http://seattletimes.nwsource.com/html/localnews/2002057338_danny08.html
Friday, October 08, 2004, 12:00 a.m. Pacific

Danny Westneat / Times staff columnist

Flu shot helps job security?

Last year, the flu shot didn't work so well. It's estimated that half the adults who came down with flu had first gotten the shot. This year, some flu vaccine is contaminated. When discovered in August, U.S. officials promised it was no big deal. They were undercut this week by the British, who, citing bacterial contamination, shut down a plant that makes half our vaccine supply. Now imagine, amid this mess, that your employer comes to you and says: "Get a flu shot or you're fired."

That's the predicament faced by 5,000 workers at Seattle's Virginia Mason Medical Center. They have until Jan. 1 to get the shot, or get canned. It's believed to be the first hospital in the nation to require flu vaccines. In doing so, it pits two ethical principles central to the practice of medicine against each other. The Hippocratic Oath says "do no harm." The hospital argues that vaccinating everyone reduces the chance a sick doctor or nurse will give the flu to vulnerable patients.

That seems reasonable. But it's also up to patients whether to accept any medical care, from surgery to drugs. Typically patients — in this case, the staff — are free to assess the risks and benefits, and decide what is injected into their bodies, without being threatened.

The union representing the hospital's 600 nurses filed suit last week against the mandatory shots.
Like most ethical conundrums, this one has no easy answer. In this case, though, I side with the nurses.  The reason? Our nation's flu program is in shambles. We're being treated to a press frenzy this week about how citizens allegedly are panicking to get their flu shots before supplies run out. But I'd argue the opposite: Unless you're in one of the high-risk groups, who would want one?

Consider the nation's medical professionals. They talk unceasingly about how everyone should get shots. But they don't follow this advice themselves. Only 36 percent of America's health-care workers get vaccinated — about the same rate as the rest of us, according to the U.S. Centers for Disease Control and Prevention. In their court filing, the nurses go so far as to allege that requiring flu shots violates the hospital's duty "to maintain a safe and healthy workplace." They contend the shots pose risks, and that the hospital's backup plan — antiviral medicine — is even worse because those medicines have "significant side effects."

Add to that the constant problems with the vaccine supply and its spotty record at warding off flu. It hardly inspires confidence, does it? I'm not saying the flu shot is categorically bad. It's one of the safer vaccines, and vulnerable people, such as the elderly, should consider getting it.  Even if Virginia Mason ends up backing away, its policy is part of a movement toward "universal vaccination." The idea is that the only way to beat the flu for anyone is to give shots to everyone.

Until healthy, intelligent doctors and nurses are willing to take the shot without being forced, count me out.

Danny Westneat's column appears Wednesday and Friday. Reach him at 206-464-2086 or dwestneat@seattletimes.com.

Ontario paramedics suspended for refusing flu shots

http://www.cbc.ca/health/story/2007/01/30/vaccine.html

Last Updated: Tuesday, January 30, 2007 | 11:13 AM ET

Six paramedics in Kingston, Ont., have been suspended without pay for refusing to accept flu vaccinations.

The County of Frontenac, which operates ambulances in the region, requires all paramedics to get vaccinated or take the anti-flu drug Tamiflu during an outbreak such as one currently underway at a long-term care facility in the region.

The only exception is for employees who can prove they suffer an allergic reaction from the vaccine.

The suspended paramedics were unavailable for comment on Monday.

'To say "you can't tell me what do" is not a very good reason when it comes to our professional, ethical responsibility to our patients.'— Dr. Ian Gemmill, Kingston's chief medical officer of health

But their union spokesman Smokey Thomas and the region's chief medical officer of health Dr. Ian Gemmill both said the suspended workers think the policy is unfair because no other group of health employees are required to take such measures.

The vaccinations are not required by law, but are required by policies covering paramedics in most municipalities, said Gemmill, who heads the Kingston, Frontenac, and Lennox and Addington public health unit.

"It provides protection. The common side effects are mild and the severe side effects basically are very uncommon," he said. "To say 'you can't tell me what do' is not a very good reason when it comes to our professional, ethical responsibility to our patients."

He added that he wants Ontario to introduce a law making flu shots mandatory for everyone who works in the health care field, even though an attempt several years ago to introduce a similar law targeting paramedics failed due to fierce opposition.

Meanwhile, chief paramedic Paul Charbonneau assured Kingston residents that part-time staff, regular staff on overtime and even managers will fill in for the missing paramedics if needed.

"We want to reassure the public that we're giving the same level of service that we gave before the influenza outbreak."

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