Tuesday, October 1, 2013

Should you be forced to get the flu shot?

At my hospital, this year the flu shot has become mandatory. I got mine today, as did most of us at my office, when one of the nurses from occ health came around to give them. Two people have declined. What is going to happen to them, we don't know. They have to the end of the year to officially decline. Then- I don't know what will happen.

It is coming down from the government. It is something easy to monitor. It is medical. It makes money for vaccine makers. In theory, it could mean fewer flu infections from provider to patient- although the vaccines are far from perfect, and most staff people will never get the flu anyway. But I think that there are a lot of other things they could do which would keep our patients healthier. Like giving us sick days that are not of our PTO, and encouraging us to use those days, when we are sick.

I think we need some germs. We are not designed to live in a sterile environment. But I'm not sure that means we have to expose ourselves and our patients to the flu. I have more of a problem with the chicken pox vaccine- which is rarely deadly or disabling (although shingles can be). We need some germs, or our immune system will go haywire, and cause all sorts of trouble.

I take the flu vaccine because I think it might protect my patients. And I really don't want to get the flu- I think it would be miserable. But I don't know if we should force every one to get it. I can't decide. If it stops there, maybe. If this is the beginning of a slippery slope, then we are in big trouble.

1 comment:

Just Me said...

It is so tricky. I now get the flu shot because with asthma it's a good idea. Before I had pertussis and then asthma I got the shots to protect patients. One year I was late and got the flu. A week after I left the contagious period (along with several co-workers) we had a flu outbreak that killed 1/8 of our patients. The only time I didn't get a shot promptly after that was the year there was a shortage and I chose not to get one at all.

Pertussis was another experience with shots. I had them as a kid but in divided doses because I was allergic and they thought it was a way to reduce the risk. The shot didn't work that way. So I caught pertussis from a patient. Because you are sick for 3 weeks before you are REALLY sick I spread it for 3 weeks. When I came back to work quite a few of my patients had been hospitalized for pneumonia but were coughing with pertussis (diagnosing pneumonia saved the local doctors from dealing with the health department). Pertussis shots don't have permanent immunity and most people don't know that. You are immune enough that as long as you are healthy you only get a bad bronchitis. If you are elderly you get sicker. If you are an infant and are exposed you can die. My niece was a few months old when I got it. I happened to not see her during the contagious period and then wasn't allowed to see her for several months. It still scares me that I could have infected her. Pertussis is not a nice thing to have as an adult who is going to survive. It's got to be a terrifying death for a baby, or illness if they survive.

All of this changed how I felt about vaccines. I'm confused too. I feel much more pro-vaccine than I did before I caught something that was in the community because of people not vaccinating (the vaccination is a community health contribution is true; I relied on others to not pass pertussis to me since I couldn't be immune from my own vaccines). And I'm glad other vaccines are available. Varivax might not be something I'd give my child but when I started asthma treatment and remembered that I had barely had chicken pox as an infant and my dr. decided to test me he said that he was sure I'd be immune, that he'd never seen anyone not be immune and didn't even know how getting an adult the shot worked. I was not immune. Chicken pox as an adult is even worse than pertussis. So I had 1 of the 2 shots. But it had to be done while I wasn't around patients so it was done a few days after I had surgery and my psych meds had been messed up and I was very manic and growing worse daily. I had the shot and the mania became akasthesia. We're 99% sure it wasn't Varivax. But it could have been part of it so I now am reliant on community vaccinations to be sure I don't get chickenpox which I may or may not be immune to.

What I do not think is necessary is the number of immunizations started before the baby leaves the hospital.