Do as I Say, Not as I Do…
“The article I've attached below by Christine S. Moyer reports
that only 37% of your medical doctors received the H1N1 Vaccination, and only
60% received the flu vaccination (this was the first time they have reached
this high of a percentage EVER). If these vaccinations were so vital to preventing
sickness, (especially in a population that treats sick people), don’t you think
your doctors would be getting the vaccination as well. Every single thing I ask patients to do in my office, I have done myself.”
-
Dr. Joshua Huffman
Flu vaccine should be condition of health
professionals' employment, group says
An epidemiology organization states there is an
"ethical responsibility" to prevent the spread of infection to
patients.
As physicians prepare for this year's
influenza season, a major health organization is calling on health care
professionals to be vaccinated as a condition of their employment.
The
Society for Healthcare Epidemiology of America recommends that the annual
seasonal flu vaccine be required for initial and continued employment of all
health care employees, regardless of whether they have direct patient contact.
The
mandate would apply to physicians, students, volunteers and contract workers.
The only exemptions: workers with medical contraindication to the vaccine.
"It's
the professional and ethical responsibility of all health care providers to
prevent the spread of infections to patients," said SHEA President Neil
Fishman, MD. "The influenza vaccine is the single best way to prevent the
spread of [the flu]."
The
organization's policy statement, issued Aug. 31, says the mandate should be
implemented as part of a multifaceted flu infection control program that is
clearly communicated to employees.
Only 37% of health professionals were immunized
against the 2009 H1N1 virus.
The
policy, in the October Infection Control and Hospital Epidemiology,
revises the society's 2005 statement. That year, the organization strongly
recommended vaccines for all health professionals but stopped short of making
annual immunizations a requirement for employment.
The
SHEA joins a handful of organizations with similar recommendations. The U.S.
Dept. of Defense requires annual flu vaccination for health professionals who
provide direct patient care in military facilities. The Infectious Diseases
Society of America supports annual flu immunizations as a condition of initial
and continued employment.
The
American Academy of Pediatrics released a policy statement on Sept. 8 that
recommends mandatory flu immunization of all health care personnel. The AAP
says medical and religious exemptions can be granted. When implementing
mandatory immunization, medical facilities should make vaccines free to workers
and conduct question-and-answer sessions about the new rules.
The
American Medical Association encourages health professionals to be vaccinated
against the flu. The AMA Council on Ethical and Judicial Affairs is analyzing
ethical issues raised by proposals to mandate vaccination as a condition of
employment. A report is expected to be presented to the AMA House of Delegates
at the Interim Meeting in November.
Dr.
Fishman said few health professionals get vaccinated, despite efforts to
educate them about the importance of being immunized. "That is just not
acceptable," said Dr. Fishman, director of the Dept. of Healthcare
Epidemiology and Infection Control at the Hospital of the University of
Pennsylvania.
As
of mid-January, 61.9% of health professionals received the 2009-10 seasonal flu
vaccine, according to the Centers for Disease Control and Prevention's April 1 Morbidity
and Mortality Weekly Report. Experts say it's the first time the
vaccination rate reached the Dept. of Health and Human Service's Healthy People
2010 target of 60%.
But
only 37.1% of health professionals were immunized against the influenza A(H1N1)
virus. The CDC said health workers were more likely to believe the seasonal flu
vaccine was safe (80.9%) compared with the H1N1 vaccine (66.6%).
Concerns about vaccines
A
concern about side effects is one reason health care employees decline
vaccines, according to the Joint Commission. Other reasons include fear of
contracting an influenza or influenza-like illness from the immunization,
perceived ineffectiveness of the vaccine and a belief that the flu is not a
severe disease.
Research
has shown that such concerns are unfounded, said Greg Poland, MD, a professor
of medicine and infectious diseases at the Mayo Clinic in Minnesota and an IDSA
member.
A St. Louis health care facility achieved 98%
worker immunization after making vaccination mandatory in 2008.
He
supports mandating annual vaccinations for health professionals, and said they
should "set aside personal preference for the greater good of the patients
you're privileged to care for."
"That's
the rationale behind it," Dr. Poland said.
Since
1984, the CDC's Advisory Committee on Immunization Practices has recommended
the seasonal flu vaccine for health professionals. Studies have shown that
immunized workers minimize the risk of flu transmission not only to patients
but also to colleagues. Vaccination also reduces absenteeism, ensuring that
hospitals and practices are sufficiently staffed, the SHEA said.
In
2004, the Virginia Mason Medical Center in Seattle became the nation's first
health care system to require its staff to be immunized, according to the SHEA.
Since the initiative started, the center's vaccine rate among more than 5,000
employees and adjunct personnel is about 98%.
Other
health care facilities have reported similar success with mandates. For
example, BJC HealthCare in the St. Louis area achieved 98% immunization among
its more than 26,000 employees after making vaccination mandatory in 2008.
As
the 2010-11 seasonal influenza vaccines begin arriving, Dr. Fishman is urging
health professionals to consider the facts before turning down the vaccine.
"It
really is a core patient safety measure. There's very good evidence now that
influenza vaccination of health care professionals decreases patient
mortality," he said.
