2013 is rife with reports of the terrible human costs of the flu. Emergency rooms nationwide have been overwhelmed. Art Caplan’s great blog post urges doctors to educate patients that the flu vaccine is not just for their benefit. He tells healthcare providers to send a clear message by getting the flu shot themselves. But what should we do when they refuse?
Flu vaccination of healthcare providers has come a long way. Before 2009, rates never broke 49%. Today, almost two-thirds of healthcare providers are vaccinated.
Still, one-third of healthcare providers do not protect themselves, their patients, and the public from influenza. We remain far short of the national Health People 2020 target of 90%. Do these providers have religious beliefs that raise tricky constitutional and statutory questions? Do they assert deeply held philosophical objections? Media accounts suggest so. We hear of the vegan customer service representative who refuses the flu vaccine because it is grown in chicken eggs, and the religious holistic nurse who objects both to vaccination and to wearing a mask.
But the main reason for going unvaccinated, according to the Centers for Disease Control, is that healthcare providers simply did not want to get vaccinated. Other common reasons: they think flu vaccines don’t work, fear experiencing side effects, or don’t think they will need the vaccine. Some reasons do not reflect the evidence. Others suggest, as Art Caplan puts it that healthcare staff need to “stop thinking only about themselves.”Mandates can counteract this resistance. Many hospitals now require vaccinations, and their coverage rate is 83%. 15% of healthcare providers say they only get the vaccine because their employer requires it. Although hospitals have taken the initiative, other healthcare institutions lag behind. Just 54% of healthcare providers at long-term care facilities are immunized so as to protect their fragile patients.
The regulatory response has been slow. Only a few months ago, Rhode Island became the first state to mandate flu vaccines for healthcare workers with direct contact with patients—in all healthcare settings. Workers who cannot be vaccinated for medical reasons or refuse to be vaccinated must wear surgical masks during periods of widespread flu. State regulation has a number of benefits over ad hoc employer mandates. It applies widely. It recognizes that healthcare workers, whether in the home, hospital, or office, risk spreading illness to vulnerable patients. Regulation ensures patients need not rely on the goodwill of particular institutions or providers. It also avoids the model of employer coercion of employees, and establishes vaccination as a professional obligation. More states should follow Rhode Island’s lead.
Most employees in hospitals get flu shots anyway and firing people for not getting a flu shot is just wrong. Mandating flu shots for people who prefer, for whatever reason, not to get them is not defendable. Getting a flu shot does NOT protect others from getting the flu from you if you get the flu, it only may make symptoms milder if the right guess was made about making the vaccine. I think the flu vaccine program is very good but please don’t try and sell us this crap about it protecting patients if healthcare workers get their shots.
Most employees in hospitals get flu shots anyway and firing people for not getting a flu shot is just wrong. Mandating flu shots for people who prefer, for whatever reason, not to get them is not defendable. Getting a flu shot does NOT protect others from getting the flu from you if you get the flu, it only may make symptoms milder if the right guess was made about making the vaccine. I think the flu vaccine program is very good but please don’t try and sell us this crap about it protecting patients if healthcare workers get their shots.
I disagree. The flu shot should not be mandatory. If you are sick, stay home! What are sick days supposed to be used for?
I disagree. The flu shot should not be mandatory. If you are sick, stay home! What are sick days supposed to be used for?
That is the other perverse side effect, in today’s short staffed hospital environment staff feel obligated to go in to work if they aren’t too bad off so, if symptoms are less severe, off to work with the flu they’ll go. Thus, flu shots have achieved the opposite of what you are suggesting.
The flu shot should not be mandatory. As one responder stated, the effectiveness all depends on the right guess for the vaccine. We have had several employees vaccinated that got the flu. What were they vaccinated against, a different strand?
The flu shot should not be mandatory. As one responder stated, the effectiveness all depends on the right guess for the vaccine. We have had several employees vaccinated that got the flu. What were they vaccinated against, a different strand?
Lawyers and Mandates are what is wrong with the healthcare system. Lawyers should leave the practice of medicine to the Physicians at Harvard Medical School!
Lawyers and Mandates are what is wrong with the healthcare system. Lawyers should leave the practice of medicine to the Physicians at Harvard Medical School!
