Flu vaccination, yes or no.

[ultrarunner]

You mentioned MMR...

Why would a doctor almost insist that I should have the MMR when I brought in my medical records going back 55 years and said just to be safe I needed to have it again and no worries as my employer is paying for it?

I insisted on the Titer test which showed I did not need MMR.

I'm an Engineer and not a Doctor or Nurse...

It just seems a lot of medicine these days is one size fits all... and this is clearly not representative of the human population.

I would be very interested in your thoughts about Hep B...

For decades there were clearly defined at risk groups for the Hep B vaccine... now it seems everyone is at risk for everything...

 

[murse72]

my issue is choice being taken away before this mandate from the federal government i never got the flu i washed my hands between patients and all the other stuff we were taught in nursing school. i can't remember ever a nurse i worked with getting the flu. i understand if you have health issues that will make you more at risk for the flu, go ahead and take it. oh i forgot the infection control nurse that gives the flu shots got the flu shot last yr. the form we are required to sign states we request the vaccine and do not hold the hospital responsible for any reaction to the vaccine. if you want to work you sign the form If payment for medicare was not determine by staff talking the flu vaccine it would not be forced on us.

 

[ultrarunner]

my issue is choice being taken away before this mandate from the federal government i never got the flu i washed my hands between patients and all the other stuff we were taught in nursing school. i can't remember ever a nurse i worked with getting the flu. i understand if you have health issues that will make you more at risk for the flu, go ahead and take it. oh i forgot the infection control nurse that gives the flu shots got the flu shot last yr. the form we are required to sign states we request the vaccine and do not hold the hospital responsible for any reaction to the vaccine. if you want to work you sign the form If payment for medicare was not determine by staff talking the flu vaccine it would not be forced on us.

Thank you for bringing up the point I hung my hat on...

The hold harmless staff is required to sign should there be any adverse reaction... **** NO... Obviously the legal department believes the risk exists or why bother?

If push comes to shove I will have my lawyer draft a release for my employer to sign stating I am subject to duress and this WAS NOT a condition of my employment, etc...

 

[oosik]

I've been very lucky - never had the flu. Shingles - OUCH!! - had a mild case about twenty years ago. Wouldn't wish that pain on anybody. Two years ago I got a shingles shot. Never had a flu shot.

 

[Johnny g]

Good morning all, when I started this discussion going on Feb 1st I never thought it would go this far, I have read every response and am enjoying it, very informative from both sides, :applause: Johnnie G.

 

[Bird]

I've been very lucky - never had the flu. Shingles - OUCH!! - had a mild case about twenty years ago. Wouldn't wish that pain on anybody. Two years ago I got a shingles shot. Never had a flu shot.

So you got the personal lesson about shingles. And now you're waiting for some personal misery to get a flu shot?:laughing::laughing:

 

[IslandTractor]

You mentioned MMR...

Why would a doctor almost insist that I should have the MMR when I brought in my medical records going back 55 years and said just to be safe I needed to have it again and no worries as my employer is paying for it?

I insisted on the Titer test which showed I did not need MMR.

I'm an Engineer and not a Doctor or Nurse...

It just seems a lot of medicine these days is one size fits all... and this is clearly not representative of the human population.

I would be very interested in your thoughts about Hep B...

For decades there were clearly defined at risk groups for the Hep B vaccine... now it seems everyone is at risk for everything...

Not clear what your doctor was thinking unless you work in a healthcare facility or there was an outbreak in your community of mumps etc or, as may be the case, you were born outside the USA. That is a general CDC/ACIP recommendation that foreign born adults receive at least one dose of MMR or document serologies. The thinking is that we don't know what vaccines were given outside the US. Probably not an issue for someone born in Salzburg (like three of my brothers born there when we lived in Schloss Aigen in the mid 1950's!) but generally an issue for immigrants who arrive from other parts of the world with non standard documentation. Giving the MMR in such circumstances is so much easier and essentially harmless that many docs just do it rather than hassle with serologies. MMR vaccination or documented serology is required for healthcare staff too.

Regarding Hep B, the initial target was high risk groups. That worked pretty well and the vaccine is very safe so the goal posts were moved to get the lower risk groups covered too. I haven't looked up the data recently but the general thought is that while high risk groups are obviously at higher risk, the total number of preventable cases in the low risk population may well be higher. Kind of like first requiring NASCAR drivers to wear seatbelts during races and then deciding that granny and little Suzy should also wear seatbelts when they drive to the supermarket. Low risk but high volume and a safe intervention.

 

[IslandTractor]

my issue is choice being taken away before this mandate from the federal government i never got the flu i washed my hands between patients and all the other stuff we were taught in nursing school. i can't remember ever a nurse i worked with getting the flu. i understand if you have health issues that will make you more at risk for the flu, go ahead and take it. oh i forgot the infection control nurse that gives the flu shots got the flu shot last yr. the form we are required to sign states we request the vaccine and do not hold the hospital responsible for any reaction to the vaccine. if you want to work you sign the form If payment for medicare was not determine by staff talking the flu vaccine it would not be forced on us.

