A shot in the arm for all in health care?: Some nurses groups have protested mandatory flu shots, but many researchers say health care workers--even administrators--should all get vaccinated.
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MALTA—U.S. drug stores have been advertising their seasonal flu shots to the public for weeks, and here at Scientific American employees have already been invited to sign up for free jabs next month.
These vaccination enticements, for the most part, come down to individuals' decisions about arming themselves against the flu. But for doctors, nurses and other workers in the health care industry, their level of protection against the season's circulating flu strains has the potential to impact hundreds of others, noted health experts at the fourth European Scientific Working Group on Influenza (ESWI) conference earlier this month in Malta.
If an office worker gets sick, he or she might spread germs to co-workers who sit nearby. But if doctors or nurses get the flu, they can pass it to the dozens of patients they come into contact with each day—many of whom have other conditions that render them more susceptible to infection. The flu still kills thousands of people each year in the U.S., most frequently those with underlying conditions, who also have more frequent contact with medical personnel than the healthy.
Last winter just under two thirds (63.5 percent) of health care workers got a seasonal flu shot, according to an August report published by the U.S. Centers for Disease Control and Prevention (CDC), even though universal vaccination of health care workers is supported by numerous scientific and medical groups.
Why would so many of these workers forgo the protective injection? "There is some question of understanding" as to whether even many health professionals are aware of the limited risks and outsize benefit of the vaccine, Maria Zambon, director of the Center for Infections at the U.K.'s Health Protection Agency, said at ESWI.
Many of those in the health care field who opted not to get the shot did not think that the vaccine "was worth the time and expense" or that it could "protect them and the persons around them from the disease," according to the CDC report. About 40 percent of the health workers who did not get vaccinated said that they did not consider influenza a serious threat to the health of people around them—and about 55 percent said that they did not think the vaccine would protect those around them.
And as tough as they can be, the immune systems of doctors and nurses are not impervious to influenza. Unvaccinated health care staffers are second only to unvaccinated adults living with kids in their likelihood of coming down with the flu. About 18.7 percent of unvaccinated health workers versus 24 percent of unvaccinated adults with children in the home get the flu each year, according to Allison McGeer, a microbiologist and infectious disease consultant at Mount Sinai Hospital in Toronto. That means "health care workers are at higher risk of influenza than other working adults," who have an annual infection rate of just 5.4 percent, she said at the ESWI meeting. And her analysis suggests that health workers tend to have a higher rate of asymptomatic infections, which "may say something about the risk of influenza transmission to patients."
Hospitals mandating vaccination for employees have raised the hackles of some unions and professional associations. States and local governments can also exercise their rights to pass mandatory vaccination laws for certain groups (such as school children, military enlistees or health care workers), according to a congressional report (pdf) produced earlier this year.
For medical institutions that have adopted a requirement that their employees get the shot, their rate of vaccination was 98.1 percent last flu season, according to the CDC report. Another study found hospitals that introduced vaccination requirements mid-season last year increased the rate of employee flu shots 62 percent to 76.6 percent. "Hospitals that are unable to improve suboptimal influenza vaccination coverage through multifaceted, voluntary vaccination campaigns may consider institutional requirements," noted the authors of the paper, which was published online September 22 in Vaccine. "Rapid and measurable increases in vaccination coverage followed institutional requirements." These employers still seemed to be in the minority, though, with only 13 percent of respondents in the CDC study reporting that they had been required to get the shot.
Another policy that has boosted shot rates in some hospitals, just shy of a full-coverage mandate, is the condition that any employees who decline the vaccination be required to wear a surgical mask for the duration of the flu season—even if that employee does not work with patients. "That means that individual is stigmatized, whether or not the face masks are doing a good job of preventing transmission," Arnold Monto, a professor of epidemiology at the University of Michigan School of Public Health, said at the ESWI. The mask policy, for example, increased uptake of the vaccine from 70 to 96 percent at one Massachusetts hospital, The Boston Globe reported earlier this month.
