Personal Medical Responsibility

"The time has come for health-care institutions to demand that all health-care workers be vaccinated. Our patients' lives depend on this change."
Dr. Ken Flegel, editorial, Canadian Medical Association Journal

"I really feel this is unfair. We're kind of being pushed and railroaded. It feels like bullying."
Diane Lockie, Alberta nurse's aide

This year in both Canada and the United States is turning out to be one of the most active flu seasons in quite a long time. Public authorities have been trying to motivate people to get out and get vaccinated. At public health clinics taking place at various times and places throughout the city. At doctors' offices. Even many pharmacies will now give flu shots. Readily available.

But the uptake is dismal. The elderly and children are seen to be most at risk. And many elderly people do opt to take a yearly flu shot in acknowledgement of their elderly immune systems. While many parents aren't convinced that vaccinating their children is what they want to commit to. Herd immunity is what a lot of flu epidemic specialists count on; that enough people will be vaccinated to ensure that viral transmission is kept to a minimum.

With insufficient uptake, people deciding to give it a pass, the protocol of herd immunity is compromised. Fewer takers, greater numbers of flu, through more opportunistic transmission. And low levels of immunization among health care workers has added to the flu outbreaks throughout the country. Despite an increasing drive to convince health care workers of the necessity to take flu shots to protect their vulnerable patients, if not themselves.

Public Health Ontario, as well as the professional nursing body, the Canadian Nurses Association, are counted among those institutions who support the need for health care workers to be responsive to the need to vaccinate themselves. It is the unions representing the health care workers, on the other hand, who oppose the thought of imposing vaccinations upon unwilling workers.

And Diana Lockie, quoted above, is one of over a dozen health care workers who were sent home from the extended health-care facility in Medicine Hat where they work, during this very active influenza season. Similar action has been taken at other health-care facilities, to protect patients from the likelihood of transmission from unvaccinated workers.

"A patient can choose and refuse treatment. When the nurse is at the other end of the needle, she or he should be able to refuse vaccination. As soon as you put in the word mandatory, you're going to put this process back 50 years", contends Linda Silas, president of the Canadian Federation of Nurses Unions.

Dr. Allison McGeer, an infectious-disease specialist at Toronto's Mount Sinai Hospital has a response to the union's contention: "In the setting of an outbreak, it's very clear that unvaccinated people get sick and transmit. You're making a decision that is counter to the advice of just about every public-health official in the world."

As for Ms. Lockie, she explains her fear that taking a preventive course of Tamiflu or getting vaccinated would likely trigger a condition she is susceptible to that causes severe stabbing pain; trigeminal neuralgia. Public health and flu experts say no evidence exists that the flu vaccine causes any side effects of such a nature.

Ms. Lockie and other health-care workers who refuse to protect themselves against the flu and thus compromise their effectiveness in working with the ill and the elderly, have other options. Which is that workers in nursing homes or hospitals who haven't been vaccinated have the choice to get the shot or take anti-viral Tamiflu.

The alternative to refusing those options is to seek alternate work. Or go home and forgo their salary.