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Sugarfoot

Losing a job for refusing a flu vaccine...

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Hi, all. This situation just came up for someone that I know, and I'm wondering if anyone knows anything about the legality of such a thing.

 

Basically, this person works for a large healthcare facility that is requiring ALL employees, vendors, everyone, to get a flu vaccine. My friend declined. She's nursing a baby and just doesn't feel comfortable getting one. Her doctor agreed and wrote a letter stating as much.

 

She was notified that her "voluntary resignation" is in 2 weeks. Her job has been posted as open.

 

I'm wondering about her rights here. Can a corporation really "force" an employee to get a vaccine and fire them if they don't?

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Hi, all. This situation just came up for someone that I know, and I'm wondering if anyone knows anything about the legality of such a thing.

 

Basically, this person works for a large healthcare facility that is requiring ALL employees, vendors, everyone, to get a flu vaccine. My friend declined. She's nursing a baby and just doesn't feel comfortable getting one. Her doctor agreed and wrote a letter stating as much.

 

She was notified that her "voluntary resignation" is in 2 weeks. Her job has been posted as open.

 

I'm wondering about her rights here. Can a corporation really "force" an employee to get a vaccine and fire them if they don't?

 

Yes.  This seems to come up every year, and the answer always seems to be that, absent some protection either in the local law (employment is generally a state law issue) or in her contract, a hospital can require employees to have flu shots and fire them for not doing so. 

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It is perfectly legal and protected (in general) to choose not to get a flu vaccine. However, it is also perfectly legal and protected (in general) to choose not to expose your clients, employees, or self to an unvaccinated person, thus requiring your employees (and vendors, etc, who wish to do business with you) to be vaccinated.

 

The nursing mom is within her rights to choose not to be vaccinated, but she doesn't have the *right* to keep her job. Being unvaccinated is not a "protected class" unless she has a legal disability that prevents her from being vaccinated, and even in that case, if the employer can show a business reason for requiring the vaccine, then she can still be fired for refusing.

 

Vaccination is not just about protecting the individual receiving the vaccine, it is also about "herd immunity" reducing the risks to the clients, etc, of the employer. If I were running a health care facility, I would require all staff to be immunized for communicable diseases as well as follow plenty of other policies designed to reduce risk to the patients. If I were making the choice to place my family member in a facility, I would certainly expect and demand that the facility did everything reasonable to prevent patients from being exposed to illness. 

 

Although a healthy adult may face very small serious risk from flu, people with compromised health can actually die from the flu and its complications. 

 

If important enough to lose her job over, then she can stay unvaccinated. If she wants to keep her job, she'll have to get vaccinated. That's the deal. 

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Stephaniez summed it up well.

 

Yes, she has the right to stay unvaccinated....

and Yes, the employer has the right to accept that as her resignation.  

 

 

Maybe they will allow her to take a leave of absence under FMLA until after flu season, but I wouldn't expect them to.  I assume anyone hired in May will not be expected to get a vaccination until Oct or Nov, so there would be some precedence to allowing unvaccinated people work certain months of the year.  

 

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If she were being forced to vaccinate that would be a serious legal problem for the hospital . Instead it's a condition of employment like showing up, following the dress code , following procedures etc.

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I'm wondering about her rights here. Can a corporation really "force" an employee to get a vaccine and fire them if they don't?

No, they can't "force" an employee to get a vaccine, but they *can* make it a requirement to remain employed. In a large healthcare facility, it makes sense to require employees to be vaccinated because there are lots of sick people and lots of people with compromised systems. Vaccinations are one way of protecting the latter from the former.

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Your friend needs to carefully read her employer's vaccination policy to see what it says, but as a healthcare facility they do have the right to make vaccinations a condition of employment.  However, she may also have the right to appeal the termination, depending on the policy language, under the condition she wears a mask TBD by the employer while she's at work in patient care areas and/or clinical settings.

 

We have a similiar policy where I work, but it does (finally!) allow declinations by employees that work in administrative-only areas and are never around patients. 

 

"All Health Care Personnel (HCPs) granted an exemption for the influenza vaccination must wear a surgical mask at all times while unvaccinated and while in any patient care or clinical care area during the influenza season – November 1 of each year through April 30 of the following calendar year. The Infection Prevention Committee (Infection Prevention) reserves the right to modify these dates depending on circulation of influenza in the community."

