Whats At Stake When Medical Exemptions Are Misused
When kids who have no need for medical exemptions get them, the rate of vaccination coverage clearly goes down. In turn the number of unvaccinated children who are susceptible to disease goes up, increasing the ease of transmission and the risk of outbreaks, Dr. Orenstein explains.
This is especially dangerous for anyone at the school who is immune-compromised and therefore particularly vulnerable to infections and unable to safely get vaccines that protect against those illnesses. There could be a child in the school with cancer whos on severe immunosuppressant medicationswho cannot get vaccinated, Dr. Orenstein says. If an unvaccinated classmate is exposed to, say, measles, they could transmit it to that vulnerable child who has little to no immune defense. This is why herd immunity is importantthe more people who get vaccinated, the more in the general herd of that community who are safe even if they cant get vaccinated themselves.
We don’t know who those 3 percent are, but they are indirectly protected if theyre not exposed by everyone else, Dr. Orenstein says. But when children without real contraindications or severe enough precautions for vaccination dont get vaccinated, that herd immunity is put in jeopardy.
This story is part of a larger package called Vaccines Save Lives. You can find the rest of the package here.
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Are Nhs Staff Selfish For Not Having The Vaccination
England’s top doctor said flu was a “double whammy” for the NHS, increasing the number of patients and putting staff out of action.
He said a third of people with the virus do not know they are carrying it so staff may not be aware they are putting patients, colleagues and their own families at risk.
In 2011, the then chief medical officer in England, Dame Sally Davies, criticised those who did not get the jab, describing them as “selfish”.
BBC Scotland spoke to a number of doctors and nurses who said many believe the flu vaccine was “ineffective”.
One GP, who wished to remain anonymous, said: “When flu changes to a new strain, the old vaccine no longer works.
“The evidence is conflicted on the benefits. The current epidemic still happened despite the vaccination programme.”
Carl Heneghan, professor of evidence-based medicine at the University of Oxford, agrees that take up is low because the evidence of its effectiveness is “uncertain”.
Prof Heneghan, who is also an out-of-hours GP, told BBC Scotland there was little good evidence on the benefits of giving the vaccination to healthy individuals in the NHS.
He said: “When the evidence is strong and makes a difference to patient care, health workers can be counted on to do the right thing.”
However, the professor said not all vaccines were equal and others such as the measles jab had clear evidence of their effectiveness.
He said the same evidence could not be claimed for the flu vaccination.
Myth #: You Dont Need A Flu Shot Every Year
Sometimes patients get the flu shot in February then come into my office in September and say they dont need another vaccine because they got it in February, Lopez says. I tell them this is a different flu season, so they need it again.
In these cases, people are assuming that their bodies will still have enough immune protection to carry them through another flu season unscathed. However, even when the influenza strains targeted by a new vaccine are the same as those included in the previous seasons shot, immune protection declines over time. Whatever defense you have leftover from last flu season may not be enough to stop you from getting sick this go-around.
When we look at individuals who get the flu shot every year versus those who skip years, there is proof that it is beneficial to get vaccinated every single year, Lopez says.
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Children And The Flu Vaccination
If you have a child over 6 months of age who has one of the conditions listed above, they should have a flu vaccination. All these children are more likely to become severely ill if they catch flu, and it could make their existing condition worse.
Talk to your GP about your child having the flu vaccination before the flu season starts.
The flu vaccine does not work well in babies under 6 months of age so it is not recommended. This is why it is so important that pregnant women have the vaccination they will pass on some immunity to their baby that will protect them during the early months of their life.
Some other groups of children and young people are also being offered the flu vaccination. This is to help protect them against the disease and help reduce its spread both to other children, including their brothers or sisters, and, of course, their parents and grandparents. This will help you to avoid the need to take time off work because of flu or to look after your children with flu.
The children being offered the vaccine this year, are:
- all children aged 2 or 3 years old on 31 August 2021
- all primary school-aged children
- all year 7 to year 11 secondary school-aged children
- children with a health condition that puts them at greater risk from flu
For more information on children and flu vaccination, visit NHS.UK.
Children Who Shouldnt Get The Nasal Spray Vaccine
Your child shouldn’t get the vaccine as a nasal spray if they:
- have a severely weakened immune system due to certain conditions or medical treatments, ask your GP for advice
- had a severe reaction to a previous dose of the vaccine, or any of the substances included in it, tell the person giving the vaccine about any allergies
- take salicylates including acetylsalicylic acid
- have a history of active wheezing at the time of vaccination
- have severe asthma
If you have a severely weakened immune system and need treatment in an isolation unit, you should avoid close contact with vaccinated children for two weeks. There is a low risk that a child could pass the vaccine virus to you.
