that has never been used before.....

[myoglobin, ASN, BSN, MSN]

3 hours ago, chare said:

As this was an interpretation of another article, and not actually research, how exactly did you come to this conclusion?

The referenced article is available free on Pub Med Central.  

I notice you do not question my equally under supported assertion that the influenza vaccine might make you less likely to get GB if you do subsequently get the flu (a pro vaccination position).  The study referenced in the article that found higher rates of GB also looked at military vets which may or may not be applicable to the general population. It is also worth noting that some of the people who get GB after getting influenza may also be people who had the influenza vaccine since the rates of effectiveness for the vaccine are typically not better than 50%. 

[ohbejoyful]

I don’t think while the vaccine is still not approved by FDA and only released by emergency circumstances it should be mandatory for anyone as a requirement of employment. However, just like flu vaccine, I would imagine, some facilities would make it a requirement of employment while others would not. At my hospital it was a condition of employment that if you declined the flu vaccine than you must wear a surgical mask all of flu season. Now that we are all wearing surgical masks all the time, it’s hard to see any need for further action if you decline. Also, many unions are implementing proposals and policies that protect workers rights to choose vaccination or not, (my hospital) and major cities are extremely short staffed (my hospital) so some facilities will likely make it a point to keep vaccination optional in an effort to retain and recruit adequate staff without having to pay for that incentive. Where there is a demand, someone will supply.

I believe in PPE being just as effective as a vaccine, I have worked almost 1,000 hours this year on a covid ICU unit with strict PPE protocols and have seen the infection transmission well controlled, extremely rare cases of employees contracting covid. It appears in other unpredictable environments that are not treating everyone as a rule out, such as the ED or facilities with less strict PPE protocols such as nursing homes employees are having issues with infection contraction and transmission. The issue is likely related to the PPE protocols, everyone should be treated like a rule out regardless of symptoms in terms or PPE. Mask, face shield, gown, gloves washing hands for 2 minutes in and out of every room no matter what. If you facility doesn’t allow and enforce this, find another facility, this is unsafe, vaccination or not.

However, If you work for a company who adequately supplies and enforces PPE protocols and you adhere to them, you and your patients are safe, vaccination or not. I know there are a lot of people, healthcare workers included who don’t believe in masks ?

The tricky and risky part is actually outside of the hospital. It is the responsibility for those who don’t feel comfortable getting vaccinated by non fda approved emergently released new vaccinations, as well as those who are vaccinated, to continue to social distance, avoid large gathering, wash your hands, wear a mask when appropriate, etc.

[chare]

37 minutes ago, myoglobin said:

I notice you do not question my equally under supported assertion that the influenza vaccine might make you less likely to get GB if you do subsequently get the flu (a pro vaccination position). ...

Thank you, I'll rephrase my question.

4 hours ago, myoglobin said:

[...]

The vaccine may modify your  immunological response in a manner so as to make you less likely to develop GB if you do get the flu. However, other sources indicate that the vaccine can significantly elevate the risk of experiencing GB https://www.disabledveterans.org/2020/03/11/flu-VAccine-increases-coronavirus-risk/ .

In the commentary quoted in the above post, or the article it discussed, how did you come to either of these conclusions?

ETA: Not questioning either of your conclusions, just trying to understand how you came to either, based on the information you referenced.

[myoglobin, ASN, BSN, MSN]

3 hours ago, chare said:

Thank you, I'll rephrase my question.

In the commentary quoted in the above post, or the article it discussed, how did you come to either of these conclusions?

ETA: Not questioning either of your conclusions, just trying to understand how you came to either, based on the information you referenced.

Here is a better meta analysis that points to a small (but statistically significant) increase in GBS and influenza vaccine https://pubmed.ncbi.nlm.nih.gov/25999283/. 

Here are a couple of studies https://www.CDC.gov/flu/spotlights/2017-2018/vaccine-reduces-risk-severe-illness.htm that show even when people get the flu after receiving an influenza shot that they tend to get less severe forms of the flu, and to spend less time in the hospital. While, this in no way proves that the influenza shot decreases GBS (when it is insufficient to prevent actually getting the flu) it is a reasonable conclusion given that influenza itself is a significant risk factor for developing GBS.  

[MunoRN, RN]

4 hours ago, myoglobin said:

I notice you do not question my equally under supported assertion that the influenza vaccine might make you less likely to get GB if you do subsequently get the flu (a pro vaccination position).  The study referenced in the article that found higher rates of GB also looked at military vets which may or may not be applicable to the general population. It is also worth noting that some of the people who get GB after getting influenza may also be people who had the influenza vaccine since the rates of effectiveness for the vaccine are typically not better than 50%. 

GB most commonly occurs secondary to a viral illness, which includes the flu.  Influenza vaccination reduces the risk of GB because it reduces the risk a viral illness that GB is often secondary to.  I'm not sure where you're getting that the argument is that the influenza vaccine directly prevents GB.  