 

"Note: HCPs are required to be immunized against influenza each year unless a specific exemption is requested and approved by {organization}. Proof of immunization of influenza obtained outside of {organization} must be provided to EHS on an annual basis."

 

The exemptions our policy refer to are for either medical or religious reasons and require all kinds of hoops to be jumped through before the exemption form can even be submitted to our organization for potential approval. If not approved, the employee is required to be immunized according to the policy.  If they fail to comply with policy requirements, they may be suspended without pay until they do comply, and terminated after 30 days of non-compliance.

 

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It is perfectly legal and protected (in general) to choose not to get a flu vaccine. However, it is also perfectly legal and protected (in general) to choose not to expose your clients, employees, or self to an unvaccinated person, thus requiring your employees (and vendors, etc, who wish to do business with you) to be vaccinated.

 

The nursing mom is within her rights to choose not to be vaccinated, but she doesn't have the *right* to keep her job. Being unvaccinated is not a "protected class" unless she has a legal disability that prevents her from being vaccinated, and even in that case, if the employer can show a business reason for requiring the vaccine, then she can still be fired for refusing.

 

Vaccination is not just about protecting the individual receiving the vaccine, it is also about "herd immunity" reducing the risks to the clients, etc, of the employer. If I were running a health care facility, I would require all staff to be immunized for communicable diseases as well as follow plenty of other policies designed to reduce risk to the patients. If I were making the choice to place my family member in a facility, I would certainly expect and demand that the facility did everything reasonable to prevent patients from being exposed to illness.

 

Although a healthy adult may face very small serious risk from flu, people with compromised health can actually die from the flu and its complications.

 

If important enough to lose her job over, then she can stay unvaccinated. If she wants to keep her job, she'll have to get vaccinated. That's the deal.

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Locally, one of the hospitals will allow you to continue working, but you must wear a mask the entire time that you are at work.

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ugh, on mobile...

 

StephanieZ's post ifs why I told my oldest daughter to NOT go into any health profession. She cannot have most vaccines! My husband's family gets extremely ill on years they have been vaccinated against the flu and not so ill on years they haven't. If herd immunity works, then all the vaccines the majority of the staff and patients get should be protecting everyone and her not getting something that is damaging to her immune system should not be an issue. This is a matter of paranoia in the medical community.

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My 18 month old son is frequently hospitalized. He is immunocompromised and easily falls into the category of those whose lives are at risk if they are exposed to the flu. He nearly died from RSV last year and his health is fragile. I would hope and expect that the health care workers who come in contact with him would be vaccinated. 

It is perfectly legal and protected (in general) to choose not to get a flu vaccine. However, it is also perfectly legal and protected (in general) to choose not to expose your clients, employees, or self to an unvaccinated person, thus requiring your employees (and vendors, etc, who wish to do business with you) to be vaccinated.

 

The nursing mom is within her rights to choose not to be vaccinated, but she doesn't have the *right* to keep her job. Being unvaccinated is not a "protected class" unless she has a legal disability that prevents her from being vaccinated, and even in that case, if the employer can show a business reason for requiring the vaccine, then she can still be fired for refusing.

 

Vaccination is not just about protecting the individual receiving the vaccine, it is also about "herd immunity" reducing the risks to the clients, etc, of the employer. If I were running a health care facility, I would require all staff to be immunized for communicable diseases as well as follow plenty of other policies designed to reduce risk to the patients. If I were making the choice to place my family member in a facility, I would certainly expect and demand that the facility did everything reasonable to prevent patients from being exposed to illness. 

 

Although a healthy adult may face very small serious risk from flu, people with compromised health can actually die from the flu and its complications. 

 

If important enough to lose her job over, then she can stay unvaccinated. If she wants to keep her job, she'll have to get vaccinated. That's the deal. 

 

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My husband's hospital has a similar policy. Honestly, with all of the immune compromised and medically fragile patients they see, I fully support the policy. It was made more than clear when he was hired. It's a choice to work there or not. My husband works for a large, legitimately not-for-profit secular hospital that receives significant government and foundation support. They are not violating the law with this policy.

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No, they can't "force" an employee to get a vaccine, but they *can* make it a requirement to remain employed. In a large healthcare facility, it makes sense to require employees to be vaccinated because there are lots of sick people and lots of people with compromised systems. Vaccinations are one way of protecting the latter from the former.

And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

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Locally, one of the hospitals will allow you to continue working, but you must wear a mask the entire time that you are at work.

