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Subscribe to RSSPatients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.
"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.
Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.
Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.
In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.
Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.
Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.
"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."
Related stories:
CDC reports flu in 47 states
Bioethicist says: Don't be selfish, get the shot
Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."
Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.
"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."
For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.
A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.
At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.
The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."
The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.
According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.
The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.
Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.
Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.
Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.
Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.
Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.
While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.
Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.
Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.
Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.
"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.
Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.
Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.
Calhoun, the Illinois nurse, says she is unsure of her options.
"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."
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Online:
R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf
CDC: http://www.cdc.gov
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If this is OK, then there should be much static about 'choice" when it comes to childhood vaccinations. You can't have it both ways. Either vaccinations are required for all crowd contact situations or its not.
The flu can be a very fast killer. We need to address this as such. All the overpopulated world proponents should understand that overpopulation in a structure, be it hotel/dorm/office, a hospital or a school spreads disease a lot faster.
I understand that the US has moved from a majority consensus to an individual partition where rights and privileges are concerned. This in itself should be a factor in the disparage of another persons "choice" of good health. As for the healthcare worker/patient relationship, this is imposed by someone in a position of authority exercising their choice that renders the other, said patient, unable to choose to avoid that situation.
Therefore, they are hindered from the whole reason for being there, obtaining better health and this creates a paradox in the healthcare industry.
I'm a physician, and while I'm happy to take the influenza shot each year, forcing people to do so is asinine! Each person has a right to decide what is put into their body, just as each patient has a choice. Being a physician or nurse does not diminish that right.
Johnathan, There is no way in heck that YOU can be a physician. Why do I write this. It is because in post #135 you wrote in effect that a person could get the flu from the vaccine. Since the influenza vaccine is made from a killed (dead) virus, people cannot get influenza from the vaccine. The vaccine can cause side effects, but that is not the flu. Any competent physician would know this. As a result, I conclude that you are fibbing.
Dale,
You are partially right, however, since you have such little faith in your medical professionals, I feel obligated to inform you that while the IM (or shot) administration of the influenza vaccine is "dead" as you put it, the nasal vaccine is live, which can be harmful to those who are pregnant, or otherwise immunocompromised. This does not affect your argument, I'm aware of that, just providing some valuable knowledge to those in need.
If you have a 'right' to refuse a simple flu shot then we have the 'right' to incarcerate you when you get ill to prevent you from spreading it to others!
We also have the right to incarcerate the mentally insane...but I digress.
As an ER nurse, I personally do not have an issue with obtaining a flu vaccine. However, the vaccine's efficiency can vary from one year to the next, and my no means provides ensured protection. This is different from the before mentioned MMR, varicella, and Hep vaccines, in which titers are drawn to ensure immunity and are required of healthcare workers. I do not believe that anyone, including healthcare workers, should be forcibly vaccinated or fired on the basis of refusing a vaccine that has such a poor failure rate (25-35%). And those rates are for strains that are covered, not to mention the strain of Flu A that is not covered by this years vaccine, failure rate is 100%. Despite what hospitals may say, these new rules are just as much about ensuring staff attendance as it is about patient care. We put our lives on the line every day to care for ill patients with meningitis, influenza, and other seriously contagious diseases. Workers who wish to refuse the vaccine are not selfish, but rather individuals who are educated, dedicated, and caring for choosing this line of work. Next time you come to the ER ill with the flu, and I've been vaccinated, and you still transmit it to me, I promise not to call you stupid for not getting a shot and would appreciate you extending this courtesy to my coworkers in return.
I disagree. I expect a health care worker to be a professional. I expect them to believe in the medicine/treatments that they are administering. I do not want a nurse or doctor who is just pretending. If they do not believe in vaccination, they should find another line of work.
FYI, with an "average" efficiency of 70% for covered strains this year, and 36% of cases this year are from a Flu A strain NOT covered by the vaccine, that leaves an overall efficacy of about 25.7%. Before some of you get all up in arms, this is per the CDC website (). You will have to do your own math should you not believe me. Point being, 25% efficacy does not begin to meet the scientific threshold on which to threaten one's personal choice or career.
True medical professionals are not "pretending". I would hope you would prefer a provider who researches each treatment/efficacy/ and outcomes before deciding on the appropriateness of therapy. Or, we could just do what everyone else does. That always works, right? Influenza vaccines are valuable for certain populations, without a doubt. But mandates, really?
