by: DR. Edward F. Group III
http://www.articlecity.com/articles/health/article_366.shtml
The article in the link above was posted on my friend's Facebook Wall. I will refer to her as Massage Therapist, because she is a massage therapist and her job is requiring her to get the flu vaccine. She doesn't feel it is right that her work is requiring this.
Here are the comments. What would you say to convince this person that getting their flu shot is the right thing?
Commenter 1:
FACT: Antifreeze is propylene glycol not ethylene glycol
FACT: thimerosal IS mercury derived, but is specifically formulated to prevent the side effects they list, which are the side effects for mercury. Which is why they don't use mercury anymore.
FACT: Antimicrobials like phenol and neomycin and streptomycin are in them to prevent infection at injection sites
FACT: The aluminum in vaccines promotes the immune response to the killed virus or bacteria that help the vaccine to be effective.
Commenter 2: Can't you say it's against your religion or spirituality or something? I'm pretty sure Colorado allows for that..
Commenter 3: The more people that get vaccinated=the more lives are saved. Your article fails to mention that death is a side effect to some old people when you DONT get the vaccine and you give them the flu.
Massage Therapist: I thought I would get some good responses...
While the article may not be completely factually sound (I mean, he
doesn't even list any sources...BIG RED FLAG THERE!), I still don't
believe in flu shots. I believe that there are much healthier
preventative measures that people can take. But mostly I believe that
it is wrong for an organization to practically force vaccination upon
it's employees. No, I don't HAVE to get it, but then I'm pretty much out
of a job until flu season is over. Apparently religion is not a
sufficient reason anymore (even tho it's an adventist hospital...) I
believe in my body's ability to take care of and heal itself as long as I
take care of it. If I'm old and die from the flu, then it was probably
about my time anyway, and I would never blame anyone for "giving it to
me". Besides I took the risk of getting it by leaving my house in the
first place, right? There are some great things about western medicine
and there are some not so great things about western medicine. I'm
still not convinced that flu vaccines are one of those great things.Commenter 2: Do you have an option to wear a mask at work if you dont get it?
Commenter 4: Massage Therapist, the CDC among other institutions have substantial evidence that for high risk groups, like the elderly, a flu shot can save lives. Your body may be able to take care of itself, but you may also have a prodrome of symptoms while you are a carrier. That carrier status will enable the virus to spread to other people in the hospital (such as recovering immunocompromised and elderly) to whom the virus could be completely crippling if not deadly. It is not your right in any way shape or form to decide if a patient is "old and at her time to die" if they get the flu. While you wouldn't necessarily get blame, you are educated enough to realize that the blame could fall on your shoulders.
It is completely within the hospital's rights to attempt to prevent high risk carriers (i.e. young people) to work in their hospital.
The flu vaccine is the best prophylaxis we currently have to a possibly deadly disease.
Commenter 2: While I absolutely respect the CDC and their mission AND many accomplishments, there are both Western and Eastern medicine perspectives that could come into play here. Hence my suggestion of the mask option. I know nurses (in Denver), that have that option if they choose not to get the flu vaccine. I hardly think the hospital would "blame" Massage Therapist if a patient in her periphery were to contract the flu, but I would hope that she would call in sick if needed. My perspective is that it is HER RIGHT to choose what is right for HER body, and whether that includes a flu shot is up to her. A non-invasive (internal) requirement the hospital could make would be to require a mask, or gloves when performing her job, and calling in sick when necessary. Although there are many medical guidelines that our government and its organizations put forth (guided by incredibly smart doctors, researchers, and lab technicians), they are guidelines. After all, the FDA can't recall a drug without first approving it.
Massage Therapist: Commenter 4, I understand my responsibility as a healthcare worker to take the proper precautions to prevent the spread of disease particularly to those that are immunocompromised. I never said it was my right to decide if a patient is old and at her time to die, I simply said that if it were me, those would be my feelings. I would never think that I could ever decide that for someone. I just simply believe that there are, in my opinion, better ways for to fulfill my responsibility to be healthy and limit the spread of disease than by introducing a foreign substance into my body. I believe that a person should always have the right to decide what to do with their own body and should never suffer repercussions because of what they decide to do or not do to their body.
Commenter 3: Massage Therapist, if you believe that, that is 100% fine. The hospital also has the option of not letting you work for logical and safe reasons that are not due to any prejudice
Commenter 2: Map by state of how you can opt-out if you want to. I'm unsure of how this applies since you work IN the hospital, but it can be "philosophical" rather than a "religious" reason. http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements.aspx
Massage Therapist: The efficacy of the flu shot in 2010-2011 was 60%. Almost a failing grade. I don't think we're going to be eradicating influenza anytime soon...