Improving uptake of the seasonal flu vaccine among health workers could also improve response to a pandemic in the future by creating wider immunity to a number of strains and by habituating people to getting the shot. "If we get it right for influenza, it will help us to be better prepared for other infections," Zambon said. But, she added, those in the health care industry are a crucial barometer: "If we are unable to convince them about the vaccine," the rest of the population might be even more challenging to rally. During the 2009 H1N1 pandemic, for example, only slightly more than a third (37 percent) of health care professionals ended up getting the shot when it became available.
Monto calls the decision to pass up the vaccine—whether you are a health worker or not—"stupid behavior," noting that the demonstrated benefits to yourself and those around you far outweigh any slight risks of adverse reactions.
McGeer put it a little more diplomatically, noting that there is "no question in my mind, from a scientific point of view, that no one should be working in health care without being vaccinated."
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24 Comments
Add CommentHigher authorities will be responsible for incidents where health care workers do not get vaccinated.They are the ones responsible for flu spreaded by these workers.
Reply | Report Abuse | Link to thisIf it is true that "About 18.7 percent of unvaccinated health workers versus 24 percent of unvaccinated adults with children in the home get the flu each year, according to Allison McGeer, a microbiologist and infectious disease consultant at Mount Sinai Hospital in Toronto. " then it means 81.3% of vaccinated health workers do NOT get the flu. The vaccine is a gimmick, as no one knows for sure which version of the virus will be loose any season and it is a crap shoot as to if the vaccine is even effective against what spreads. Since leaving the AF in 1983 I haven't received a flu shot, nor have I had the flu, something prevalent during my military/vaccinated years.
Reply | Report Abuse | Link to thisThat should be 81.3% of UNVACCINATED workers.The Spell checker keeps correcting it to vaccinated. Hmmmm.
Reply | Report Abuse | Link to thisAll health care workers need to ensure that they are exposed. Take a few days off and return to work. If their vit D levels are good ,they will not get sick
Reply | Report Abuse | Link to this"About 18.7 percent of unvaccinated health workers versus 24 percent of unvaccinated adults with children in the home get the flu each year"
Reply | Report Abuse | Link to thisBut how many vaccinated workers and parents get the flu??? That seems like a big missing piece of info. Could workers and parents just have higher rates of flu, regardless of vaccination?
Based on current evidence of the effectiveness of flu shots, I don't think health care workers who decline flu shots are irresponsible. What would be irresponsible is if health care workers go to work while sick, regardless of whether they have been vaccinated or not!
What I want to know is: Why on earth would a health care worker not get the shot?
Reply | Report Abuse | Link to thisI am in administration for a health care company. My company offers free immunizations to anyone who wants them, both those who have patient contact and those who do not have patient contact (like me). I just can't figure out why anyone would not, especially if it is free.
I can understand that someone with limited income might not get one if s/he had to pay for it, but most people who work in health care make enough to pay for it even if their employer does not.
Mandating the shot for caregivers is unethical. If the vaccination rate os too law for this subgroup, it is the same problem as the rest of the population.
Reply | Report Abuse | Link to thisEducation.
Pandering to social misinformation in media is what needs to be regulated, not personal choice. This solution has the potential to fix both the voters and the US federal government in one fell swoop.
For 30 years, I have been a 911 ambulance paramedic. I'm sure than many, many times I have been exposed to various kinds of flu, yet I have never gotten sick. In all of that period, I have never taken a flu shot. The last time I had the flu was the Asian flu back in the 1970s. Note: I take a daily vitamin containing vitamin D and have for 40 years.
Reply | Report Abuse | Link to thisIn 1980 my partner had a flu shot and afterward was seriously ill for two weeks. I did not have a flu shot and did not get sick. Nor have I had a flu shot since, and have not gotten the flu. Neither the government--nor our employers--should mandate what we put into our bodies, period. The emphasis should be on the good daily habits that contribute to a healthy immune system. One of them would be getting hospital workers to wash their hands, thereby eliminating a big source of infection. If they washed their hands, stopped smoking, exercised, ate healthily, were not stressed in the work environment, and watched their weight, the incidence of flu would go down without vaccination.