OKAPN, Your arithmetic is wrong. If 36% of the cases this year are from a flu which is not covered, then 64% are from covered strains. 70% effectiveness for the 64% = 44.8% which is nearly double your 25.7%. That is using your numbers without any challenge.
Hospitals need nurses to be at work, not home with the flu. They especially don't need nurses or doctors trying to work with the flu.
Wow, I think I have to hand it to you on your math, I apologize for my hasty calculation. But then I just spent 12 hours caring for many ill patients, forgive me. That being said, 44.8% isn't impressive either. And I agree that nurses should protect themselves with the vaccine, despite it's lackluster benefit. However forcing this on hardworking persons is not right.
SERIOUSLY?????? If anyone in my company comes to work coughing and sneezing (and its always the selfish ones who NEVER cover their noses or mouths before spewing their spit, snot and germs) they are FIRED on the spot and made an example to others . . . believe me, EVERYONE love and supports this policy!
Well, that sounds great, but how does this apply to the discussion regarding mandating influenza vaccines for healthcare workers??
Cynthia I would suspect your company is 1 in a million then - any company I've ever had contact with had the policy that if you can stand upright then you'd better come in to work or you'll be fired. I also suspect your company is a lawsuit waiting to happen - allergies can cause those same results and are 100% non-contagious.
The first staff infected with the flu after being forcibly vaccinated should sue the hospital.
The flu vaccine is a killed (dead) virus. No one, but no one can get influenza from the vaccine.
From the gov. site...
The nasal spray is:
CDC, "Unlike the flu shot, the nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened) and cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist. Some children and young adults 2-17 years of age have reported experiencing mild reactions after receiving nasal spray flu vaccine, including runny nose, nasal congestion or cough, chills, tiredness/weakness, sore throat and headache. Some adults 18-49 years of age have reported runny nose or nasal congestion, cough, chills, tiredness/weakness, sore throat and headache. These side effects are mild and short-lasting, especially when compared to symptoms of influenza infection."
Plus, the issue is the flu shot, not the nasal spray.
from the livestrong website:
i already debunked this myth earlier
So, per the FluMist manufacturer site, studies have shown that the nasal immunization can "shed" from the vaccinated for up to 21-28 days, and the potential to infect another person is averaged to be 2.4%. The full study is available on their website, as well as this little gem: "Safety and effectiveness of FluMist have not been established in pregnant women, nursing mothers, geriatric adults or children less than 2 years of age." Seems that the CDC may be fudging a few facts, doesn't it?
Source: medimmune dot com / pdf/ products/ flumist_pi dot pdf (in case link doesn't post)
http://www.medimmune.com/pdf/products/flumist_pi.pdf
so waht if you can shed?
what is the cdc fudging?
I would also like to demand that the health care pros that I see set a good example for good health. Like no obese health care workers!! They set a bad example for people and our children. Lower their pay so they cant eat so much!! Force them into an exercise program.
Harold, I agree with you. I would never go to a doctor who had worse health habits than I do. I also expect that health care workers (nurses, doctors) believe in their profession. I don't want someone who just goes through the motions. This actually applies to other professions. Do you want your house exterminated by a pest control person who doesn't believe in the efficacy of the insecticides he/she is using?
Dale,I agree with you.And I get a flu shot every year.I own a cleaning service and do not want my customers becoming sick because of my health or from my cleaning.
No, cleaning lady, you don't want to miss out on work that makes you money. If you are cleaning a persons house with germ killing chemicals, it is highly unlikely that they would be able to contract much of anything from you by the time you were finished.
I can't even believe I am seeing this in the USA. Whatever happened to individual liberty. This reeks of Communism or socialism.
If you don't believe in modern medicine, including vaccines, don't become a nurse or doctor.
Welcome to the United States of Socialism!!
Yep. That socialist government that builds the roads, provides for social security, the common defense, etc. However, in this case it is private industry, the hospitals that are requiring employees to get vaccinated.
Your argument is flawed, these private industry hospitals are primarily funded by federal funds. The Centers for Medicare and Medicaid are requiring these facilities to show a 90% vaccination compliance rate in the next several years, or risk having their reimbursements decreased. So, it really is backed by the government.
No, Obama 'reeks' of Communism . . . forced Gun Control 'reeks' of Communism . . . THIS is just mandating what humans should be doing out of concern for others!