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Summary Of Those Who Are Recommended To Have The Flu Vaccine
They include:
- everyone aged 65 and over
- everyone under 65 years of age who has a medical condition listed above, including children andbabies over 6 months of age
- all pregnant women, at any stage of pregnancy
- all 2 and 3 year old children
- all children in primary school
- all Year 7 to Year 11 secondary school-aged children
- everyone living in a residential or nursing home
- everyone who cares for an older or disabled person
- all frontline health and social care workers
Those aged 50 to 64 years old will also be offered flu vaccination this year.
For advice and information about the flu vaccination, speak to your GP, practice nurse, pharmacist or school immunisation team.
It is best to have the flu vaccination in the autumn or early winter before any outbreaks of flu. Remember that youneed it every year, so dont assume you are protected because you had one last year.
Check NHS.UK to find out if you are eligible.
Vaccine Support From Religious Groups
One study of vaccine-preventable disease outbreaks among religious groups found that “while the church was the common link among cases, there was no formal advice regarding vaccination from the church before the outbreak. Instead, vaccine refusal was attributed to a combination of personal religious beliefs and safety concerns among a subgroup of church members.”
Most religions offer no formal advice regarding vaccination. Rather, many religions have clear positions in support of vaccination including:
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Flu Shots Religious Beliefs And Employee Rights: Navigating The Complex Intersection
Can a health care provider force all employees to get flu shots, even over an individual’s religious or medical objection? Generally, the answer is no. But employers should review their rights and their employees’ rights to successfully navigate such issues.
Title VII of the Civil Rights Act of 1964 prohibits employers from discriminating against employees on the basis of their religion. Employers must accommodate religious observances and practices, absent undue hardship. Their duty to evaluate accommodation requests is often triggered when an employee has a sincere religious belief that conflicts with a mandatory flu vaccination policy.
The Equal Employment Opportunity Commission uses a very broad definition of “religion.” It includes not only organized religions but also religious beliefs that are “new, uncommon, not part of formal church or sect, only subscribed to by a small number of people or that seem illogical or unreasonable to others,” as well as non-theistic moral or ethical beliefs. Believe it or not, a federal court recently confirmed that veganism, in some circumstances, can constitute a religious belief that could exempt an employee from a flu shot requirement. So, an employee’s refusal to get a flu shot may not be based on religion at first glance, but the courts might view it that way. Employers should, therefore, ordinarily assume that an employee’s request for religious accommodation is based on a sincerely held religious belief.
When Medical Exemptions Are Misused
Now were at the part where medical exemptions get really controversial. The concern is whether the term medical exemption is being abused, Dr. Orenstein says. This is mainly a concern in states where it’s easy to get a medical exemption but hard or even illegal to get a nonmedical one. In those states some doctors will write medical exemptions for children that aren’t actually necessary, which can drive down the overall rates of vaccinated children in those areas.
Exemptions for people with objections to immunization based on sincerely held religious beliefs are currently available in 45 states and exemptions based on personal, moral, or philosophical beliefs exist in 15 states, according to the National Conference of State Legislatures . As with medical exemptions, the ease of getting nonmedical exemptions differs among states. For example, in some states the parent has to get a religious leader or state official to vouch for their exemption or visit the health department, per a 2017 study published in Open Forum Infectious Diseases that Omer coauthored.
The distinction between medical and nonmedical exemptions matters because were seeing a clear trend in states taking action to cut down on nonmedical exemptions, with Washington, Maine, and New York all removing personal and/or religious belief exemptions for some or all vaccines this year alone.
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Im Healthy So I Dont Need A Flu Vaccine
It is true that certain groups of patientsthose who are pregnant, young children, seniors and patients with chronic conditions such as heart disease, diabetes or asthmaare at higher risk of severe complications from flu infection. But the flu is a contagious disease that can lead to other serious illnesses, such as pneumonia.
Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults, notes the Centers for Disease Control and Prevention notes. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.
I Hate Getting Injections
While needles are no fun, a trip to the hospital or a couple of weeks in bed are no picnic either. And as already stated, it can be even worse than that. Any little discomfort that you may feel from the flu shot is nothing compared to the suffering caused by influenza, the CDC says.
The flu can make you sick for several days, send you to the hospital or worse. For those who do not like shots, the nasal spray flu vaccine may be a good alternative.
This season, getting a flu vaccine has the added benefit of reducing the overall burden on the health care system and saving medical resources for care of COVID-19 patients, says the CDC. If you havent gotten your flu vaccine yet, get vaccinated now.