Reply | Report Abuse | Link to this1) I have not had the flu for over 30 years. Why, therefore, would I want to put something into my body that could interfere with my immune system?
Reply | Report Abuse | Link to this2) The statistics (the CDC's own) do not bear out a relationship between vaccination an incidence of flu.
I am a healthcare worker who agrees with Carolina. To suggest we decline because we don't have enough info is insulting. Like most healthcare workers, we are better educated than the general public re the efficacy of the flu vaccine and that info is right on the CDC website. All these reports should be studied closely for what is not reported: vaccinated adults who get the flu, 'flu-like' illnesses classified as the flu w/ no swab, statistics of healthcare transmission of the flu (where are those?). No thx.
Reply | Report Abuse | Link to this"Research shows that the unvaccinated staff have a decent chance of getting sick--and passing that infection on to at-risk patients"
Reply | Report Abuse | Link to thisWhat exactly IS a "decent chance"? Is that somewhere between zero and a hundred percent?
With crap claims and alarmist garbage science like this, it's no wonder people are leery of the vaccine industry. All they have to do is listen to some pie-eyed true believer like Paul Offitt, "then each infant would have the theoretical capacity to respond to about 10,000 vaccines at any one time" or his Hollywood hacktresses Amanda Peet and Jennifer Garner (they're both doctors, right?) to understand the industry is lying.
Or they could just read the transcript of the "Scientific Review of Vaccine Safety Datalink Information June 7-8, 2000 Simpsonwood Retreat Center Norcross, Georgia" and learn that industry and regulators discussed how to commit fraud to cover up the 10 percent of vaccinated kids who wound up with neurological problems. They did so by eliminating over half the study group and changing the conditions of the study after the results were in, then not changing the diagnosis if it changed later in the study. This is known as "fiddling with the base" by statisticians. Everyone else calls it "fraud."
I have heard so many people say "I had it last year but, I won't be having it this year"
Reply | Report Abuse | Link to thisThey were so ill that they would not have it again.
Please do not make this mandatory Our bodies are our own.
Best wishes,
Marjorie.
This article lacks much of the required information for making an honest assessment of the benefit vs. risk of the flu shot. I've gotten a flu shot every year for the past 5 years. I have not gotten the flu during that time. Before I started getting the flu shot I had gotten the flu twice.
Reply | Report Abuse | Link to thisHere is a big clue for the mentally feeble: 1 person is not a reliable sample size!!! Neither is 10 people. Just because something did or did not happen to you does not qualify you as a valid scientific sample. I have my doubts about the flu shot because I have yet to find both sides of the data.
I get the flu shot because before vaccines we had a mortality rate of about 80% before 18 years of age. Now it is down to less than 5% mortality by age 18. I don't know if that is causality or only corelation but I'm guessing that at the very least there is a pretty hefty chunk of us that grew up instead of dying because of those vaccines.
Yes, and those lives were all saved by vaccines, not advances in nutrition, prenatal care, sanitation, infant health care programs, reductions in pollution, food inspections, germ theory and child labor laws.
Reply | Report Abuse | Link to thisFor those who have been brainwashed into thinking that flu shots in particular and vaccinations in general are necessary they need to look at the history and then follow the money trail. The following was written by an M.D. in a newsletter: Pres. Reagan signed the National Childhood Vaccine Injury Act that decrees "No vaccine manufacturer shall be liable in a civil action for damages arising from a vaccine-related injury or death". The drug companies essentially told congress and the Pres..."Yes the vaccines we create for children are toxic. They are designed to make them sick in order to stimulate an immune response, and they contain highly toxic ingredients that will cause serious side effects, including death. Therefore, if you don't eliminate our liability, we will never be abel to implement our master plan for mass vaccination of American children, because we could never withstand the judicial scrutiny of vaccine damage in courts of law."
Reply | Report Abuse | Link to thisOf course this talks about children but the law also applies to adults and it has been discovered over the years that some the substances that have been found in the vaccinations have been mercury and aluminum that are known to create very toxic side effects to the recipients.