I have been an ER nurse for the past 17 years. I have worked in Healthcare for the past 20. I have been VOLUNTARILY getting the flu shot for at least 18 years. The last time I had the “real flu” and trust me I know what it is, was 16 years ago. This year my healthcare facility MANDATED that everyone who has patient contact MUST get the vaccine unless you have a true allergy or your doctor wrote an explanation as to why you could not get it. Well, to be sure someone is truely allergic to the vaccine or something, the employees were sent to the allergy clinic to get tested. Leaving employees with mild allergic reactions and having to be medicated to relief the reaction. This is obsurd. It was basically, get the vaccine or go find another job. REALLY? I planned to get the vaccine this year even if it was not mandated, but here is what has put me over the edge. Being in the ER, you are on the front lines of every germ the public has. Even though it is in the newspapers and the news, even national news…”if you think you have the flu…STAY HOME” Those who do come to the ER are seen by us medical professionals and your discharge instructions say “stay home, get plently of fluids, rest and tylenol” and if you have the flu “stay home from work” Well that is not working. My ER sees over 300 patients a day! The primary complaint “I have the flu”. Well guess what has happened? The ER nurses, medics, doctors and support staff are dropping like flies because we have the flu!!!!!! Oh by the way, did I mention we were MANDATED to get the vaccine. I fell victim to the flu last Saturday. I woke up that morning with cough, congestion, chills, body aches, etc. Thought it would just pass. The day went on and I spiked a fever. It went on all day Sunday, had to call off from work Monday (12 hr shift), still had a fever. I tried to go to work for a 12 hr shift and did nothing but cough, chills, temperature of 99.7. I made it 4 hrs and went home. What I have not mentioned yet is that if we call off sick or leave work sick, we get 1 point for every hour of work we miss. I missed 20hrs in 2 days. With our point system, you 1st get a verbal warning, then a written warning and once you get to 80 points or something, you can be terminated! Oh by the way, did I mention we were MANDATED to get the vaccine. So at this point the healthcare facility is doing nothing for employees who do get the flu. Many employees are trying to come to work SICK due to the fear of accumulating points. We work 12 hr shifts. By missing 2 days, that is 24 points which leads to a verbal warning. The points go away next year at this time. It is now 11 days since the flu hit me…It lasted Sat thru Tuesday. Felt better Wednesday untill I developed a low grade fever, chest pain, cough, etc… I went to work over the weekend Sat. and Sun both 12 hr shifts (coughing, diaphoretic and feeling miserable). Which is what several of my coworkers were feeling. Before I left work on Sat I checked in as a patient. Diagnosed with bronchitis, taking antibiotics, steroids and breathing treatments. It is now day 11 since the flu hit me, I know have pneumonia. The Employee health dept at my facility will not furlough employees until the flu becomes an EPIDEMIC. I am not someone who gets sick. I think I have a helluva an immune system. Usually it’s the sniffles for a day or two and back to norm. I am not looking for sympathy. I am just pissed off. And I know I am not the only healthcare provider in this situation. Many of us are walking around with coughs, fevers, and look much worse than those individuals coming to the ED to get the magic cure for “the flu”. So for those who are not in the healthcare profession and you go to the ER because you have a cold or you have a family member who is very ill with other medical conditions…do you want to hear your nurse or doctor coughing, sniffling and sneezing while you are being examined??? I sure as hell wouldn’t. I would run like hell and go home! This needs to be fixed. I am in the process of taking this up with my facility. Please do not get me wrong that nobody should go to the ER if they have the flu…I highly encourage those who have uncontrolled fevers, infants, children, elderly and those with underlying medical conditions that can cause complications from the flu to seek MEDICAL TREATMENT IMMEDIATELY!!!! I wish everyone the best this influenza season!!! Wash your hands, use hand sanitizer and please, please cover your mouth when you cough and sneeze! MAYBE THE GOVERMENT SHOULD MANDATE THAT EVERY SINGLE AMERICAN GET THE INFLUENZA VACCINE AND IF YOU DON’T ,MAYBE YOU SHOULD FIND ANOTHER COUNTRY TO LIVE IN!
