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Mandating Flu Vaccines for Nurses

September 30, 2009

By Diana J. Mason, RN, PhD, editor-in-chief emeritus

Yesterday, nurses and other health care workers from New York State went to the state capitol in Albany to protest a regulation issued by the New York State Department of Health mandating that all health care workers get vaccinated for both the seasonal flu and for the pandemic H1N1 2009 influenza by November 30th or lose their jobs. Deborah Gerhardt, RN, who was interviewed by USA Today, says she may have to lose her job because she doesn’t have confidence in the safety of the new H1N1 vaccine: “Just because the FDA approved the H1N1 vaccine ‘doesn’t mean it’s safe in my book.'”

mandatingflushotsNew York State Commissioner of Health Richard Daines, MD, disagrees, and followed up an open letter to health care workers released on September 24th with a press conference to defend the new policy. The New York State Nurses Association, which urges nurses to get vaccinated but is against mandatory vaccinations, wrote their own open letter in response.

Citing one study of health care workers during a mild flu season that showed that 23% of the workers showed evidence of having had the flu that season but that 59% of these said they didn’t have the flu that year, Daines said that his concern is that workers are carrying the virus and exposing at-risk patients without realizing it. When challenged on whether family members and other visitors represent an equally great threat to patient safety, Daines noted that some hospitals would close their doors to visitors if an infectious disease were spreading.

Should we have a choice? Does our health and safety come before that of our patients?

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For more on the ethics and safety of getting vaccinated, see these recent blog posts as well:

Nurses Express Safety Concerns About H1N1 Vaccine
Is It Ethical for a Nurse to Decline the H1N1 Vaccine?

9 comments

  1. [...] 2009 H1N1 pandemic, people worried about whether or not to get the new combined vaccine, and the question of mandatory vaccination for health care workers remains a hot topic even [...]

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  2. [...] on Bring Back the House CallPeggy on The eICU: Big Brother or Team Member?Diane on Mandating Flu Vaccines for NursesDiane Kopeykin on Mandating Flu Vaccines [...]

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  3. Oh and yes, if you would like me to wear a mask while caring for you or your loved one, I will. I may ask you to do the same, OK?

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  4. I am a healthcare worker in the state of PA, my employer is requiring both the seasonal flu and the H1N1 vaccine. I have issue with being mandated to do anything. My job, which I have been working for more than 20 years, has been threatened. I have been an employee for 22yrs and can count on one hand the number of times I have been out sick. Not once has it been for the flu. In my entire life I have gotten the flu shot once, that year I felt sick immediately after…mild symptoms for a few days no biggy. That was 21 years ago. I have worked 20 flu seasons on the front lines (x-raying patients in the hospital and emergency room) without so much as one symptom. No missed work days, none. I am in agreement with the above poster in saying that the public access to the hospital patients is by far the most risky inlet to infection of the in-house patients. If the hospital is not going to limit unvaxed visitors then they are not working toward their purported goal of patient protection.

    In agreement, again with a previous post, the person worried about the flu should vaccinate themselves and watch their own exposure.

    I have been fully vaccinated for the accepted public health risks; those being TB, Hepatitis, MMR. For these the immunity is measuable and lifelong. The flu is a year-by-year best estimate that does not eradicate disease at all. (eg polio)

    If the flu vaccine was eliminating the flu from the list of diseases that threatens mankind, then I would totally get it. It doesn’t even really improve your chances of not getting the flu by more than 50% IF you are conveniently exposed to one of the three flu viruses that happen to be in the current year’s vaccine coctail. If you come in contact with another influenza, you are just as vulnerable as any other joe

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  5. I’ve never had a flu shot and never had the flu. I rarely got colds. If I was still working in healthcare I would refuse a flu shot–my immunity seems to be working just fine so why would I want to mess with it? And especially, take a new and untested vaccine against a flu strain that seems fairly contagious but no more virulent than other flu strains.

    But nowhere does the “physician question” fall into play. Is Richard Daines going to mandate that all physicians in NYS get flu shots? There is deafening silence about that, and I wonder if anyone has asked him. Or what his answer will be. When individual hospitals have tried to mandate flu shots, physicians were always left out of the mix–as though it is impossible for a patient to catch the flu from an MD. So Dr. Daines, what is your take on physicians? Do they all have to stop practice, lose their hospital privileges, if they don’t step up to the plate?

