Providence hospital employees get vaccine ultimatum
Get a flu shot by Dec. 31 or find a new job
<!-- Story Photo -->
By LISA DEMER
ldemer@adn.com
(12/08/08 23:16:56)
Many of us debate whether to get flu vaccines every year, but at Providence Alaska Medical Center, workers have no choice: The hospital is requiring all employees to get flu shots by year's end or face dismissal.
Its new policy is cutting edge -- and controversial, especially among nurses.
Infectious disease experts say the measure makes good health sense. It is intended to protect patients, already ill, from being infected with potentially deadly influenza while hospitalized.
Doctors on the hospital's infection control committee unanimously supported the requirement, said infectious disease physician Megan Clancy.
"They said 'our vaccination rates are terrible to the point of being embarrassing, and we really need to fix this problem,' " said Clancy, Providence's medical director of infection control.
Nationally, fewer than half of health care workers receive flu vaccines, even though the U.S. Centers for Disease Control and Prevention recommends they do so. Even if health care workers don't get ill from flu themselves, they can pass germs on to people who are frail.
Before this year at Providence, about 40 percent of employees were vaccinated, Clancy said. That's close to the 42 percent tallied nationally during the 2005-06 flu season.
But with the new mandate at Providence, close to 70 percent of employees have been vaccinated, with the deadline a few weeks away, said Becky Hultberg, Providence communications director.
Many nurses don't want to be forced to get a shot that carries health risks of its own and doesn't always work, according to the nurses' union. Some employees are struggling with whether to tolerate the poke in the arm, or face consequences, said Debbie Thompson, executive director of the Alaska Nurses Association.
Thompson said she's fielded 300 to 400 calls on the controversy.
"If someone said you had to have a flu shot or lose your job, what would your reaction be?" she said.
The nurses' union has filed a grievance protesting the policy.
"Our goal is to work with employees to ensure both their participation and their continued employment.
Ultimately, some employees may have to decide if they want to continue to work at Providence," Hultberg wrote in an e-mail.
Neither Alaska Regional Hospital nor the Alaska Native Medical Center requires all employees to get flu vaccines, but they strongly encourage it.
All Anchorage hospitals provide free flu shots to employees.
At Alaska Regional, more than half of the employees have been vaccinated. Nearly three-fourths of employees of the Alaska Native Tribal Health Consortium, one of two organizations that staff the Native hospital, have gotten their flu shots so far this year.
At Southcentral Foundation, which also provides staff for the Native hospital and runs the Primary Care Center on the campus, employees are asked to either get a flu shot or sign a paper that acknowledges their refusal and details the risk to patients, said public relations director Kristin Tolbert.
Close to 62 percent of Southcentral Foundation employees have gotten their flu shot, another 10 percent signed the paper, and a big push for more to be vaccinated will come on Friday, Tolbert said.
At Providence, the new requirement affects the more than the 3,100 employees at the main hospital in Anchorage and the administration building a short walk away. As of Friday, 2,139 had been vaccinated, Hultberg said.
All of the employees are expected to get a flu shot by Dec. 31, unless they have a medical reason not to, Hultberg said. She has allergies and is debating what to do herself.
People with egg allergies shouldn't get a flu shot, and neither should those who have had a bad reaction in the past, doctors say. But those circumstances are rare. It's a myth that the flu shot can cause the flu because it uses a dead virus, said Jay Butler, the state's chief medical officer.
By next year, the requirement should cover all Providence employees statewide, Hultberg said. Doctors, though, are not hospital employees and so far aren't covered.
"I can tell you that I would like the medical staff to be required also. That is on my agenda, everyone's agenda," said Dr. Robert Bundtzen, another infectious disease specialist.
Studies show that an average of 36,000 people nationwide die every year from flu-related causes, Butler said.
Workers can spread the germs without even knowing they are carrying them, he said. In fact, research shows that about a quarter of health care workers become infected without becoming seriously ill, he said.
Immunizing workers provides "a ring of protection" around vulnerable patients: sick children, pregnant women, people who may have had heart attacks or strokes, Clancy said.
"You don't want to come into the hospital for one issue and end up getting an infection," Clancy said.