This is the policy at my facility. Because most don't want to wear a mask, we're all getting the vaccine.

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And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

If a person is immune compromised then working in a healthcare facility (around sick people) probably isn't a wise career choice.

 

Bill

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And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

I'd say it's pretty hard to prove this. Not that I don't believe it, but there's really no way to prove that, is there?

 

eta: Bill pretty much summed up my thoughts.

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And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

The only exception offered by my husband's employer is a verified medical exception like an allergy or a condition that precludes the vaccine. Though if someone is immune compromised working in a medical facility may not be the wisest choice. Hospitals are by definition full of germs.

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And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

My immune compromised son wouldn't be able to work at a hospital (not as things stand, anyway). It would be too risky.

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I'm curious when a compromised immune system means you shouldn't get a flu shot. My sister got a stem cell transplant for leukemia two years ago. I know that for the first year she could not get vaccines, but at the one year mark, she got all of the childhood vaccines all over again as well as annual flu shots. Now doing a little google searching, I found this at the Leukemia and Lymphoma website:

 

Cancer patients and survivors should get the flu shot - not the nasal mist form of the flu vaccine. Shots are safe for people with compromised immune systems because they're made from inactivated virus; the flu mist is made from a live virus.

 

My sister lost a friend that she met on her health journey who had a successful transplant years ago, but got the flu during last year's rough flu season with a compromised immune system. So I'm curious what medical conditions or what types of compromised immune systems make the risk of the shot greater than the risk of the illness, if anyone is willing to share.

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I'm curious when a compromised immune system means you shouldn't get a flu shot. My sister got a stem cell transplant for leukemia two years ago. I know that for the first year she could not get vaccines, but at the one year mark, she got all of the childhood vaccines all over again as well as annual flu shots. Now doing a little google searching, I found this at the Leukemia and Lymphoma website:

 

Cancer patients and survivors should get the flu shot - not the nasal mist form of the flu vaccine. Shots are safe for people with compromised immune systems because they're made from inactivated virus; the flu mist is made from a live virus.

 

My sister lost a friend that she met on her health journey who had a successful transplant years ago, but got the flu during last year's rough flu season with a compromised immune system. So I'm curious what medical conditions or what types of compromised immune systems make the risk of the shot greater than the risk of the illness, if anyone is willing to share.

We all get the flu shot (not the mist) because of the risk for ds. I think that's pretty typical.

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I'm curious when a compromised immune system means you shouldn't get a flu shot. My sister got a stem cell transplant for leukemia two years ago. I know that for the first year she could not get vaccines, but at the one year mark, she got all of the childhood vaccines all over again as well as annual flu shots. Now doing a little google searching, I found this at the Leukemia and Lymphoma website:

 

Cancer patients and survivors should get the flu shot - not the nasal mist form of the flu vaccine. Shots are safe for people with compromised immune systems because they're made from inactivated virus; the flu mist is made from a live virus.

 

My sister lost a friend that she met on her health journey who had a successful transplant years ago, but got the flu during last year's rough flu season with a compromised immune system. So I'm curious what medical conditions or what types of compromised immune systems make the risk of the shot greater than the risk of the illness, if anyone is willing to share.

 

It’s going to depend on the particular medical condition and the particular shot. In general, someone whose immune system is acutely compromised (ie: post-transplant, someone on high-dose steroids or receiving chemotherapy) should not get any live vaccines. People who have a condition that may cause them to have a harder time fighting infections should get vaccines as the risk of disease is greater than the risk of the vaccine, if it’s possible it’s better to not get a live vaccine, like with the flu shot over the flumist. 

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It also has to do with Medicaid reimbursement. It is a 2% reduction ( or increase I've never gotten the straight of it) if you have less than 90% vaccination rate among employees. 2014 is the year they start the penalties. I pretty sure a similar thread ran last year and links to the policies were in that thread.

 

That aside. Getting the flu vaccine doesn't protect any person but the one vaccinated from catching the flu. (It may or may not depending on which lit and from which country you read prevent the person vaccinated from getting the flu.) But it does not keep said vaccinated person from being exposed to the flu and passing that exposure on to the patient. Mandating hand washing and mask wearing would lower the rates faster than mandated flu vaccines. Even if every single person was vaccinated, flu possibility is still there and it can still be passed on even if the vaccinated person never gets sick. It does not ensure you won't be exposed and pass that exposure on. But everyone wearing a mask and washing hands would.

