Some in health care refusing flu vaccine

Kathy Plonka photo

Kootenai Health recruiter Brittany Stockstill decided to wear a mask instead of getting a flu shot while working in the business services department at Kootenai Medical Center in Coeur d’Alene. Six percent of hospital staff chose a mask over the vaccination.

January 16, 2013 - Updated: 9:01 a.m.

Hospitals, clinics and nursing homes increasingly are requiring their employees to get a flu shot, but some health care workers are refusing, putting their jobs on the line.

A Newman Lake woman said she felt she had no choice but to resign from Kootenai Behavioral Health because she would not comply with a new policy directing employees to get vaccinated for influenza or wear a mask at work during flu season.

Sarah Peterson, a mental health specialist, resigned Dec. 7 after more than 17 years at Kootenai Behavioral Health, which is part of Kootenai Health.

“They have every right to make it mandatory, and I have every right to stay or quit,” said Peterson, adding she didn’t want to be fired.

Two other workers at Kootenai Health have resigned for the same reason rather than face discipline that could lead to their dismissal, spokeswoman Kim Anderson said.

So far, 94 percent of Kootenai’s 2,242 employees were vaccinated and 6 percent agreed to wear masks, Anderson said.

The intent of the policy is to protect patients from getting sick, particularly when they may be least able to fight off disease, said Dr. Walt Fairfax, chief medical officer for Kootenai Health.

“We should not get the flu if we can avoid it, and we should not give the flu to other people if we can avoid it,” Fairfax said. “And the best way to avoid that is vaccination.”

While most health care professionals get the flu vaccine, Peterson’s experience is not unique. Several hospitals in Indiana, Missouri and other states recently fired nurses and other health care employees who refused to follow flu vaccine policies.

The reasons they resist vary: Some raise objections on religious grounds, some question the effectiveness of the shots and some worry about what’s in the vaccine, which is reformulated annually to combat the virus strains expected to be most prevalent.

Motive for the mask

Peterson chose not to vaccinate herself or her children because she believes ingredients in the flu vaccine, including the mercury-based preservative thimerosal, can harm human health.

The Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health all say the flu shot is safe. But Peterson is convinced the risks outweigh potential benefits of the vaccine and that there are safer ways to boost one’s immunity to ward off disease.

She also said she offered to wear a mask if she became ill or when she sees a patient who is ill or whose immunity is compromised, but did not think it necessary to wear one constantly for months on end.

“It’s coercion to try to get you to take the vaccine,” she said.

Peterson, who worked with children and teens in the acute psychiatric program, said wearing a mask would have made her job difficult.

“Ninety percent of our communication on the psych unit is nonverbal, and how do you do that with most of your face covered?” she said. “It’s very claustrophobic, uncomfortable. It’s just not a realistic option, and they know that.”

Bonnie Castillo of National Nurses United, the largest union of registered nurses in the U.S., said she opposes requiring workers to wear masks when they decline the vaccination.

“It creates a false sense of protection for employees and patients, because the masking doesn’t fully stem transition,” Castillo said.

But Fairfax, a doctor of 30 years, said health care workers have a responsibility to do what they can to protect their patients and colleagues.

“It is not my right to say that I will put them at risk of having an infectious disease because I don’t like the potentially preventive measures that I can take,” he said.

Some hospitals are dropping the mask option and mandating flu shots for all employees who can get them – a direction Fairfax believes Kootenai Health should move in as well.

Providence Sacred Heart Medical Center in Spokane and other hospitals in the Providence system require employees to get a flu shot or wear a surgical mask in patient care areas when the flu is active in the community.

The policy previously applied only to those who worked in patient care areas but was expanded this year to cover all employees, including cafeteria, custodial and office workers. As of Tuesday, 87 percent of Sacred Heart employees had received the vaccine.

A ‘natural disaster’

This year the Centers for Medicare & Medicaid Services has started requiring hospitals to report employee flu vaccination rates and will post the results on the federal government’s “Hospital Compare” website.

Down the road, hospitals may be required to meet mandatory vaccination targets to continue receiving Medicare and Medicaid reimbursements.

“Flu is a natural disaster that comes in a timed fashion every year. And we can prevent it,” Fairfax said. “I think what the federal government is telling us is that we’d better darned well move toward preventing us being complicit in that particular natural disaster.”

The American Medical Association supports mandatory shots for those working directly with nursing home patients, who are more vulnerable to flu-related complications.

The American Nurses Association favors exceptions to vaccination mandates for medical or religious reasons.

National Nurses United, representing 170,000 nurses, says every RN should be vaccinated against the flu. But the organization opposes mandatory compliance and cautions against relying too heavily on the vaccine, which the CDC says is effective about 60 percent of the time.

Mandatory vaccination engenders distrust and resistance among employees and raises ethical and legal questions about employee rights, the NNU says.

“It really doesn’t make sense to be firing highly trained individuals at a time when you have a critical need for these highly trained individuals to provide care for the community,” Castillo said.

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