Nurses continue to question the effectiveness of the flu vaccine. Some Providence nurses say they won't get the flu shot, even if it comes down to their job.
"I'm constantly bombarded so I have a natural increased immunity to the flu," said nurse Roamy Kilmer.
She said she's not anti-vaccine -- she was vaccinated for hepatitis, and her children got vaccines. But Kilmer, a nurse for 20 years, never has gotten a flu vaccine, or the flu. She doubts CDC statistics and says she's seen no evidence of reduced deaths from influenza despite the vaccine. She objects to a push for vaccines when regular hand washing and the wearing of face masks can prevent the spread of germs.
Anyway, why single out hospital workers when people may come into the hospital carrying the flu bug or catch it from visiting family members? she said.
Molly Connelly, a nurse in the Providence neonatal unit, said she is very frustrated with being told she must get a shot.
"I don't like to take Advil when I have a headache," she said. "I don't take meds unless I have an ear infection."
The nurses also note that the vaccine isn't always well matched against the strains of influenza that arise.
Experts say the vaccine works well in preventing the flu or at least reducing the symptoms. Hospitals should do all they can to protect patients from disease, Clancy said.
In recent years, the vaccine has been a good match for the virus, and has been effective in 70 percent to 90 percent of healthy adults, Butler said. Even when not the best match, it can still make symptoms milder, he said.
As to the nurses-are-immune argument -- not so, according to the CDC. Because the viruses are ever changing, past exposure doesn't protect against new strains, the agency says.
A preview of what may happen at Providence can be seen in the Seattle area at Virginia Mason Medical Center, now in its fourth year of mandatory flu vaccines. The nurses union there protested the requirement as a contract violation and won in arbitration.
But most of the hospital's 5,000 employees get the vaccine, and so do many nurses. Last year, 98 percent of employees complied, and the rest either had medical or religious exemptions, or were part of the nurses' union, said Alisha Mark, the hospital's media relations manager. Only a handful of employees have lost their jobs, she said.
"If I have to get a shot, I will get a shot," Providence nurse Connelly said. "But I will not go in there until the last day."
Get a flu shot by Dec. 31 or find a new job
<!-- Story Photo -->
By LISA DEMER
ldemer@adn.com
(12/08/08 23:16:56)
Many of us debate whether to get flu vaccines every year, but at Providence Alaska Medical Center, workers have no choice: The hospital is requiring all employees to get flu shots by year's end or face dismissal.
Its new policy is cutting edge -- and controversial, especially among nurses.
Infectious disease experts say the measure makes good health sense. It is intended to protect patients, already ill, from being infected with potentially deadly influenza while hospitalized.
Doctors on the hospital's infection control committee unanimously supported the requirement, said infectious disease physician Megan Clancy.
"They said 'our vaccination rates are terrible to the point of being embarrassing, and we really need to fix this problem,' " said Clancy, Providence's medical director of infection control.
Nationally, fewer than half of health care workers receive flu vaccines, even though the U.S. Centers for Disease Control and Prevention recommends they do so. Even if health care workers don't get ill from flu themselves, they can pass germs on to people who are frail.
Before this year at Providence, about 40 percent of employees were vaccinated, Clancy said. That's close to the 42 percent tallied nationally during the 2005-06 flu season.
But with the new mandate at Providence, close to 70 percent of employees have been vaccinated, with the deadline a few weeks away, said Becky Hultberg, Providence communications director.
Many nurses don't want to be forced to get a shot that carries health risks of its own and doesn't always work, according to the nurses' union. Some employees are struggling with whether to tolerate the poke in the arm, or face consequences, said Debbie Thompson, executive director of the Alaska Nurses Association.
Thompson said she's fielded 300 to 400 calls on the controversy.
"If someone said you had to have a flu shot or lose your job, what would your reaction be?" she said.
The nurses' union has filed a grievance protesting the policy.
"Our goal is to work with employees to ensure both their participation and their continued employment.
Ultimately, some employees may have to decide if they want to continue to work at Providence," Hultberg wrote in an e-mail.
Neither Alaska Regional Hospital nor the Alaska Native Medical Center requires all employees to get flu vaccines, but they strongly encourage it.