 

But flu vaccines certainly ensure more money goes in the pocket of your employer. Not that I am jaded or anything.

 

My hospital is still allowing voluntary flu shots. They seem to think as long as everyone participates by filling out the forms either yes they do have a flu vaccine or no they refuse that will fulfill the mandate. We'll see. I love my job but I will leave if it becomes mandatory and I can't be exempt. There are better ways to prevent the flu with more effective rates but for now, the flu vaccine gets the hype.

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Does anyone have any information or figures about patients contracting the flu from health care personnel? I'm an RN and I have looked after people who are very ill from the flu, but they all got it prior to admission. I can not remember looking after anyone who got the flu and became very ill with it while in the hospital. I would be very interested to know what the numbers are. I have heard of people who have gone to a doctors office for something and contracted the flu from other patients in the waiting room etc.

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Can she opt for the flu mist instead? My employer (a large hospital system) strongly urges everyone to get the flu vaccine. I've declined in the past, but since I "float" in the hospital itself occasionally, I thought I should get it. I chose the mist, which is a weakened live virus and doesn't have the preservatives the shot does. I do not know if a nursing mom can get the mist. I remember the nurse asking if I was around anyone who was immune suppressed or if I was on chemo or anything. 

 

At this point, we can decline the vaccine and it's not something you'll be fired for.

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Supertech mom is correct in that the flu vax does not seem to protect those exposed to the vaccinated person from getting the flu. I researched this a lot, as I hoped vaccinating family would protect my immune compromised and, at the time, mostly house bound child without actually vaccinating him. It doesn't seem to work well for that..but then the vax isn't terribly effective anyway!

 

That said, the hospitals here legally require flu vaccinations as conditions of employment.

Can you friend go on medical leave for the flu season while she's nursing the baby? Pump and dump for a bit? Ask to wear a mask? I'm sorry she's going to lose her position over a policy that I really don't think protects people. Masks would protect people.

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Maybe it was already mentioned but in the hospital my DH works for if you decline the flu shot, you have to wear a mask all the time.

 

Alley

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Can she opt for the flu mist instead? My employer (a large hospital system) strongly urges everyone to get the flu vaccine. I've declined in the past, but since I "float" in the hospital itself occasionally, I thought I should get it. I chose the mist, which is a weakened live virus and doesn't have the preservatives the shot does. I do not know if a nursing mom can get the mist. I remember the nurse asking if I was around anyone who was immune suppressed or if I was on chemo or anything. 

 

At this point, we can decline the vaccine and it's not something you'll be fired for.

the mist is a live virus.

the injection isn't.   I had the injection when I was pregnant because I was already immune compromised (and pregnancy compromised it even more.)

my daughter is a PharmD student and they've already gone over this area.  when I told her about this, she just rolled her eyes.  She also works in a hospital, around patients.  she has to have the flu shot every year.

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And if an employee is immune compromised and cannot have the vaccines because it will further damage them?

Then they would not be working at a hospital, which is one of the worst places, if not the worst, for an immune compromised person to be. 

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I'm curious when a compromised immune system means you shouldn't get a flu shot. My sister got a stem cell transplant for leukemia two years ago. I know that for the first year she could not get vaccines, but at the one year mark, she got all of the childhood vaccines all over again as well as annual flu shots. Now doing a little google searching, I found this at the Leukemia and Lymphoma website:

 

Cancer patients and survivors should get the flu shot - not the nasal mist form of the flu vaccine. Shots are safe for people with compromised immune systems because they're made from inactivated virus; the flu mist is made from a live virus.

 

My sister lost a friend that she met on her health journey who had a successful transplant years ago, but got the flu during last year's rough flu season with a compromised immune system. So I'm curious what medical conditions or what types of compromised immune systems make the risk of the shot greater than the risk of the illness, if anyone is willing to share.

CHOP did a study a few years back showing that people with severely compromised immune systems do not form antibodies to the vaccines very well, so there is little protection. It is less about a danger to the IC, and more about vaccines providing a false sense of security to IC people. My ds was on chemo for over 3 yrs for leukemia, and statistically by the third yr of treatment his body probably did not accept the flu vaccine, so it was important that everyone he was in contact with got the vaccine (it was a lonely year). I felt somewhat better knowing that his healthcare team was vaccinated.