That right, as long as you agree with it, it is okay. If it forces your views on someone else, it's the right thing to do. If others force their views upon you, it's communism.
I don't get flu shots and I'm rarely sick, like once in 6 years. The people I know that get them are often sick and most of them are sick shortly after taking them. Coincidence? I think not. Remember they used to say cigarettes are good for you. So just because a lot of people say they are good for you means nothing. Will this news headline be a shocker to you? "A new study has shown flu shots might actually do more harm then good".
Should we also not make it law that a politician have a brain and prove it before being elected?
Except that the politicians write the laws. Or rather, their staff write the laws. It sounds like a good idea, but it would take brains to implement and that is sadly lacking in most legislative bodies.
Absolutely , less their college degrees which strip them of common sense.
Why all the institutional control. We have been taken by the Insurance industry, the car industry, the food industry and most of all the Pharmaceutical industry all backed by the same govenment we feed our taxes to. Personally I haven't had the flu, neither have I taken any flu shots since the stupidity came out. Yes dumb ass the stupidity of instead of finding a cure we keep feeding pharmaceutical pockets and the dumb ass medical field that is fed by 90% idiots. Remember the medical field is offered to you as a Medical Arts degree not a Science. If you have a little common sence is just artistical and meant for you to believe in it not necesarily that its true. Why should anyone be forced to be fed something they don't want.. And yes dumb ass those that work in lower ranks of the field see the truth before the profitters start showing you the truth and are debunked. And by the time time a lawsuit comes up they are in a private island in the Caribbean enjoying your dumbness. By the way those that work in the lower ranks are the ones also taking in the data and its why they don't take it.
I never have and never will land I've been around and visited people that have been hospitalized by it. I take natural herbs like the Indians did back in the days when those epidemics where brought here. Its a cure not a relief.. A relief is just a profit for those in the medical industry..DUMB ASS... Sorry I forgot your fake ass name...
I doubt if a cure for viruses ever come to fruition as viruses are continually mutating.
Lies, lies , lies. The medical industry is no different from the gov. Liars and cheats!!
Harold, There are a lot of dedicated health professionals. From personal experience, I know that most members of both the government bureaucracy and the medical professionals are honest and hard working. When a house catches on fire, who comes to put the fire out? It is a government employee, the fireman/woman. How about a robbery? We the voters/taxpayers elect our representatives. If they are idiots, then we have only ourselves to blame. The fact is that vaccinations help prevent disease. Hospitals do not want their staff off on sick leave during an influenza outbreak. Even more so, they do not want sick staff attempting to work.
You know what I mean
Even if you are dying they will try to keep you alive regardless of cost, just to get the bucks!! If you are dying, your dying. No sense in wasting money to keep one alive
No one should be forced to undergo a medical procedure without consent. No one should be penalized because they refuse to undergo a medical procedure for whatever reason. These are basic principles of medical ethics. I'm not going to go through a post vaccination syndrome to protect other people. I get vaccines to protect myself. If I don't need a flu shot, I'm not going to get it. I'm a healthy adult. If you are an at risk person, get the vaccine. What happened to people being responsible for their own health?
This is BULL@!$%#! When they CHOSE to work in the health care profession they GAVE UP their 'right' to decide not to protect themselves and others with vaccinations. They all should be FIRED if they refuse! We need to g back to quarantining people who are ill or they suffer the penalties and go to jail and forced to comply!
I'm all for mandated lobotomies for those too ignorant to understand basic human rights.
My father DIED because a nurse had the flu and STILL chose to come to work because she 'needed the money'. This was 8 years ago and since then I STILL would KILL the bitch if the opportunity presented itself and I knew where she could be found! We have epidemics because people are so damn selfish that they don't care if they give their illnesses to anyone else. They send their sick brats to school and go to work sick and shop sick. In the old days you stayed at home until you were WELL. I hate this bitch with all my heart and soul. YES . . . they should be MADE to have all shots available!
Well, then blame yourself for not taking your father in to get his own flu shot. You don't know where he got the flu. You just want to blame that nurse because it's easier than taking responsibility it yourself.
Have you thought about seeking some medical help for your issues? I don't mean that harshly, but you seem to really have some unresolved guilt/anger issues that may need addressed.
My wife, a retired Rn worked at a world famous hospital and they've required the nursing staff to have the flu shot for years. The only exception were for those employee's who were deemed allergic to the shot and that is a very small number.