Please be polite in your responses. The massage therapist is a good friend of mine and she is well educated. I would like your help in finding a comment that can shut down her arguments.
I do not think that I can help you “shut down” your friend’s arguments. I actually think that she has every right to her opinions and beliefs, just as you have every right to disagree with her.
ReplyDeleteVaccines are obviously a hugely contentious issue in our culture. Hospitals do have the right -- and the responsibility -- to minimize the risk to which they expose patients. If she feels strongly about the flu vaccine, she probably should consider working in a different setting. There are plenty of options for massage therapists that do not require flu vaccines - work settings where she could just offer a disclaimer that she is not vaccinated against the flu.
I do not work in a healthcare setting, and I have never had the flu vaccine. It is not even something that I thought about at all until a few years ago. I saw one of my good friends from high school at a wedding. He had always been extremely health conscious – even in high school when no one else was. He was an athlete, he never drank alcohol, etc. He had gotten a flu vaccine about a year before the wedding and had serious neurological side effects. He has young kids and was trying to be responsible, so he got the vaccine, but the health effects were devastating. He is a professor, and he couldn’t teach, he could barely work at all. These side effects are extremely rare – like 1 in a million. He realized, though, that when you are that one, it just really sucks. Even worse, in his opinion, was the fact that his doctor had no knowledge about how he could regain his health. He was a healthy, fit person before the vaccine, and could barely do anything after the vaccine. He actually went to numerous doctors and eventually found a naturopath who helped him return to normal. It was a slow process though. I saw him about a year after the vaccine, and he was still on a severely restricted diet, but he finally felt healthy again – just frustrated with the whole debilitating experience.
I am not saying that people should not get the flu vaccine because there is a one in a million chance that they might have a similar experience. I am not saying that hospitals do not have the right to try to minimize the risk for patients. However, I do think that people have a right to make their own healthcare choices. From a public health perspective, I don’t think that arguments about vaccination apply equally to all illnesses. I simply don’t think of myself as creating a public health nightmare because I have never gotten a flu vaccine.
My friend has 3 daughters now, and I am pretty sure that none of them get the flu vaccine anymore. His grandmother is still alive and doing great, and I don’t know if he worries about her or encourages her to take immune boosting measures when she’s around the kids in the winter. I respect that different people have different experiences that shape their lives and their opinions.
In terms of your friend, it is a difficult issue, but I do think that if she feels strongly about not getting the flu vaccine, then she should consider alternative places to practice and try to have a policy of full disclosure about her flu vaccine status for anyone who is worried about it. I have nothing against immune boosting herbal remedies, but I seriously doubt that they are going to replace flu vaccines in the hospital setting at any point in our lifetimes.
Maggie,
ReplyDeleteI agree that everyone is entitled to his or her own opinions and beliefs, and that I have the right to disagree with her. However, if everyone lived their life only according to their own opinions and beliefs with no regard for others and without social/governmental mandates, murders would occur much more frequently because some people do not believe murder is wrong. I am not trying to say murder is the same thing as a healthcare worker not getting their flu shot, but I do believe that certain people, especially healthcare workers, should be required to receive the influenza vaccine.
Rational people form their opinions based on information and experiences. They also often change their opinion based on new information and experiences. While my friend is entitled to her opinion, I want to see if we can come up with any information powerful enough to change her mind. It sounds like you think that the influenza vaccine is a good thing, even after your friend’s extremely unfortunate experience. I am sorry about your friend, and I am glad that he is returning to normal. Why do you and I still think the vaccine is a good thing for healthcare workers, even though it involves introducing foreign substances into the body and there is a 1 in 1,000,000 chance of the side effects you describe?
My best argument comes from an article on CDC website measuring the deaths related to influenza over the last 31 years. It reports that while the number is difficult to estimate, an estimated 3,000 to 49,000 (mean 23,000) US citizens die annually from influenza-associated causes or on average 9 deaths per 100,000 people(1). Compare this to the 2009 estimate of motor vehicle related deaths, 12 per 100,000 Americans, also listed on the CDC website(2). Even the lower range of the estimate is alarming. If you could do something to prevent the death of even some of the 3,000 annual deaths would you? I assume that healthcare workers want to help people by preventing and treating illness. In 2010-2011 flu season, there were 115 children under the age of 17 in the US who died from confirmed influenza, almost half of which were younger than age 5(3). Should healthcare workers be required to use the only reliable tool we have to prevent this illness that claims lives, even if there is a one in a million chance that it will harm them? My take is yes, if you are signed up for healthcare, then you should be required to receive a very low risk vaccine that saves lives.