 

Yes, she can be let go for that, and the healthcare profession may not be the right place for her right now given her circumstances. I understand her concern, and it is important that she understand the concern for patients. Masks are not very effective unless she is willing to use the respirator type masks all day long. Those paper masks just scare people away, so you are not close to anyone to get sick. ;) Very effective if an immune compromised person must go shopping, people will duck into aisles thinking you have the plague.

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Thank you, everyone, for the discussion. 

 

I don't know how she feels about the mist. I have a feeling she wouldn't want it, though.

 

I have a lot of thoughts swirling around in my head about this issue. Some concern the flu and the questionable efficacy of the vaccine, but most relate to the bigger issues. From what I understand, her legitimate exemption was denied. The whole thing seems really heavy-handed to me. 

 

 

 

 

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Thank you, everyone, for the discussion.

 

I don't know how she feels about the mist. I have a feeling she wouldn't want it, though.

 

I have a lot of thoughts swirling around in my head about this issue. Some concern the flu and the questionable efficacy of the vaccine, but most relate to the bigger issues. From what I understand, her legitimate exemption was denied. The whole thing seems really heavy-handed to me.

I don't know the details of your friend's medical history but if her only reason was concern due to breast feeding that isn't going to be considered a legitimate exemption even if a doctor did sign off or write a letter. For most of these policies you would have to have a recognized medical reason or accepted religious exemption. For example, I know there was a case at one hospital where a group claimed a religious exemption to the flu shot but could not provide any texts, policies, statements,etc. from any religious group/organization to support that belief. They went to court and the judge ruled that they could be required to get the vaccine as part of employment. You can claim a religious exemption if you can show that you have been a Christian Scientist and follow those beliefs; you can't if it's just a personal belief. It's a higher standard than exemptions for school vaccine requirements.

 

As a doctor, I know many doctors disagree about lots of things. Hospitals are going to make policies based on public health decisions and the most widely accepted information. You could probably find a doctor who would wrote an individual patient a note not to get a flu shot (or any other shot) for almost any reason. That doesn't mean the hospital

will see it as legitimate if it gives against mainstream policies. There is no contraindication to someone breastfeeding getting the flu shot. It's one thing to feel uncomfortable and decline it's another to have it be a medical exemption.

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Thank you, everyone, for the discussion.

 

I don't know how she feels about the mist. I have a feeling she wouldn't want it, though.

 

I have a lot of thoughts swirling around in my head about this issue. Some concern the flu and the questionable efficacy of the vaccine, but most relate to the bigger issues. From what I understand, her legitimate exemption was denied. The whole thing seems really heavy-handed to me.

I feel for your friend; however, breastfeeding in and of itself isn't considered a legitimate medical reason for refusing the vaccine. And one doctor writing a note for her simply won't override public health and safety concerns of the hospital. We can debate the efficacy of the flu vaccine all day; but, right now the public health standards which are commonly accepted are such that hospital systems & other healthcare entities can require employees to get the vaccine. I think the only thing the hospital could have handled differently is the method. Her supervisor could have re-explained the hospital's policy, including the consequence of refusing the vaccine, and then informed your friend to her face that she was being fired.

 

Most medical personnel, especially those who work in hospitals & EMS, by virtue of their chosen job are considered essential personnel. This means that requirements can be laid on them that would be unacceptable and even illegal for non-essential workers. It's simply a part of the gig. This is what your friend needs to fully understand and be willing to accept. If there were some sort of public health emergency - say a localized epidemic in her area (one of the more reasonable scenarios, though there are others) - she could, depending on the nature and how many personnel the hospital thought it needed, be required to work well past her normal shift's ending.

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Supertech mom is correct in that the flu vax does not seem to protect those exposed to the vaccinated person from getting the flu. I researched this a lot, as I hoped vaccinating family would protect my immune compromised and, at the time, mostly house bound child without actually vaccinating him. It doesn't seem to work well for that..but then the vax isn't terribly effective anyway!

 

That said, the hospitals here legally require flu vaccinations as conditions of employment.

Can you friend go on medical leave for the flu season while she's nursing the baby? Pump and dump for a bit? Ask to wear a mask? I'm sorry she's going to lose her position over a policy that I really don't think protects people. Masks would protect people.

The flu vaccine definitely isn't THE answer but it's one till in the tool box.

 

Good safety protocols depend on redundancy because there rarely ever is one answer and individual measures often fail. So hospitals require flu shots but also hand washing and maybe also masks and gloves in certain situations.