    Also, as Diana mentioned, nothing has been said about visitors. Does Dr. Daines really think that visitors and family are going to be prohibited from entering the hospital? Dream on, buddy. There is no enforcement at all, as to who comes during visiting hours. And family members have much closer contact with the patient than does a healthcare worker. They may hug and kiss the patient (spreading germs galore), not wash their hands, spend hours at the bedside sneezing and coughing…really, if you want to mandate a vaccine to protect patients, then start with visitors.

    Anyway, if I was still working as a nurse and living in NY, you better believe that I would be at the head of the protest line–and asking Dr. Daines the questions I just put forth here. I am surprised that no one has mentioned if this mandatory for the MD.

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  6. I understand the need for vaccinations. I received all of my shots as a child and I usually get the flu vaccine yearly. I have exposed numerous times to the A type of flu in my office and so far have not contracted it. Why? Natural immunity? Luck? Who knows. Will I get the Swine vaccine? Not sure. I tend to sit back and watchfully wait before taking anything new. That goes for regular medications also. I don’t prescribe anything that hasn’t been on the market for a while. It’s only fair to let it work out the kinks before I subject my patients to it unless they insist on trying it.

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  7. Before anyone considers being pressured by anyone else to get a vaccination, please get informed about what is in it. WHO wants to mandate it worldwide. Some states and medical facilities have. There are other ways to build your immunity other than via vaccination. We have had it given to us as the only way to overcome disease is via vaccination. Even the vaccination itself says it may not prevent disease. Consider what happened with Gulf War Syndrome. The troops were vaccinated like guinea pigs. Do you want to risk that as well? Do you know what might happen long term? Nobody does. Whey did the drug companies have immunity from being sued if their product is so safe and effective? Something to consider..if you think outside the box.

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  8. The above comment, by nurse blogger JParadisi RN http://jparadisirn.com/ is open-minded, constructive, thoughful, and yet passionate. We appreciate that. It so happens that this blogger is also the artist whose work is used on AJN’s October cover: http://journals.lww.com/ajnonline/Fulltext/2009/10000/On_the_Cover.7.aspx
    -Jacob Molyneux, blog editor

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  9. The other day I was walking through a hallway at the hospital, when one of the staff began coughing. He looked embarrassed, and I told him he’d better cut it out, or someone may call a Code Oink, which is: he gets tackled to the floor, has a cotton swab pushed up his nose, a vaccination shot into his arm, and a mask thrown over his head, before he’s booted out of the hospital and into the street. We both laughed, but neither of us was sure it wouldn’t actually happen.

    I’ll probably get the H1N1 vaccination this flu season. I’ve had MMR (measles, mumps, rubella), tetanus shots, and the hepatitis C series, all without damage.

    Personally, I’m still waiting for SARS, West Nile Virus, Bird flu, and killer bees, each of which were predicted as the next pandemic of their time.

    Cynical as I am, it’s logical to admit that eventually the epidemologists will be right, and we’ll have a pandemic of something; maybe it will be the Swine Flu.

    What been puzzles me is my aversion to taking the vaccine. As mentioned, I’ve been vaccinated for almost everything else. Why am I dragging my feet over this?

    The answer is: I resent the insinuation that I am not considering my patients’ or coworkers’ safety if I refuse the vaccination.

    Nurses work twelve hour shifts, often without breaks of any substance. We stay over time because of late admissions, coding patients and short staffing. We come in on our days off for education and staff meetings. We miss family birthdays and holidays. We fly in small aircraft through bad weather transporting sick patients from one hospital to another so that they receive the care they need. We admit patients with contagious diseases we aren’t aware that they have. We continue to take care of them once we know what terrible, contagious disease they have. We are exposed to second hand smoke from our patients and their visitors. We are exposed to violent patients. Still, we return for our next shift.

    I cannot speak for any nurse other than myself, but attempts to make me feel guilty do not motivate me; they make me feel manipulated.

    Just tell us what I perceive to be the truth: Administrators are afraid that this time, there really is going to be a pandemic, and if health care professionals don’t get the H1N1 vaccine, there may not be enough available staff to take care of all of the sick patients. Just say “please get the vaccination. We can’t afford for all of you to get sick.” Admit it: you need us, all of us.

    We’ve known it all along.

    jparadisirn.com

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