It bugs me when health workers won’t get flu shots

The Alberta government’s flu vaccination program is underway and that necessarily leads us to the recurrent, all-important question of whether there should be mandatory vaccinations for health-care workers.

Statistics show that vaccination rates for health-care workers are notoriously low. Alberta Health Services figures report this rate as 43.9 and 43.7 per cent in recent years. The Canadian Medical Association Journal estimates that 55 to 65 per cent of Canadian physicians do not get vaccinated. These estimates may be lower than the actual rate because of self-immunization, but even if the health-care worker vaccination rate reached 50 per cent, it doesn’t exactly provide a ringing endorsement for a public vaccination program.

Health Minister Fred Horne says a mandatory vaccination policy for health-care staff would be “a last resort” and that he prefers to rely on encouragement and education. Fair enough, but it takes a heck of a lot of education and encouragement to overcome the public perception that results when most medical workers refuse the shot, unions threaten legal battles over mandatory vaccination and the province’s medical leaders remain silent or, worse still, malign the procedure.

The United Nurses of Alberta has encouraged its members to get a shot. But it has also threatened a legal battle in the event of a mandatory vaccine policy, and its spokesperson called the vaccine an “invasive needle,” thereby sending a very public message that the flu shot is far from the relatively benign procedure that education campaigns portray.

So far, the Alberta Medical Association and the province’s College of Physicians and Surgeons have not endorsed — or even addressed — the flu shot program. That, in concert with low physician compliance rates and the above comments by a leading nurse in the province, speaks volumes. Unfortunately, the message is: Don’t get a flu shot.

In British Columbia, the first province to attempt a mandatory vaccination program for all health-care workers, the BC Nurses’ Union outright rejected the policy. President Debra McPherson said the union opposed the policy because of the “clearly contradictory evidence about the effectiveness of the flu shot.”

It is comments like those above, combined with noncompliance in vaccine programs, that contribute to the public credibility of claims that vaccines cause serious harm, such as autism.

The refusal of B.C. nurses to comply with a mandatory program because of “conflicting studies” about the efficacy of the vaccine has very little legitimacy. After all, it shouldn’t matter if the vaccine is 40 or 80 per cent effective — if it reduces the number of flu deaths and flu cases, slows the spread of infection, reduces the severity of flu symptoms and prevents the outbreak of a pandemic to any degree, shouldn’t they comply?

The efficacy of the flu vaccine varies from year to year, but most studies report that the vaccine is 50 to 60 per cent effective. That mark is far too low for some, but, on the other hand, it’s the only strategy we currently have to reduce the spread and severity of the flu.

Flu shots don’t need to be mandatory if people simply apply common sense. If a health-care worker has a health issue that could be worsened or is in some way at risk by getting a flu shot, then don’t get one. Wear a mask when dealing with patients and — above all — wash your hands before and after touching each patient.

Health-care workers who have no reason to refuse a vaccine should get one.

They have a duty (and an ethical responsibility) to provide the highest standard of care to their patients — and that includes doing all they can to reduce the possibility that they could unknowingly transfer an infection to their patients. They should also be very aware of the message that their actions send to the public and the perception that their words create in the public realm.

If the risks are as minimal as education campaigns claim, there is no reason to not be vaccinated.

On the other hand, if there are serious risks involved that the public is not privy to, then health-care workers have an obligation to tell us what they are so we too can make an informed decision.