In general, competent adults shouldn't be forced into any medical intervention, but taking on certain jobs comes at the cost of accepting certain responsibilities. As health care workers, we are given special access to people at their most vulnerable, and with this access comes a special responsibility. Most health care institutions require proof of vaccination or proof of immunity for several vaccine-preventable diseases, such as measles, mumps, rubella, and chicken pox. So why is influenza vaccination so controversial? Influenza vaccines are safe and effective. We accept that we must show immunity to other diseases, so why not flu?
There is good data showing the vulnerability of health care workers to the current pandemic---we are doubly vulnerable in that we are not only exposed in the community, but also at work. Vaccination is the best protection against seasonal and pandemic influenza; we have the tools to prevent illness readily available. Given the safety of vaccination, and the special responsibilities we have as health care workers, I sympathize but ultimately disagree with those who oppose mandatory flu vaccines in health care settings. We have two essential responsibilities: to be available to care for the sick, and not to make them any sicker.
Health care entails special responsibilities, and when we signed up for this gig, we knew we'd have to prove our immunity to many infectious diseases. Some of us came to health care work with a good understanding of this, but many others just needed work and didn't have the luxury of considering it one way or another, and this must be considered as well. If we are expected to take on certain extraordinary burdens, we must also receive certain protections.
If we are going to mandate this, we must make it as easy as possible. Vaccination must be without cost to the worker, and must be easy to get. We must also encourage those who either can't get the vaccine or who get ill anyway to stay home without penalty. Staying home because of the flu during this pandemic should be paid and should not use up sick days. Removing these penalties for fulfilling your responsibility during the pandemic would go a long way to making the workplace safer.
Health care workers have always had special responsibilities with regard to infectious diseases. Influenza is no different---just more immediately urgent.
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I agree with you. The cost of "presenteeism" probably outweighs the cost of "absenteeism," as sick workers spread their unproductivity to others.
Forgot to get my flu shot today. Monday!
Definitely agree with you about the sick days. Techs and other low-wage health workers, who often don't even have health insurance themselves, seem particularly vulnerable in this situation. An ER tech friend of mine felt pressured to go back after < 7 days because of her financial situation (fortunately for the patients her charge nurse sent her home).
I've also been mulling over the situation wrt volunteers like me. At least at my hospital, we're an untracked and largely uninformed pool of potential vectors and as yet there's been no effort to educate us. Now that I think of it I think I'm going to call the volunteer coordinator on Monday and make some noise.
Hmm, somehow lost part of my story there. My friend felt pressured to go back after < 7 days due to her financial situation (fortunately her charge nurse sent her home).
OK, I'm not so bright, the comments can't handle less-than signs. Sorry for crufting up your blog, Pal.
To finish the story, she felt pressured to go back to work after fewer than 7 days because of her financial situation.
I was thinking about the health worker vaccine issue this morning. I think there could be a little more carrot to go with the stick.
My idea, free vaccine parties (what would be an appropriate cocktail for that?) AND/OR a giftcard for a starbuck's drink when you get your shot...that would be a shot with your shot.
Also, making it free and easy (on site) is a must.
It is free at my workplace, although not mandatory. Of course, I'm in socialist Canada. My colleague got H1N1 earlier this year, from her daughter, and they both were ill for 2 weeks. That's serious incentive.
In our jobs, we are 'free' to do a lot of things. We are free to quit. We are free to be insubordinate. We, however, have to face the consequences of our decisions.
As healthcare workers, we are free to refuse the flu shots. However, our employers are then free to penalize us for doing so. Our patients are free to find another doctor.
Let's focus on what makes the most sense. Get vaccinated.
As an asthmatic with a severely asthmatic grandmother who has been hospitalized a couple of times already this year, I have to admit I get very angry when I see healthcare workers pontificating about how stupid it is to get a flu shot. I used to enjoy reading "NHS Blog Doc", because his snark is sometimes quite entertaining, but he's been posting about how he is not going to get a flu shot (he works in a hospital) and how he doesn't think other health care workers should be required to do so (or even encouraged to do so) either, suggesting that influenza vaccination is just cargo cult science.
It's like, okay, you can't guarantee you won't catch/transmit influenza, even after vaccination. But you can reduce your risk a bunch -- say, 20%. (Figure pulled out of thin air.) Don't you owe it to your patients to give them that 20%? Hand sanitizer kills most germs -- should you stop scrubbing because the sanitizer does a good enough job, and that extra risk reduction is just too much of a nuisance? Of course not, and somehow I doubt the healthcare workers railing against influenza vaccination would endorse such a position.
Just had to vent. Thanks, PalMD, for this important post.