All Anchorage hospitals provide free flu shots to employees.
At Alaska Regional, more than half of the employees have been vaccinated. Nearly three-fourths of employees of the Alaska Native Tribal Health Consortium, one of two organizations that staff the Native hospital, have gotten their flu shots so far this year.
At Southcentral Foundation, which also provides staff for the Native hospital and runs the Primary Care Center on the campus, employees are asked to either get a flu shot or sign a paper that acknowledges their refusal and details the risk to patients, said public relations director Kristin Tolbert.
Close to 62 percent of Southcentral Foundation employees have gotten their flu shot, another 10 percent signed the paper, and a big push for more to be vaccinated will come on Friday, Tolbert said.
At Providence, the new requirement affects the more than the 3,100 employees at the main hospital in Anchorage and the administration building a short walk away. As of Friday, 2,139 had been vaccinated, Hultberg said.
All of the employees are expected to get a flu shot by Dec. 31, unless they have a medical reason not to, Hultberg said. She has allergies and is debating what to do herself.
People with egg allergies shouldn't get a flu shot, and neither should those who have had a bad reaction in the past, doctors say. But those circumstances are rare. It's a myth that the flu shot can cause the flu because it uses a dead virus, said Jay Butler, the state's chief medical officer.
By next year, the requirement should cover all Providence employees statewide, Hultberg said. Doctors, though, are not hospital employees and so far aren't covered.
"I can tell you that I would like the medical staff to be required also. That is on my agenda, everyone's agenda," said Dr. Robert Bundtzen, another infectious disease specialist.
Studies show that an average of 36,000 people nationwide die every year from flu-related causes, Butler said.
Workers can spread the germs without even knowing they are carrying them, he said. In fact, research shows that about a quarter of health care workers become infected without becoming seriously ill, he said.
Immunizing workers provides "a ring of protection" around vulnerable patients: sick children, pregnant women, people who may have had heart attacks or strokes, Clancy said.
"You don't want to come into the hospital for one issue and end up getting an infection," Clancy said.
Nurses continue to question the effectiveness of the flu vaccine. Some Providence nurses say they won't get the flu shot, even if it comes down to their job.
"I'm constantly bombarded so I have a natural increased immunity to the flu," said nurse Roamy Kilmer.
She said she's not anti-vaccine -- she was vaccinated for hepatitis, and her children got vaccines. But Kilmer, a nurse for 20 years, never has gotten a flu vaccine, or the flu. She doubts CDC statistics and says she's seen no evidence of reduced deaths from influenza despite the vaccine. She objects to a push for vaccines when regular hand washing and the wearing of face masks can prevent the spread of germs.
Anyway, why single out hospital workers when people may come into the hospital carrying the flu bug or catch it from visiting family members? she said.
Molly Connelly, a nurse in the Providence neonatal unit, said she is very frustrated with being told she must get a shot.
"I don't like to take Advil when I have a headache," she said. "I don't take meds unless I have an ear infection."
The nurses also note that the vaccine isn't always well matched against the strains of influenza that arise.
Experts say the vaccine works well in preventing the flu or at least reducing the symptoms. Hospitals should do all they can to protect patients from disease, Clancy said.
In recent years, the vaccine has been a good match for the virus, and has been effective in 70 percent to 90 percent of healthy adults, Butler said. Even when not the best match, it can still make symptoms milder, he said.
As to the nurses-are-immune argument -- not so, according to the CDC. Because the viruses are ever changing, past exposure doesn't protect against new strains, the agency says.
A preview of what may happen at Providence can be seen in the Seattle area at Virginia Mason Medical Center, now in its fourth year of mandatory flu vaccines. The nurses union there protested the requirement as a contract violation and won in arbitration.
But most of the hospital's 5,000 employees get the vaccine, and so do many nurses. Last year, 98 percent of employees complied, and the rest either had medical or religious exemptions, or were part of the nurses' union, said Alisha Mark, the hospital's media relations manager. Only a handful of employees have lost their jobs, she said.
"If I have to get a shot, I will get a shot," Providence nurse Connelly said. "But I will not go in there until the last day."
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