Fighting the flu
New regulations require B. C. health care workers to get shots or cover up when treating patients
Health care workers in B. C. will be the first in the country required to either get influenza vaccinations or wear masks when treating patients.
The regulations, to be introduced this year, were announced on Thursday by provincial health officer Dr. Perry Kendall. They are designed to improve the low rate of vaccinations among health care workers and reduce the risk of infections among the most vulnerable people in the province.
According to Kendall, about 50 per cent of health care workers in B. C., including those in long- term care homes, receive vaccinations, which he said is a staggeringly low number considering the potential for transmitting flu viruses.
“That’s way lower than we’d like to see and it’s actually been dropping over the years,” he said.
Hospital Employees’ Union spokesman Mike Old said the union supports improving the vaccination rates among staff, but would prefer to keep vaccinations voluntary.
The B. C. Nurses’ Union would not comment on the new regulations Thursday, but a bulletin sent to members in 2011 indicated the union believes flu vaccines should be promoted through education “rather than through a punitive approach by the employer.”
Micheal Vonn of the B. C. Civil Liberties Association said the advocacy group will be studying the issue “very intently.”
“In particular we would be interested in finding out what the scientific evidence is that the government is relying on to make the claims that it makes. This is a highly contested medical field and the claims are bold and very general,” she said, referring specifically to the claim that such a measure will save lives.
“A million questions arise as to what we are getting for what we are losing. It’s a very draconian step to mandate a medical intervention and in order to justify that, the benefits have to be crystal clear and [ of] a very high standard.”
The new regulations were backed by the BC Centre for Disease Control.
“Patients should not have to worry that they could get sick from their care provider,” said Dr. Bonnie Henry, director of communicable disease prevention at the BCCDC. “Getting vaccinated is the best way to protect patients, as well as health care workers themselves and their families.”
Similar policies have been introduced at some facilities in the U. S.
In 2004, Seattle’s Virginia Mason Medical Center was the first hospital to implement a mandatory influenza vaccination policy. All workers at the hospital are required to be vaccinated as a condition of employment. Beverly Hagar, a registered nurse at the hospital, was part of the team that introduced the policy.
“We have an older population in our facility and they are the ones that are most likely to have full efficacy from [ staff] getting vaccinated, so we wanted to protect our vulnerable patients,” she said.
Hagar noted that in 2005 — the first year her team implemented the policy – five employees left the hospital due to the mandatory vaccination and two were terminated for non- compliance. In recent years, however, vaccination rates among hospital employees have increased to 99.5 per cent from 54 per cent.
Although the effect of the high vaccination rates on transmissions to patients has not been evaluated, Hagar said the hospital has observed a decrease in employee sick leave during peak influenza season.
There are no U. S. states that require influenza vaccines for all public health care workers, according to a database maintained by the Centers for Disease Control and Prevention, though some require employees to provide a written declaration of having refused the vaccine.
A press release issued Thursday by B. C.’ s Ministry of Health declared that New York was the first state to have done so.
However, Susan McQuade of the New York Committee for Occupational Health and Safety, said in an interview Thursday that an order requiring the shots— issued as an emergency measure in response to the H1N1 outbreak in 2009 — was rescinded a couple of weeks after it went into effect.
That happened after health care workers balked at the prospect of the shots and lawsuits were filed, said McQuade, whose group was among those opposing the measure.
“There was tremendous pushback from a lot of the workers in saying that you cannot be forcing me to get a vaccine.”
New York’s health department claimed the policy was rescinded because there was not enough vaccine to go around.
Programs to educate health care workers about the importance of getting the flu shot and make it easily accessible have been successful at increasing vaccination rates in the U. S., McQuade added.
Health officials in B. C. have always encouraged workers to get vaccinated, but too few people have followed that advice, Kendall said.
“It’s always been a bit of a puzzle. Some people believe they’re healthy and they don’t get influenza, some believe the vaccine will give you influenza, which is a myth. There is no way
Patients should not have to worry that they could get sick from their care provider. Getting vaccinated is the best way to protect patients, as well as health care workers themselves and their families. DR. BONNIE HENRY BC CENTRE FOR DISEASE CONTROL
the vaccine can give you influenza.”
He also said masks can be very effective in reducing the spread of the flu. Masks covering people’s mouths prevent the transmission of droplets. The HEU’s Old, however, said such a method could get expensive, considering half of health employees are not getting vaccinated.
Kendall has talked to his counterparts in other provinces across the country about the new rules and he expects at least some will follow B. C.’ s lead.
In a good year with a vaccine that matches well with the dominant influenza strain, protection in adults can reach up to 80 per cent. In a bad year, that figure drops to about 40 per cent.
“It’s not perfect, but it’s better than no protection at all,” Kendall said.