“For many people influenza is like being pushed off a cliff. Neither the push (the flu) nor the fall (underlying condition) kills you.
It is the sudden stop.” – Mark Crislip(4)
1 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a1.htm
2 http://www.cdc.gov/Features/TeenDrivingDeaths/index.html
3 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6036a1.htm
4 http://www.sciencebasedmedicine.org/index.php/influenza-deaths/
To continue on this topic about the benefits of vaccination vs. freedom of choice. I must say that I take a utilitarian ethical approach. Therefore, I support the greater societal approach over individual sovereignty. I think that healthcare professions are not just responsible for the care of others but are also role models.
ReplyDeleteFor example, would you be likely to wear a seatbelt while driving if your driving instructor didn't?
The answer is ofcourse not.
Taking that mode of thinking and applying it to this scenario, if the physician or other provider doesn't believe in vaccinations are patients going to be willing to get them. The result is a massive drop in herd immunity and an influenza epidemic.
To approach this issue on another frontier, the risks of infection spread are greatly elevated in a healthcare setting. Would it be wise to be a part of infecting vulnerable patients with influenza who are already fighting off other diseases? and what about immuno compromised patients in which that infection could be very severe even fatal.
Healthcare professions are there to help the ill not cause them further harm. Therefore, the benefits of vaccination greatly outweight the risks and individual freedoms.
When it comes to health care policies or any policies for that matter, I believe one should take into consideration the benefit of a group as a whole and not the individual preferences. Objectivity should precede subjectivity. While it is important to have awareness of the risks of any measure, clearly, the benefits should outweigh the risks for the group and not the individual. Of course, individuals can still have their own preferences but as such they will have to face consequences and such consequences should only affect the individual and not the group. After all, it is the individual making the choice and it should not affect the group. In the health care setting, individuals should have the right to opt out from immunization and the consequences should only affect them. That is, removing themselves from the health care setting should be the consequences they face.
ReplyDeleteLastly, it is important to remember that the environment is literally crawling with bugs and viruses ready to find their niche in the human body. Bearing that in mind I would much rather voluntarily allow foreign bugs into my body in a “controlled” manner (vaccines), such that I would be protected against disease instead of having foreign organisms attack my body (because they can) at their will, and risk losing the battle while my body tries to futilely overcome the infection because it is not prepared. I do not see the logic in sending an unprepared army (my immune system) to war (fighting infection), do you?
The more I think about vaccination, the more I realize I am torn on this subject. I volunteer at UCH and all volunteers required to get flu shots. This makes sense because you don't want to give flu to already sick patients. Even if a person doesn't show any flu symptoms, they still maybe carriers and can infect people around them. On the other hand there could be serious effects. I came across a case report describing occurrence of rheumatoid arthritis after swine flu vaccine in a predisposed individual. Or the case Maggie discussed. Even though side effects from vaccines are very rare, you never know who will develop them.
ReplyDeletehttp://www.hindawi.com/crim/rheumatology/2012/785028/
Nelly,
ReplyDeleteFrom the article in the link you posted, it reads, "In conclusion, a causal relationship has not been confirmed between swine-flu vaccine and onset of RA, but there is a temporal connection between the two based on our case report." Even if the flu vaccine did give that patient RA, would it be possible that the vaccine may have prevented her from developing more severe RA as a result of contracting the flu? The paper does suggest that genetic screening of HLA-D alleles may be useful in the future to prevent the alleged vaccine-triggered autoimmunity in predisposed individuals. However, at the moment we don’t know who predisposed individuals are. The genetic tests we have still don't have strong enough predictive value to warrant the idea of sheltering a patient from vaccines in order to prevent an autoimmune disease. Instead, for RA, a commercial test to predict disease like "decode me" (http://www.decodeme.com/rheumatoid-arthritis), may only be as predictive as a cholesterol test in the prediction of coronary heart disease. If a person does have an 80% risk of developing RA from vaccines, should they be exempt from getting all vaccinations, like MMR, Hepatitis B, Tetanus, Pertussis, Polio? At the risk and expense of the rest of the population? Or would they need to have a higher likelihood?
Is it also possible that the report you cited is from one person who happened to be developing RA symptoms at the same time as she got her flu shot? It could be coincidental that out of the 1.5 million Americans living with RA, one of those had a disease onset around the time of a flu shot.
http://www.jrheum.com/subscribers/06/12/2376.html
http://www.cdc.gov/arthritis/basics/rheumatoid.htm