Mandatory vaccines – sorta

by SophiaZoe on September 28, 2009

When I got home and fired up my laptop I was greeted by blazing red headliner letters on Drudge Report that read “Mandatory vaccination for 500,000 in NY“.  Given my interest in the pandemic issue and my general belief in the efficacy of the influenza vaccine in the face of a pandemic, even a mild one, I experienced a visceral reaction to the headline.  Crap! That’s all we need to fuel the controversy – tell people they are subject to a mandatory vaccination.

However, after reading the actual news item I take acceptation to the headline.  This is not a legal requirement, this is a requirement of continued employment – they are two different things.  New York health care workers are completely free to not get vaccinated and their employers are completely free to fire them if they do not.

Via Newsday.com

Mandatory flu vaccination splits workers

Despite a planned rally in Albany Tuesday to protest a state regulation requiring health care workers be vaccinated against influenza — both seasonal and swine flu — New York’s top public health official predicts dissenters will ultimately extinguish their anger and roll up their sleeves.

The regulation, which was approved in August, comes with a stinging addendum: Get vaccinated or get fired.

But some nurses and many other health care providers say the regulation violates their personal freedom and leaves them vulnerable to vaccine injury. And they cite deaths associated with the last federal government swine-flu vaccination program in 1976.

Refusing to be immunized against H1N1 because of the vaccine debacle in 1976 “is like saying a plane crashed 33 years ago so I’ll never fly again,” said Dr. Richard Daines, New York State health commissioner.

New York is the only state in the nation to require that health care workers be vaccinated, though other states are considering such measures. Health workers, including doctors, must be immunized by Nov. 30. Opponents say it’s simply unnecessary.

I am a staunch and vocal proponent of immunizations, the influenza immunization included.  I am also in absolute full agreement with this employment requirement.  Medical professionals come into physical contact with the patients they serve.  Setting aside proactively protecting one’s own health, becoming infecting and passing the infection on to others, some of whom may develop life threatening complications – and some of those might be fatal is something to be guarded against with the means we have at our disposal, in this case that is a vaccine, along with standard hospital infectious disease protocols.  When someone’s health and life are at risk extra burdens are placed on those who introduce the element of risk.

It is technically no different than the requirements I had to meet yearly to remain a certified police officer; without certification a person cannot be a law enforcement officer in the state of South Carolina.  Those requirements were to protect the public I was out protecting.  Some professions carry extra burdens for those who are in them, it’s just the way of it – accept it or move on.

Several registered nurses said they will neither contract nor transmit the flu because they’re constantly washing their hands.

The ignorance of that belief is astounding.  I can’t help but wonder if these nurses have read or heard anything about Canadian nurses and the SARS outbreak in that country.  Canada was not the only country that had nurses become infected with SARS, some of which were fatal.

SARS was not as transmissible as the influenza virus and SARS was also not infectious until after obvious symptoms presented.  With influenza a person can be infectious prior to physical symptoms, in other words, a person can infect someone else [potentially] before they even know they are infected themselves.  The exact threat or how much virus is shed prior to symptoms has not been quantified.

[snip]

“We cannot force employees to be vaccinated; however we do not have an infinite number of non-patient care positions available to reassign those who simply refuse the vaccine,” said hospital spokeswoman Lauren Sheprow.

To restate my earlier point: Accept it or move on.  If the choice is to not receive a vaccine that would be a choice freely exercised.  A choice freely exercised does not a victim make.

I applaud New York’s decision.  It protects the most people in the best manner we have at our disposal.  Sometimes, the best we can do is imperfect, but – it’s the best we can do.

{ 2 comments }

1

D 10.03.09 at 12:36 pm

Hi
I respect your opinion as you are a healthcare worker. I like your blog and know you are extremely well regarded. Please remember this as you read my 2 cents worth…..
I am a seasoned HCW, one of the mandated many in New York, and have willingly accepted this vaccine for years. I have developed a sensitivity to some chemical in the past 2 years so that I get quite ill and must premedicate now to take the vaccine to minimize the reaction.

While I think the hospitals have a right to pressure us to take the vaccine, who is liable if I get anaphylaxis one day? I am sorry to get so personal here but there are acceptable losses whenever a public health decision is made, and clearly that applies to HCW too. I just think the law is too extreme. If I or someone like me reaches the point where there a full blow allergy attack (and you know some allergic reactions attenuate) it seems the only options are to abandon the patients or wear a mask 4 months out of the year which may not work anyway.

This law was a knee jerk reaction and not thought through adequately for these contingencies and now it is permanent. I have many people who depend on me and resent being in the position of having to move out of state just for this one reason. Think about it. Same for the Massachusetts quarantine laws.
Too quickly enacted and now will never be corrected.

Otherwise, obviously HCW are to be held to a higher standard and that is what the public wants. And perhaps deserves too.

2

SophiaZoe 10.03.09 at 9:42 pm

D.,

Thank you for your very reasoned and thoughtful comment. First, let me say that I am not a HCW, nor have I ever been. I am an ex-cop-cum-accountant and long time influenza blogger, long time by Flublogia standards that is.

Given your described autoimmune issues perhaps you would qualify for one of those limited non-patient centric personnel slots mentioned in the article. Your condition, and please forgive me if this sounds unduly harsh, irrespective of what that condition is, does not exempt you from doing everything within reason to prevent endangering those you serve in the performance of your job, and that is up to and including preventing you from performing that job, ie, terminating your employment.

As an example: I wish to have some reconstructive surgery that will require about a week in the hospital. I cannot do so until I am able to get the H1N1-2009 vaccine, and I am at the back of the line as I meet no criteria that places me before any other segment of our society – unlike HCW’s.

The hospitals in my state [or county] do not require immunizations so I would risk a nosocomial infection immediately following some rather *significant* abdominal surgery: think zipper and you’ll have a good idea. That sort of surgery and an illness that produces coughing do not mix. Fortunately, my surgery is not an issue of health or life, but it is something that I can only have done over the winter as that is my “slow period” at work and the only time I can take the six – eight weeks off to heal without it being a matter of “life & death”.

I would just ask you, and anyone else reading these words, to remember that when we acquire an infectious disease we put others at risk of infection. Do any of us have the right to endanger others when something as simple and effective as an immunization prevents that endangerment? I do not believe we do.

As a last point: Our Constitutional Rights are sacred and sacrosanct, but we must never forget that “my rights stop at your nose”. I cannot endanger or harm you, nor you me, and claim some “right” to do so. My “right” is to feel secure in knowing that “you” [collective "you"] cannot endanger me without legal and/or civil mediation/intervention. To refine it a bit more: My right not to be harmed by you takes precedence over anything you may feel is your right to exercise.

So, given an individual’s right to not be harmed, the hospital’s civil liability should someone suffer preventable harm, I fear the HCW who refuses to be vaccinated is the “odd person out” in that entire chain of who has what right and who has what responsibility.

Comments on this entry are closed.

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