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The Flu Vaccine Isnt Safe And Can Give Me The Flu
Flu vaccines are safe, as shown by more than 50 years of research and experience among hundreds of millions of Americans who have been immunized against influenza. There are some common side effects, such as swelling or redness from the shot, muscle aches, fever and nausea. But those should not be mistaken for influenza, which sends between 140,000 and 810,000 Americans to the hospital annually since 2010, according to the CDC.
Flu vaccines cannot cause flu illness. Flu vaccines given with a needle are made with either inactivated viruses, or with only a single protein from the flu virus. The nasal spray vaccine contains live viruses that are attenuated, or weakened, so that they will not cause illness. However, you may still catch a non-flu virus. Non-flu cold viruses cannot be prevented by an influenza vaccine. And since it takes two weeks for the protective effects of the flu vaccination to kick in, you can still catch the flu during that time period.
Ill Wait Until Flu Hits My Area
As mentioned above, it takes two weeks after flu vaccination for your body to develop the antibodies that protect you against influenza. Because of that, trying to time your vaccination to when the flu starts to circulate in your community is no simple task.
It is important to note, though, that if you have not been vaccinated by the end of November, it can still be protective to get the flu vaccine. This is because the flu is unpredictable and has varying seasons, typically peaking between December and March, but occurring as late as May, says the CDC.
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Common Reasons For Refusing Vaccines
The Centers for Disease Control and Prevention reported that between January 1 and May 23 of this year, there were 288 cases of measles reported in the US. Thats more than the total number of cases in any year since 2000, when measles was eliminated in the U.S..
We have got to get more people immunized.
Essentially all of the cases were linked to importations, cases brought in from other countries were measles is common. Most of the cases were in people who werent immunized. Of the 195 U.S. residents who caught measles and werent immunized, 85% chose not to be immunized as opposed to being too young or having a medical reason that prevented getting the vaccine.
It got me thinking about the families I see who choose not to immunize their children. While I think that vaccines are a great idea and have immunized my children, I respect every familys right to make the medical decisions that they think best for their children. And while I think that the recommended vaccine schedule is safe, I am always willing to work with families if they really want to do something different. Better to have some vaccinations, or vaccinations on a different schedule, than none at all.
But when I read about the resurgence of vaccine-preventable diseases like measles, polio or pertussis, I worry and wish that there wasnt so much fear about vaccines. Here are the most common reasons I hear for refusing or delaying vaccines:
How Do Vaccine Exemptions Affect Disease Outbreaks
Overall, vaccination rates in the United States have stayed high. More than 90% of children are vaccinated against measles, mumps, rubella, polio, and chickenpox.
Yet some small communities around the country have high numbers of unvaccinated children. When someone who is sick comes into one of these areas, outbreaks can happen.
One example is measles. The United States wiped out measles in 2000, but people still bring it into the country when they travel to Europe, Israel, or other regions of the world that have outbreaks.
“Typically, the outbreak starts among vaccine refusers,” says Daniel Salmon, PhD, professor and director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. “Then it spreads to kids who are too young to be vaccinated or who can’t get vaccinated for medical reasons. It also spreads to what we call vaccine failures — kids who have been vaccinated but the vaccine didn’t work for them.”
States that make it easy to get nonmedical exemptions have more exemptions, and higher rates of vaccine-preventable diseases, than states with tougher laws, research finds. States that offer personal exemptions have more than twice the rate of whooping cough as those that only allow religious exemptions.
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Other Vaccination Issues For Employers
How should we deal with disputes between colleagues over vaccination?
This could become a tricky area for HR professionals in future. For instance, there could be situations in which employees are uncomfortable working alongside other colleagues who have decided not to get vaccinated, and make their discomfort known. Or employees may spread misinformation about the vaccine and encourage colleagues not to get vaccinated.
These situations could become especially fraught if they involve characteristics that are protected under the EqA – for example, if an employee is inappropriately grilled on how their decision about vaccination fits with their beliefs, or if an employee with a vulnerable disabled child at home accuses colleagues of being irresponsible for not taking up the vaccine. As with other issues around clashes of rights in the workplace, this would require careful handling. Employers may need to remind employees to be sensitive and aware of the diversity of opinion that is likely to exist within the workplace.
Can we be liable for serious or long-term side effects of vaccination?
This may be a concern for employers who are mandating the vaccine or, in future, providing the vaccine . Such employers are unlikely to face liability for long-term or serious side effects of an approved vaccine unless they could somehow be found to have acted negligently. Employers typically provide flu jabs without these concerns arising.