 

Flu vaccines don't offer a guarantee, no. But in an environment where people's lives can be endangered by viruses that are generally nothing but a nuisance it pays to control as many variables as you can. An individual sheep hair isn't all that warm but spin it together with many others and you've got wool that will keep you warm.

 

Hospitals aim for the same thing, layers of protection that individually may be questionable but en masse are a strong barrier. It's the principle of small numbers adding up to big ones.

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If most hospitals require vaccination, I don't know how you would interpret any stats.  You wouldn't know if the rate is low because of requiring everyone to vax or due to some other factor. 

 

I think another reason why some employers either require it or encourage it is because they want to cut down on the number of days their employees have to miss work for illness.  If they have something that can lower the rate I can see why they would do it.  My husband works for a company that makes computer software.  They offer the vax every year right at the office.  They even pay for it.

I thought maybe there would be studies carried out before the flu shot was widely available and mandatory and could be compared to studies after health care workers widely received the vaccine. Surely, if we're being scientific about this, those sorts of figures should be available. I would imagine there are some countries in which the flu shot is not routinely given to health care workers and maybe transmission figures could be compared with the US.

 

 

ETA - I personally think that the reduced sick time has a whole lot to do with the requirement. Why not just be honest about it if this is the case. I much prefer being able to see the proof, or being told the real reason. I've asked at the hospital I work at and haven't been offered much information other than CDC recommendations. The people I've spoken to don't seem to be aware of actual evidence. I was hoping someone on here might know of something. FWIW I have had the vaccine and I did so prior to it being mandatory. I just don't like being fed a line that can't be substantiated.

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Most states are employment at will so yes, it's legal.  It stinks but she needs to decide which matters more to her, avoiding the flu shot or keeping her job.  (and she won't get unemployment since she is "resigning" plus it may be very difficult to find another nursing job if chooses to quit over the flu shot)

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I knowthat I've told my daughter not to go into the medical field, but with everyone tossing out " herd immunity", then my daughter should be protected, other immune compromised should be protected, and those vaccinated should be protected... based on that theory, it should not be an issue. btw, immune compromised don't avoid hospitals, doctor offices, or society. Some do, some do not. My MIL is immune compromised... she's an RN.

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I don't know the details of your friend's medical history but if her only reason was concern due to breast feeding that isn't going to be considered a legitimate exemption even if a doctor did sign off or write a letter. For most of these policies you would have to have a recognized medical reason or accepted religious exemption. For example, I know there was a case at one hospital where a group claimed a religious exemption to the flu shot but could not provide any texts, policies, statements,etc. from any religious group/organization to support that belief. They went to court and the judge ruled that they could be required to get the vaccine as part of employment. You can claim a religious exemption if you can show that you have been a Christian Scientist and follow those beliefs; you can't if it's just a personal belief. It's a higher standard than exemptions for school vaccine requirements.

 

 

 

Right. Her exemption is legitimate to her, but she has absolutely no say in the matter. 

 

My DH is in and out of the same hospital but not technically an employee. He gets the flu shot every year, although he is far from convinced it's effective. It's just not a big deal for him to get one. Our DD is immune-compromised, as well.

 

Anecdotally, I've only known a few people who've actually gotten the real flu. Interestingly, they'd all been vaccinated.

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The flu vaccine definitely isn't THE answer but it's one till in the tool box.

 

Good safety protocols depend on redundancy because there rarely ever is one answer and individual measures often fail. So hospitals require flu shots but also hand washing and maybe also masks and gloves in certain situations.

 

Flu vaccines don't offer a guarantee, no. But in an environment where people's lives can be endangered by viruses that are generally nothing but a nuisance it pays to control as many variables as you can. An individual sheep hair isn't all that warm but spin it together with many others and you've got wool that will keep you warm.

 

Hospitals aim for the same thing, layers of protection that individually may be questionable but en masse are a strong barrier. It's the principle of small numbers adding up to big ones.

 

 

 I actually don't think it should be a utilized tool because it really doesn't help, and there is something effective that could be in place instead. And, who knows, it might actually be in practice if health care worker mandatory vaccination wasn't the over-riding policy and somehow presumed to be good enough protection for most situations.

 

The logic that the vax isn't very effective but it's all we have and better than not vaxing works, for me anyway, for an individual who needs to avoid flu in him/herself. That's why I (usually) have my family get vaccinated. It doesn't, though, extend to this situation in my opinion.