To me its the same as a nurse saying he/she doesn't think washing there hands are a big deal. If I'm in a hospital fighting for my life and it is, its your life when its you, do you want a nurse to pass the flu on to you and kill any chance you had of recovery because in their mind they didn't want a flu shot.
PS, its a medical not my fact but a scientific medical fact the flu shot does not give one the flu. People take this to mean you will not get flu like symptoms. That is the fallacy. I get minor flu like symptoms like the chills and then a minor fever. Sometimes this can last a few hours to up to 24 hours and that is considered normal. The thing is its minor, but it does protect me from the real effects of the flu which I haven't had in 25 years or more.
The shot works. It may in some people give them a symptom of the flu and it may not. It will protect you in the long run.
I am actually more concerned about the fact that it seems there are more and constantly more virulent strains - not to mention those yearly never before heard-of types - of diseases and 'conditions' in the last 20 years or so. What on earth did our grandparents do before 'medicine' stepped in to 'save' everyone from everything? And now that all of these means of 'protection' are being mandated, people are finding that they are left with less and less say about whether to accept that at times overreaching 'protection'. This one statement in the article stands out most for me - "courts have endorsed forced vaccination laws affecting the general population during disease outbreaks". Beware America...while you're being distracted the theatrical debates on money, control of your own body is being stripped away. Do you really believe they will stop with the 'health' profession and the flu shots? Why not immunizations for the parasites that those 'travel' shots are supposed to protect you from? Will they next mandate those for people in food service...including both those who put the plate in front of you AND those who package it at the plants...or butcher shop? Why not the Farmers? Customs workers who inspect the shipments which pour into the US every hour? Once it becomes accepted because 'by god, those people SHOULD BE required to!', where does it stop after that? If it's alright for this group of people, I guess it will be alright when a 'national health emergency' is declared and they come busting through Your front door, hauling you off to get vaccinated against the 'Super-strain' of the next 'Big Disease'. Right?
This is Bogus.
Having Medical Staff Vaccinated isn't about the Patients Welfare. It's a Hospital for Gods sake. Half the Patients already have the Flu. The Virus is Everywhere. During Flu season, most of the patients coming to the emergency room & being admitted are there because they have the Flu already.
This is ALL about Staff having to take off work when their down sick with the Flu. Nothing Else. SPIN SPIN SPIN. Why don't they just tell it like it is.
Looking about, seeing the people I know that have had the Flu Vaccine this year I can only say 1 Thing. This Years Vaccine was pretty much a Total Bust. Nearly everyone I know who received it have been down with the Flu. I would note that my Girlfriend who teaches & all her fellow Staffers received this years Flu vaccine & all of them were sick. EXCEPT ME who was exposed while taking care of my sick girlfriend. I Didn't get the Flu Shot????
I would like to see a Valid review of those who received the Flu Vaccine & Those Who Didn't. What are the percentages. I have a feeling you wont find much variance in the results.
The Flu travels around the world by season. Vaccines are administered accordingly just ahead of Flu Season. A Health Advocate group in the UK wanted to see the Hard Data from the Pharma Group that produced the Vaccine. Seems they were aware that this years Vaccine was way under effective with a high rate of side effects up-to & including Deaths. They Have Been Refused Access. They've also received a Lot of Pressure to STFU...
I WOULD STRONGLY RECOMMEND an INVESTIGATION.....
Of Course that would be a waste of time & money. Would be like asking the FDA to Investigate it's self. YES, There that in Bed with Big Pharma...
You must comply. Resistance is futile. Whats the problem though. If everyone that is worried about it take it and those who are not worried don't whats the matter. If the non vaccinated get sick, oh well. Those that took the shots will be alright. I mean they are protected right? I find it weird that the areas that gave out the most free vaccines are the same areas which have the highest rates of infection. But thats just coincidence, right?
My kids both have asthma so they can't take the nasal vaccine, and they are allergic to eggs. We'll take our chances. Every time I get the vaccine, I end up with the stomach flu 2 days later. I have gotten the actual flu twice when I was vaccinated, so I will pass.
bubble,You can't get the stomach flu from the flu shot.
Any nurse who refuses the vaccine on any grounds OTHER than having a verified allergic reaction is a dumb selfish pig who should be fired and possibly barred from the industry.