Should the H1N1 flu vaccine be mandatory for all health care workers?

[VentMedic]

I look at it this way. We are potentially exposed to all types of communicable diseases during the course of our duties. As part of our job, we use PPE and take proper precautions to minimize the risks to ourselves and to our families. I see nothing different about this. I look at the fiasco with the Avian flu and the panic we were exposed to. I refuse to take a shot for something I am not convinced is the best course of action.

Unlike what happened with the Avian flu, we do have cases in the U.S. of H1N1 and it has proven itself to be deadly. However, we have always had Influenza A around at various times during the year and have taken precautions. It just happens that there are many more cases than usual this year in a younger population excluding school age where the flu is present each year. However, Influenza B is still the leader for deaths here in the U.S. For some it is a crap shoot if they get the flu with or without the shot. For others it may offer protection. Most will go on a little protection might be better than none at all.

I am not convinced we know exactly what influenza virus types or subtypes will predominate and if this vaccine will offer adequate protection. I believe it was last year's seasonal flu vaccine that was stated to have misjudged what the predominant strain was going to be. Even more so, will that give some a false sense of security for maintaining the highest standards for precautions?

Right now in many hospitals, everybody with flu symptoms are considered guily under proven innocent or well or dead. Those that are subsceptible are getting hit hard with what some have termed as Flu Associated ARDS. This can be deadly and requires serious intervention with the big technology and expertise of the intensive care Physicians.

For testing we use rapid antigen tests, which can give results in as little as 15 minutes. These tests can usually distinguish between influenza A and influenza B, but they do not identify subtypes. Some tests are not as sensitive in adult patients as they are in children, who shed more viruses. That fact can result in false-negative results for adults. For more specific testing, the specimen goes to a CDC lab and even those results are returning sorta positive and sorta negative with nonspecific whatever type of flu.

Other vaccinations I don't have a serious problem with since we can test for titers to determine one's immunity. Mandatory TB testing also doesn't bother me since that is determining presence from exposure.

[HERBIE1]

Unlike what happened with the Avian flu, we do have cases in the U.S. of H1N1 and it has proven itself to be deadly. However, we have always had Influenza A around at various times during the year and have taken precautions. It just happens that there are many more cases than usual this year in a younger population excluding school age where the flu is present each year. However, Influenza B is still the leader for deaths here in the U.S. For some it is a crap shoot if they get the flu with or without the shot. For others it may offer protection. Most will go on a little protection might be better than none at all.

I am not convinced we know exactly what influenza virus types or subtypes will predominate and if this vaccine will offer adequate protection. I believe it was last year's seasonal flu vaccine that was stated to have misjudged what the predominant strain was going to be. Even more so, will that give some a false sense of security for maintaining the highest standards for precautions?

Right now in many hospitals, everybody with flu symptoms are considered guily under proven innocent or well or dead. Those that are subsceptible are getting hit hard with what some have termed as Flu Associated ARDS. This can be deadly and requires serious intervention with the big technology and expertise of the intensive care Physicians.

For testing we use rapid antigen tests, which can give results in as little as 15 minutes. These tests can usually distinguish between influenza A and influenza B, but they do not identify subtypes. Some tests are not as sensitive in adult patients as they are in children, who shed more viruses. That fact can result in false-negative results for adults. For more specific testing, the specimen goes to a CDC lab and even those results are returning sorta positive and sorta negative with nonspecific whatever type of flu.

Other vaccinations I don't have a serious problem with since we can test for titers to determine one's immunity. Mandatory TB testing also doesn't bother me since that is determining presence from exposure.

Testing is a whole different issue. I have no problem with a screening, but mandatory INOCULATIONS is a different animal.

I think we overestimate our ability to handle many things- especially viruses. We have spent BILLIONS on AIDS research and still cannot come up with a vaccine for HIV. A virus is a an insidious beast that by design constantly mutates. A virus is designed to take over a host cell's processes and replicate, which makes a one size fits all "cure" sketchy at best since we are all different. Many times, the yearly vaccines we develop turn out to be far less effective than planned because by the time we develop the vaccine, the virus has already mutated to either a more or less virulent form. I think it is foolish to think we can rush into an H1N1 vaccine without those same issues- especially since this vaccine is not fully vetted.

[VentMedic]

Testing is a whole different issue.

The testing I am referring to is our screening process. This is not done just because of the publicity of H1N1 but has been used as any other diagnostic test to determine what the patient may have so that early treatment can begin. This is not "optional" if you are seeking medical treatment with certain symptoms or if an employee, present to work with flu like symptoms.

Edited September 30, 2009 by VentMedic

[emt11]

What they are not telling you about the N1H1 vaccine is it is for the older strains. N1H1 is mutating, so chances are if you are exposed or have N1H1 it is not the same as the vaccine and would be susceptible anyways. In my "day job" I work in a lab with a bunch of micro geeks, not a single one of them is getting the vaccine. It hasn't been tested enough or long enough.