[myoglobin, ASN, BSN, MSN]

On 1/5/2021 at 1:09 AM, MunoRN said:

GB most commonly occurs secondary to a viral illness, which includes the flu.  Influenza vaccination reduces the risk of GB because it reduces the risk a viral illness that GB is often secondary to.  I'm not sure where you're getting that the argument is that the influenza vaccine directly prevents GB.  

My argument is theoretical admitted. However, it is based on evidence that the influenza vaccine seems to help prevent the most severe forms of the flu even when it does not prevent actually getting influenza.  If one gets a less severe case of influenza (thanks to getting the influenza vaccine) it may be reasonable to suppose that the immunological response is less likely to "go awry" and contribute to GB (which is usually thought of as an autoimmune disorder in part).  

[myoglobin, ASN, BSN, MSN]

On 1/3/2021 at 12:16 AM, brandy1017 said:

Yes that is my main concern for this vaccine as I have a hx of pcn anaphylaxis where my throat started closing up and I felt like I couldn't even swallow.  No symptoms until one night out of the blue bam.  

Where I live all the hospitals mandate the flu vaccine as I hated it as I was aware I was at risk for GB esp as over 50 and had taken care off several patients who got it after a flu vaccine.  We even had a coworker who got GB from the flu vaccine, but thankfully recovered.

I believe I already had Corona this Spring but they wouldn't test me so I don't know for sure.   I am retired now, but if I was still working I'd probably get it.  

One thing that does bother me is that the govt has gone above and beyond to offer immunity to the pharmaceutical companies for any adverse reaction, and limited recourse for people who may be harmed by the vaccine.   They already had immunity and you have to go to the govt for compensation, but they have specifically changed the rules for anyone injured by this vaccine.  That is wrong, but most people and the general public for sure won't know any of this. We considered waiting until he was older and letting him make the decision (whether or not to get an social security number) when he was older (for the same reason we decided to raise him without a specific religious faith,  and let him make his own religious decisions when he was older, however now at 20 he is on the path to becoming Catholic and blames/hates me for not baptizing him when he was an infant). 

It is a risk to benefit analysis especially if you believe that you have already been exposed to Covid.  One option might be to get an antibody test which might help to add some additional data points to your analysis. Then again we don't know how long a previous infection will prevent you from getting infected again (one recent study I posted suggested that probably at least six months). Then again we also don't know how long the vaccine will prevent infection (or how much it will mitigate infection if it occurs, since there is data that the influenza vaccine seems to contribute to a less severe influenza infection even when it does not completely prevent infection).  I agree that mandates stink. However, at the same time they are likely. Ultimately, I believe (in the next 1 to 5 years) failing to have the Covid vaccine may involve giving up things like being able to have a passport, attend certain sports or concert venues, or even to visit certain private companies or federal facilities as well as exclude you from many institutions of higher learning and many job opportunities. Ultimately, you may have to ask yourself "how much am I willing to give up?" to stand for a principle or to satisfy the demands of uncertainty. I can remember that my SO and I seriously debated at one point if we even wanted to get our son (when he was very young) a social security number because we feared that one day it might lead to inclusion in a totalitarian system.  However, not getting one would have meant no tax deductions, no passport, exclusion from most scholarships (or even applications to universities, he was homeschooled so school until college wasn't and issue) not to mention exclusion from 95% of all jobs and social security benefits. At the end of the day way decided that a social security number was more important than our fears or principles. 

[myoglobin, ASN, BSN, MSN]

Also this article https://www.theguardian.com/world/2021/jan/10/coronavirus-covid-19-vaccine-hesitancy-us-health-workers illustrates that you are not alone. Around 30-50% of healthcare workers are electing not to get the vaccine even in the UK. I do believe that "incentive" programs might help. For example here are "three" proposals:

a. If a healthcare worker takes the vaccine they become eligible for 1 million in term life insurance for no more than $50.00  per month with a 20 year level term guarantee. This was something that I did at about age 43 and it is the most valuable thing I own.  I would imagine that many would readily accept risk from a vaccine (real or imagined) if the risk were tied to greater financial security for their family.

b.   Perhaps it could be tied to a significant health insurance discount. As someone with absolutely no health insurance (a state that certainly involved increased risk) being able to get lower cost coverage would certainly help justify risk from a vaccine (real or imagined).  Indeed, given that I paid about $1800 per year in "penalties" for about four years for not having health insurance (under the Heathcare Reform act) we might even imagine a scenario where not being vaccinated carries with it actual extra fines or penalties (although I do not support this).  

c. Again, healthcare workers are so over worked that even offering them two weeks off of unpaid vacation would probably be a strong incentive. I hated my ICU job so much that I would have literally taken ten lashings with a whip if it meant I could take two weeks off without penalty even if it was without pay.