In spite of this the FDA has not seen fit to carry out their legal duty to protect the public. Follow the money trail. The FDA is nothing more than an arm of Big Pharma and they are curiously quiet about such matters. Who suffers... the citizens. Then such articles as this published by the "Scientific American" give credence to this absurdity that is a health hazzard to our people and they try to put a guilt trip on those who choose to protect themselve. So, SA DO YOUR HOMEWORK and for God's sake be careful about believing anything our gov't buroeucracy promotes.
Hello I am a Healthcare worker,mind you I have received the flu shot for the past 5 years. I now have decided I do not want to get the flu shot, I have read of the mercury,and other harmful substances that are in the flu shot and what they do to your body over time when your body cannot get rid of it. It's not a good thing to be putting toxins into our bodies the right thing would be to educate people to take vitamin D which increases the immune system, stay home when sick and uses natural substances to get healthy. It a liberty issue as well, when the hospitals start regulating and not allowing you to make a descision that is taking away our freedom and rights as a free society. They cannot guarantee that I won't get the flu, or that I will, from what I am reading here the percentages are off as well, have they done a study of those who go the flu while on the flu shot? My point is we should be given a choice not fired and out of employment, because we decide not to, that is just creating more of the same. Doesn't anyone see that its about the right to choose what we place in our bodies, I certainly doubt that if everyone knew they were putting mercury into there systems which is suspected to cause Alzehemers, and autism in children, our bodies cannot get rid of it let alone we should leave it to who to pick which strains they want to give us? come one Education, should be key tell us what you are giving us, let us make the decision, if you find we are sick all year and have a problem like that maybe, but if you educate tell everyone to take more vitamin D in the winter, show them healthier ways to do things, and be stricter on the things that keep pharmecudicals in business, start putting more positive into the world we would be free from this mess. I think america needs to wake up and take back their rights, as a free country little by little we are moving towards socialism. Is that really what you want? whats next micro chips they are coming?
Reply | Report Abuse | Link to thisHealthcare workers are also required to follow personal protection measures as well. Wearing gloves, masks, gowns, washing their hands. This will soon fall into that same set of rules, overall getting vaccinated is beneficial.
Reply | Report Abuse | Link to thisAs has been noted by many in this forum previously there are numerous reasons for some NOT to be vaccinated. For example, those who have decided to focus on a life style that enhances a strong immune system.
Reply | Report Abuse | Link to thisThe greater questions are: Who really benefits from requiring everyone to be subjected to vacinations? And who is ultimately responsible for personal health?
With a little logical thought I think most of us can determine the answers...but just in case that's not within one's realm of consciousness, could the answer to question #1 happen to be: the manufacturers of the vaccine? And for question #2...could it possibly be: that we are responsible for our own health?
Those that are tied into the "disease care model" usually want someone else to assume responsiblity for their lack of dedication to a healthy life style, so, of course they would advocate that all should be vaccinated and of course the manufacturers love this kind of thought process because it fits in with their monetary objectives. The appeal (or warning) being that it is in the common good for all to be vaccinated. A noble thought indeed as long as the rights of the individual are ignored. When this kind of information is put forth we must always ask who is behind it or who benefits? As is usual...FOLLOW THE MONEY TRAIL.
As a nurse for the past 32 years, I have had all of the basic immunizations, including hep b. I knew exactly for what I was being immunized. The influenza vaccine is science's best guess from the previous year, what strains of influenza will likely be infectious the following year. Depending on the studies one reads about the accuracy of those predictions, the percentages can vary about forty percent from one study to another. I have never received the flu vaccine and have never gotten the flu. I understand that that is not necessarily predictive. In my experience, health care workers are much more likely to get sick from each other than from their patients. We know our patients are sick, and take appropriate precautions. Nurses are frequently penalized for calling out sick. Staying home ill may cost you your job. Therefore, many nurses go to work with infectious illnesses, share the same phones, refrigerators, microwaves, bathrooms, etc. and infect their co workers. Respecting the fact that we know when it is appropriate to stay home without being punished for it, would improve the health of all of us. I, and may others of us who have been doing this job for a few years, understand that the flu shot does not give you the flu, make you sick, or even cause Gillain-Barre syndrome. There are just apparently a lot of coincidences. Believe what you may. I don't believe that we should be mandated to have something injected into our bodies to continue to pay the mortgage and put food on the table. Each competent patient has a right to refuse a treatment or medication. Why take that right away from those who provide care to those patients!?