 

Cochrane analysis of efficacy of mandatory health care worker vaccination (with elderly, as these are the populations tracked/studied):

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005187.pub4/abstract;jsessionid=9F24A0703B25805C319BCEC2C3F17608.f01t04

There is no evidence that only vaccinating healthcare workers prevents laboratory-proven influenza or its complications (lower respiratory tract infection, hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 or over in LTCIs and thus no evidence to mandate compulsory vaccination of healthcare workers. Other interventions, such as hand-washing, masks, early detection of influenza with nasal swabs, antivirals, quarantine, restricting visitors and asking healthcare workers with an influenza-like illness not to attend work, might protect individuals over 60 in LTCIs. High-quality randomised controlled trials testing combinations of these interventions are needed.

 

On the other hand, if we're talking about (simple surgical type) masks:

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006207.pub4/abstract

We included 67 studies including randomised controlled trials and observational studies with a mixed risk of bias. A total number of participants is not included as the total would be made up of a varied set of observations: participant people and observations on participants and countries (the object of some studies). Any total figure would therefore be misleading. Respiratory virus spread can be reduced by hygienic measures (such as handwashing), especially around younger children. Frequent handwashing can also reduce transmission from children to other household members. Implementing barriers to transmission, such as isolation, and hygienic measures (wearing masks, gloves and gowns) can be effective in containing respiratory virus epidemics or in hospital wards. We found no evidence that the more expensive, irritating and uncomfortable N95 respirators were superior to simple surgical masks. It is unclear if adding virucidals or antiseptics to normal handwashing with soap is more effective. There is insufficient evidence to support screening at entry ports and social distancing (spatial separation of at least one metre between those infected and those non-infected) as a method to reduce spread during epidemics.

 

 

As a family who has dealt with immune compromise, I'd rather health care workers mask up (and hand wash with soap and water vs. the gels...I think my son wouldn't have c. diff if they did that). It's more protective.

 

It doesn't change the legality of the requirement. But I really wish solid science drove those policies and their revisions.

 

Right. Her exemption is legitimate to her, but she has absolutely no say in the matter. 

 

My DH is in and out of the same hospital but not technically an employee. He gets the flu shot every year, although he is far from convinced it's effective. It's just not a big deal for him to get one. Our DD is immune-compromised, as well.

 

Anecdotally, I've only known a few people who've actually gotten the real flu. Interestingly, they'd all been vaccinated.

Most people just don't get flu in any given year. And those who think they have influenza often actually are found to have another resp. virus instead if labs are run. But, FWIW, we (2 kids, husband) had influenza that was lab confirmed (type B ) two years ago. None of us were vaccinated that year. I skipped it because, statistically, it's just not very effective. We generally do get vaxed though, because my boys are asthmatic and one has immune system issues. We've never had influenza while vaccinated. But my closest friend's family has never had it unvaccinated either. Most years, any given person is unlikely to get it, vaxed or not.

 

But I'm replying because I'm gathering from your post that your daughter isn't vaxed. Do her doctors want her flu vaxed? My son's do want the vax. It was hard to tell his doctor I skipped it the year he actually did get flu (he did ok, thankfully).

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I can always tell when it's getting to be flu season, because this exact same topic is posted, and someone has lost their job under the exact same circumstances. :rolleyes:

 

I'm not picking on the OP, because I'm sure she didn't know that we have discussed this in the past, but I do find it interesting that the same topics come up at the same time each year... every year.

 

And somehow I end up reading the new thread, even though I know I shouldn't bother.

 

I guess I'll never learn. :)

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I would highly recommend your friend NOT get the flu mist.  It can shed, and she could infect her infant.  If she wants to get the shot that is another matter, but anyone around the immuno compromised or infants should not get the mist.  And I would think that would include healthcare workers.  I stay well away from those I know who have had the mist for at least a month.

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I can always tell when it's getting to be flu season, because this exact same topic is posted, and someone has lost their job under the exact same circumstances. :rolleyes:

 

I'm not picking on the OP, because I'm sure she didn't know that we have discussed this in the past, but I do find it interesting that the same topics come up at the same time each year... every year.

 

And somehow I end up reading the new thread, even though I know I shouldn't bother.

 

I guess I'll never learn. :)

Maybe we should print out this thread and make it mandatory reading for all healthcare personnel!  

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