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| Should the Flu Vaccine be Mandatory? |
| By Jeffrey E. Keller MD |
| Published: 10/06/2014 |
So I caught the flu [a while back and was] pretty miserably sick for going on 7 days; fever, achy, cough. Also cranky, peevish, and insufferable. My hair hurts! Is that even possible? I usually get a flu shot, but I didn’t get one this year. Why not? I just didn’t get around to it. It would have been easy. All I had to do is ask one of the nurses to give me one back in the fall when we were doing them. Duh. The CDC announced the official onset of influenza season a couple of weeks ago. Flu season is extraordinarily late, probably due to the mild winter most of us (me included) have experienced this year. Coincidentally, around the same time as this announcement (and before I myself caught the dreaded bug), I ran across a couple of thought-provoking articles dealing with the flu that are relevant to our institutionalized patients. The first study was done in England to see if vaccinating nursing home health care workers against the flu would have any impact on the health of the nursing home residents. In half of the nursing homes studied, the researchers encouraged all health care providers working in the nursing homes to get an influenza vaccine. Their success rate was approximately 50%. In the other half of the nursing homes, they did nothing, and only 6% of the nursing home health care workers were immunized. There was no difference in the influenza vaccination rate among the nursing home residents. The results were remarkable. Of course, the health care staff in the vaccination group took fewer sick days; that’s a no-brainer. And, of course, there were also fewer cases of influenza among the residents, even though their own immunization rates were identical to the control nursing homes. But these nursing home residents also had fewer hospitalizations and significantly fewer deaths! This finding has since been verified in other studies, including this one. In fact, in institutionalized settings like nursing homes and jails and prisons, it may be more important to immunize the staff than it is to immunize the residents. The idea here is that as a health care worker, when you are deciding whether or not to get the influenza vaccine each year, it is not only your own health you should take into consideration, but also that of your patients. Since influenza patients shed virus for a couple of days before they know they are sick, you may have a couple of days at work infecting your patients (and your co-workers) before you take sick leave. (So how many people have I infected this last week?) Mandatory Influenza Vaccinations? As a result of studies like these, there is a movement afoot to require health care staff to receive influenza vaccinations in order to work. Here is an editorial published recently in the Lancet in support of this idea: Time to Mandate Influenza Vaccination in Health-Care Workers. Forced immunization is not just an idea of the nutty English, either (actually, the editorial was written by an American). The American Academy of Pediatrics supports this idea. I have heard that some US hospitals have already instituted this policy, notable Virginia Mason Hospital and the Mayo Clinic. Once hospitals mandate influenza vaccination, staff immunization rates go from around 50% to 99%. However, I just don’t see mandatory influenza vaccination programs going anywhere in corrections. Any opinions about this out there? Has anyone tried it? But there are ways to increase the staff immunization rates at your facility. Mostly, this involves just pushing the idea. Here is a study about a program in one hospital in which health care workers attended a little 15 minute lecture on the importance of getting the flu vaccine: Flu in 15: a novel 15-minute education program to promote acceptance of the influenza vaccine among health care workers. Even better than this is to assign one person or a group to vaccinate every health care worker in your facility. You track down the thoughtless and irresponsible doctor (that would be me) and given him his damn shot! In order not to get the influenza vaccine, health care staff would have to refuse in writing. Any opinions about this? What is the immunization rate among health care workers at your facility? How about among the detention staff? Corrections.com author, Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of practice experience before moving full time into the practice of Correctional Medicine. He is the Chief Medical Officer of Centurion. He is also the author of the "Jail Medicine" blog Other articles by Keller |
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Cheers Jeffrey, No healthcare workers should not be forcefully vaccinated for influenza anymore then a prisoners should be forcefully vaccinated for influenza. Even the influenza vaccine promoting CDC admits the influenza vaccine has not had a signficant effect on mortality or morbidity in the last 60 years. (CIDRAP's review to CDC) You might want to look at little closer at the study you cited from the english hospital. The cochrane have done a total of 4 systematic reviews on this topic and each time come to the same conclusion: no evidence hcw vaccination has any benefit to patients. All cause mortality is an unspecific end point that truly expects us to believe that HCW vaccination status has an effect on death from cancer, alzheimers, trauma etc. BTW, many of the trial researchers using this unscientific endpoint start counting bodies before influenza outbreaks even happen and still attribute the mighty flu vaccine for saving the day. PLEASE read chapter 7 page 54-60 of the CIDRAP report to CDC regarding how vaccine recommendations for healthcare workers have been promulgated at http://www.cidrap.umn.edu/cidrap/files/80/ccivi report.pdf This is a vital piece of information as it critically examines the poor studies that our government, is using to endorse forced vaccination. Any study not covered by CIDRAP is addressed in Abramson's review: http://www.hindawi.com/journals/ijfm/2012/205464/ I am always shocked at the bedazzlment towards the United States, The United States does not lead by example... Medical injuries, including hospital acquired infections are the third leading cause of death in the USA, (thats just behind cancer and heart disease)To put that into numbers, thats 210,000 to 440,000 deaths per year ( equivalent to An Airbus crashing daily with no survivors ) America, is a virtual playground for the pharmaceutical industry, structured to prioritize revenue and profits, not safety and quality. Is United States of America a pillar of good practice? Actually, quality healthcare indicators ranks the US dead last among industrialized countries( Steven Brill, bitter pill, 2012) Yes, Virginia Mason proudly says they were the first to force and yet, do you notice you never hear anything about their flu outcomes? I know mandatory campaings are motivated by good will, but science and evidence must navigate our healtcare initiatives, not emotions Thanks