1) It is HIGHLY unlikely that you "never got the flu". Virtually every person living has had the flu multiple times. You may have self diagnosed incorrectly that you had just a cold but virtually nobody living in the USA has not been exposed to the flu many times. As a hermit you might avoid exposure but going to school or work in a group setting or shopping at the mall etc ect will definitely get you exposed to flu at least once every few years.

2) I'm glad you wash your hands between patients and if you are rigorous about it then you are one of the few US healthcare workers who is. Observation studies show that healthcare workers, including nurses and physicians, on average wash their hands about half the times that they theoretically should. Even if you wash your hands 90% of the time, a HCW has so many contacts, direct or indirect, with potentially contaminated secretions that repeated exposure to respiratory viruses is simply a fact of life. It will happen in a healthcare setting. Do you use a paper towel to open every single door in a public facility or hospital? Somebody who just opened the door before you after wiping his hand across his nose has already contaminated it. Howard Hughes was right, use tissue to open doors.

3) I cannot defend what hospital lawyers do in requiring that you sign a release. If the hospital simply requires you to be vaccinated because it is a CDC recommendation then that is a pretty darn good defense for them. Spurious lawsuits are an issue in this country and perhaps they are just trying to impress upon you that bringing a lawsuit isn't worth your while. Besides, we have a national system to take care of true vaccine related injuries and that system works well even though it pays out far far more than it should.

4) I feel it is reasonable for HCWs to be forced to get vaccines that are important to protect patients. Influenza kills. It may not be exactly the same thing as requiring pilots not to drink alcohol within 12 hours of flying but requiring HCW to get vaccinated against flu or Hep B or measles etc is done with the same intent: you are the professional with another person's life in your hands and your opinion about drinking or vaccination doesn't matter as much as passenger or patient safety. If you like to drink before work you can but you cannot be a pilot. If you abhor vaccines then find work outside a healthcare facility where vulnerable people come for help.

 

[IslandTractor]

FYI, I'm happy to continue this discussion but will be limited to pecking away on an iPhone for the next few days as I take my daughter to her hockey tournament. It's an important public health discussion and I'd like to fully participate. Sorry if I don't reply quickly.

 

[IslandTractor]

Except for those like a sibling of mine who got vaccinated on one day and the next, it was like they were a different person...
They are now an adult, but are well behind their physical age.
My kids have been vaccinated, but from single dose vials vs multiple dose ones (our Dr suggested that as there are reportedly less/different preservatives in a single dose vials than in a multi dose one) and they get their shots at the Dr rather than at the Hospital when they are born.

Aaron Z

This is the type of anecdote that Trump raised during his campaign. It is very natural for us to make "causal" associations when two events occur close in time. Our brains are hard wired to do exactly that. Any of our ancestors who didn't associate a Lion's roar with the risk of being eaten are simply no longer represented in our gene pool. However, there are also spurious associations as well as real ones. With pediatric neurological problems this is a very difficult determination as the timing and frequency of the childhood vaccine schedule overlaps almost completely with the expected time that certain severe neurological problems will become evident for the first time. For purposes of determining an association with a vaccination, the standard is to consider a problem that appears within a month of vaccination. If you look at the childhood vaccination schedule you will see that more than half of the first 18 months of life is within 30 days of receiving some vaccine. That means that there is a 50% chance that any illness that occurs within the first 18 months of life is temporally "associated" with vaccination. The fact that the vast majority of these neurological conditions existed before vaccination was routine tell us that clearly vaccines are not producing most of these illnesses. For example, there are genetic disorders of mitochondria that are evident only after the first year or so. We know those illnesses will occur if the gene is present and that the illness would normally present in the first 18 months even if no vaccine was ever given. But the odds are 50:50 that when these kids first manifest neurological symptoms, it will be within 30 days of receiving a vaccine. Of course reasonable people are going to make the association even if it is false. We can study these associations using the tools of epidemiology and statistics to show that the number of kids with a given condition who first get ill within 30 days is no different than those who first become ill more than 30 days from their last vaccine and that type of data is what reassures pediatricians and public health types that there is not a causal association. However, it is very understandable that people worry about such things. Which is why I thought it was simply "ordinary" for a non physician like Trump to have raised the issue during one of the debates but why it was simply atrocious that both Ben Carson and Rand Paul did not contradict Trump and instead muttered inanities. Every physician is not a vaccine expert but every licensed physician should know enough about the FDA process for licensing vaccines and the CDC processes for investigating side effects to know that Trump's answer was ignorant and not based on science.

Regarding single versus multidose vials, they are equally safe. The preservatives in the multidose vials are safe despite all the brouhaha about mercury etc. My kids all were vaccinated from multidose vials. Single dose vials are just an unnecessary expense IMO.