I have been an ER nurse for the past 17 years. I have worked in Healthcare for the past 20. I have been VOLUNTARILY getting the flu shot for at least 18 years. The last time I had the “real flu” and trust me I know what it is, was 16 years ago. This year my healthcare facility MANDATED that everyone who has patient contact MUST get the vaccine unless you have a true allergy or your doctor wrote an explanation as to why you could not get it. Well, to be sure someone is truely allergic to the vaccine or something, the employees were sent to the allergy clinic to get tested. Leaving employees with mild allergic reactions and having to be medicated to relief the reaction. This is obsurd. It was basically, get the vaccine or go find another job. REALLY? I planned to get the vaccine this year even if it was not mandated, but here is what has put me over the edge. Being in the ER, you are on the front lines of every germ the public has. Even though it is in the newspapers and the news, even national news…”if you think you have the flu…STAY HOME” Those who do come to the ER are seen by us medical professionals and your discharge instructions say “stay home, get plently of fluids, rest and tylenol” and if you have the flu “stay home from work” Well that is not working. My ER sees over 300 patients a day! The primary complaint “I have the flu”. Well guess what has happened? The ER nurses, medics, doctors and support staff are dropping like flies because we have the flu!!!!!! Oh by the way, did I mention we were MANDATED to get the vaccine. I fell victim to the flu last Saturday. I woke up that morning with cough, congestion, chills, body aches, etc. Thought it would just pass. The day went on and I spiked a fever. It went on all day Sunday, had to call off from work Monday (12 hr shift), still had a fever. I tried to go to work for a 12 hr shift and did nothing but cough, chills, temperature of 99.7. I made it 4 hrs and went home. What I have not mentioned yet is that if we call off sick or leave work sick, we get 1 point for every hour of work we miss. I missed 20hrs in 2 days. With our point system, you 1st get a verbal warning, then a written warning and once you get to 80 points or something, you can be terminated! Oh by the way, did I mention we were MANDATED to get the vaccine. So at this point the healthcare facility is doing nothing for employees who do get the flu. Many employees are trying to come to work SICK due to the fear of accumulating points. We work 12 hr shifts. By missing 2 days, that is 24 points which leads to a verbal warning. The points go away next year at this time. It is now 11 days since the flu hit me…It lasted Sat thru Tuesday. Felt better Wednesday untill I developed a low grade fever, chest pain, cough, etc… I went to work over the weekend Sat. and Sun both 12 hr shifts (coughing, diaphoretic and feeling miserable). Which is what several of my coworkers were feeling. Before I left work on Sat I checked in as a patient. Diagnosed with bronchitis, taking antibiotics, steroids and breathing treatments. It is now day 11 since the flu hit me, I know have pneumonia. The Employee health dept at my facility will not furlough employees until the flu becomes an EPIDEMIC. I am not someone who gets sick. I think I have a helluva an immune system. Usually it’s the sniffles for a day or two and back to norm. I am not looking for sympathy. I am just pissed off. And I know I am not the only healthcare provider in this situation. Many of us are walking around with coughs, fevers, and look much worse than those individuals coming to the ED to get the magic cure for “the flu”. So for those who are not in the healthcare profession and you go to the ER because you have a cold or you have a family member who is very ill with other medical conditions…do you want to hear your nurse or doctor coughing, sniffling and sneezing while you are being examined??? I sure as hell wouldn’t. I would run like hell and go home! This needs to be fixed. I am in the process of taking this up with my facility. Please do not get me wrong that nobody should go to the ER if they have the flu…I highly encourage those who have uncontrolled fevers, infants, children, elderly and those with underlying medical conditions that can cause complications from the flu to seek MEDICAL TREATMENT IMMEDIATELY!!!! I wish everyone the best this influenza season!!! Wash your hands, use hand sanitizer and please, please cover your mouth when you cough and sneeze! MAYBE THE GOVERMENT SHOULD MANDATE THAT EVERY SINGLE AMERICAN GET THE INFLUENZA VACCINE AND IF YOU DON’T ,MAYBE YOU SHOULD FIND ANOTHER COUNTRY TO LIVE IN!
I think the federal government has become way to involved in the daily lives of all people at this time. The flu vaccine is not like other “vaccines” it does not prevent the flu, you are still suseptable to the disease, with hopes that the effects will be lessened. Because of this I do not feel it should be mandated, is should be a choice, in my facility we promote and encourage all staff to receive it and this year had 100% participation. But if someone comes in with a cough or runny nose they still put on a mask, receptionist, nurse, tech or physician. We do this out of courtesy for each other. We are a small out patient surgery center and need all of us here to run efficiently, so we try not to infect the other staff or our patients.