Reply | Report Abuse | Link to thisPeople that do not study the research of vaccines for themselves have no right to instill the unnecessary onto others. Just because it's free and supposedly benefits our health, there is nothing that proves that. Who actually thinks that this mandatory vaccine is perfectly tested enough to become forced onto people? Why do they cause autism and deaths in some people? I seriously doubt that they've been tested and proved 100% safe for EVERYBODY. People need to do their own homework and not believe everything they are told and think for themselves for once. The vaccines are a scam, there is something behind these "mandatory" vaccines that is bothersome, possibly something far more potent in these that are meant to be triggered later. If people want to put something in their bodies and their children, then go ahead and take that risk... but leave the informed ones out of it. Lately it seems as if fiction has been closer to the truth for people who have awakened and opened their eyes.
Reply | Report Abuse | Link to thisI haven't gotten a flu shot in 5 years or more. All I've had in that time is the sniffles, at worst. You still get flu when you get the shot, so what's the point? Personally, I think you're actually getting the sniffles, but it turns into the "flu" because your body is trying to regurgitate all that mercury, formaldehyde and aluminum you've been injected with... Yeah, look up the ingredients before you get your next one... Mercury is a known neurotoxin, so using it as a vaccine preservative may not be the brightest move scientists have made. Formaldehyde is known to cause cancer. Aluminum is what your soda can is made of. That's just a few of the ingredients flowing through your blood and through your brain.. Ridiculous that people are forced to get these injections in order to keep working. Land of the Free, unless you want a job..
Reply | Report Abuse | Link to thisAll health care workers have an obligation to protect their patients. As a Registered Nurse, I also feel an obligation to my employer to be the best I can be in every way possible at all times while on the job. I also feel an obligation to my family. My children need a healthy mother who has a job. There is yet another obligation most people miss, and that is, to humanity and doing the right thing, even if it means a sore arm for a few days. There are people worldwide right at this very moment, who, for the lack of education, and/or the inability to understand disease and transmissability, and/or a lack of conscience, and/or the lack of resources to afford condoms, who are infecting others, even innocents, with the AIDS virus. There is no excuse whatsoever not to avail oneself of every opportunity to prevent death, disease, and all the suffering that goes with it. I wear a seatbelt when I'm in a car, I expose myself annually to radiation for a mammogram to detect the early signs of breast cancer, if I have an infection, I swallow powerful chemicals (antibiotics) to prevent my death or disability. I can't understand why there is such a mental disconnect concerning vaccines, and I am referring to my coworkers, not the general public necessarily. If I carried a firearm and was careless and harmed you or someone you love, I would go to jail, and rightly so. How is it different if by my indifference I unknowingly, because I am contagious but asymptomatic, transmit influenza to your grandmother in the hospital who was already fighting for her life against pneumonia, and now dies? Am I blameless because you can't prove it was me that did her in? What about if she lives but incurs another month or two of expenses in the hospital, which we all pay for through taxes on our income? What if she misses your son's wedding because her life was shortened due to complications of disease? Would you miss her? Do you still think it's a good idea for me to skip getting my flu shot this year? No worries. I rolled up my sleeve, and everyone who is able should, too.
Reply | Report Abuse | Link to thishttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870528/
Reply | Report Abuse | Link to thishttp://www.ncbi.nlm.nih.gov/pubmed/18298852
http://summaries.cochrane.org/CD001269/vaccines-to-prevent-influenza-in-healthy-adults
http://summaries.cochrane.org/CD005187/influenza-vaccination-for-healthcare-workers-who-work-with-the-elderly
When these people tell me it's that ineffective, especially a cochrane review, it really is that ineffective. The flu vaccine is about money - not about making people less likely to catch the flu. I'm only sorry that as a health care professional that I supported flu vaccination for as long as I did.