N1H1 is the flu....wash your hands and cover your cough, simple as that.

[HERBIE1]

The testing I am referring to is our screening process. This is not done just because of the publicity of H1N1 but has been used as any other diagnostic test to determine what the patient may have so that early treatment can begin. This is not "optional" if you are seeking medical treatment with certain symptoms or if an employee, present to work with flu like symptoms.

Now you are talking about a whole different situation- reporting to work with a communicable disease- from a common cold to the flu. It's great to say- don't go to work when you are sick, but that's easier said than done for most people. Many people do not have the luxury of being able to take off work any time they are ill. Missing work means losing money for people who may not have sick leave, so they show up to work and are a potential hazard to others. Some are afraid that if they do not work, they may lose their jobs- a real concern in this economy. Obviously someone in our business can cause serious harm to anyone in an already weakened state or a compromised immune system.

[VentMedic]

Now you are talking about a whole different situation- reporting to work with a communicable disease- from a common cold to the flu. It's great to say- don't go to work when you are sick, but that's easier said than done for most people. Many people do not have the luxury of being able to take off work any time they are ill. Missing work means losing money for people who may not have sick leave, so they show up to work and are a potential hazard to others. Some are afraid that if they do not work, they may lose their jobs- a real concern in this economy. Obviously someone in our business can cause serious harm to anyone in an already weakened state or a compromised immune system.

The CDC and other health organizations have also thought of this and it has been mentioned several times in the memos which should be posted for employees to read and a discussion should be initiated with your employer before something does happen.

These are some of the options for employers from the CDC Flu update sites which I have linked to periodically on this forum in H1N1 discussions. I also recently saw both national and local TV news stations featuring this issue.

Option A: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to take additional sick leave without pay.

Option B: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to take additional paid sick leave.

Option C: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to borrow sick time from the following years entitlement.

If we are out sick for flu like symptoms, we must also go to Occupational Health for a rapid flu test for clearance to return to work.

Edited September 30, 2009 by VentMedic

[HERBIE1]

The CDC and other health organizations have also thought of this and it has been mentioned several times in the memos which should be posted for employees to read and a discussion should be initiated with your employer before something does happen.

These are some of the options for employers from the CDC Flu update sites which I have linked to periodically on this forum in H1N1 discussions. I also recently saw both national and local TV news stations featuring this issue.

Option A: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to take additional sick leave without pay.

Option B: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to take additional paid sick leave.

Option C: COMPANY provides employees with paid sick time and other benefits to compensate employees who are unable to work due to illness. However, in the event that an employee who has influenza and/or is experiencing influenza-like symptoms does not have sufficient sick leave to cover the absence, COMPANY will permit the employee to borrow sick time from the following year’s entitlement.

If we are out sick for flu like symptoms, we must also go to Occupational Health for a rapid flu test for clearance to return to work.

Unless this is another government mandate, the employer can chose to abide by or completely ignore any or all of these recommendations. Unless there are penalties for not complying with these CDC ideas, there is no teeth to this.

The people most in fear for their jobs will not not push the issue- ie call the employer out on these CDC recommendations. They simply will not risk losing their jobs. That's how employers take advantage of low skilled and low paid workers in so many cases- they know they can get away with skirting laws and recommendations such as this. The employee needs the job far more than the employer needs them.

Again, in a health care setting, it's a bit different.

I am simply not convinced of the efficacy of this vaccine.

[VentMedic]

Unless this is another government mandate, the employer can chose to abide by or completely ignore any or all of these recommendations. Unless there are penalties for not complying with these CDC ideas, there is no teeth to this.

What lines of communication have you made with your employer? Right now that is all you need to be concerned about if the H1N1 vaccination is not mangatory in your state as one can't change the world or speak for everyone's situation. Many however don't stay informed enough to understand what their options are. Do you really want that much governmental control over businesses to where everything must be "mandated"?

The MA Bill 2028 was very comprehensive at addressing some of these issues and it has been criticized extensively. During Katrina, there wasn't enough legislation to prepare for a disaster of that magnitude which also includes medical care and vaccinations.

It is difficult to please everyone but you must take the first steps to stay informed and know where your employer stands on these issues.

[ERDoc]

I'll withold my opinion for now, but just to add some food for thought. Those that say that it should not be mandatory, does personal freedom outweight public health/safety?

[MedFire]

I don't believe that we should be mandated to get a vaccine for a virus that is just going to mutate over time and get stronger. Now I do believe that people who are at rick should get vaccinated but I do not believe that everyone should have to get it.

I also think that this entire "pandemic" is over rated. My service has already had to go through training for the emergency dispensing site for the H1N1 vaccine. I will keep my opinion to myself about how I feel with that.

I think everyone needs to remember just how many people a year die from the regular flu. It sure beats H1N1 but no body is freaking about that.