Workplace Flu Vaccination Requirements And The Ada
From the desk of Tracie DeFreitas, M.S., Principal Consultant ADA Specialist
Its that stuffy head, fever, sore throat, coughing, body aching, kind of season flu season. While the influenza virus is active all year-round, October trends as the month that marks an impending flu season. With a barrage of public service reminders to get vaccinated, many people are in the midst of deciding whether to get the shot, or not. The Centers for Disease Control recommends annual vaccination as the best way to protect against the flu, but sometimes people either choose not to be vaccinated, for personal or religious reasons, or cannot be vaccinated for health-related reasons. As it pertains to health-related reasons, according to the CDC, people with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine , people who have had Guillain-Barré Syndrome, and people who are not feeling well, should not be vaccinated for the flu. Also, those who are pregnant, have experienced a severe allergic reaction to the vaccine in the past, and some people with certain medical impairments cannot receive the live attenuated nasal spray flu vaccine.
When immunization for the flu is not recommended, due to health-related reasons, it may be necessary to approve alternative infection control practices as a form of accommodation, if effective and reasonable. Accommodations will vary, but possible solutions might include:
When Did Mandatory Vaccinations Become Common
Cristina Valldejuli, a graduate of theUniversity of Iowa, is an HNN intern.
Herbal panaceas, special cloths, strictdiets, cool drinks, eschewing fireplaces, and the edict that apatients bedclothes be no higher than the patients waistthesewere the prescriptions of the pre-inoculation era when someonecontracted smallpox.For centuries pandemic diseases devastated much of mankind. Hardlymore than a century ago, 20% of children fell to disease before theage of five, a staggering 20% more died before entering intoadolescence, survivors finding little recourse in adulthood from thescourges of the agediphtheria, yellow fever, small pox, measles,pertussis, and a deadly handful of others.It was in such a dire period that the first federal health mandateswere made and bore the political origins of compulsory vaccination.
Astring of yellow fever outbreaks erupted between 1793 and 1798,taking thousands of lives and leaving the nation dizzy with loss.Shortly after the outbreaks, John Adams signed and established thefirst federal quarantine law against the recurrent epidemics ofyellow fever. Accordingto Carleton B. Chapman, an MD, the Federal Quarantine Proposal of1796 met virtually no opposition.
Since its inception compulsory publichealth laws have generated skepticism and resistance. Today, recentmeasles outbreaks176affected from January 1rst to March 13th, 2015have revitalizeda long-lived debate and precipitated discussion about new approachesto public education.
Can A Flu Shot Wear Off If You Get It Too Early Perhaps Scientists Say
But the methodology of the studies produced results that dont stand up to scrutiny, the authors of the new paper said.
None of the studies were conducted in hospitals all took place in long-term care facilities. One the studies, from Britain, calculated that one influenza death would be averted for every eight staff members vaccinated.
But if that were correct, vaccinating the estimated 1.7 million health care workers employed in long-term care in the United States should prevent 212,500 flu deaths a year among residents. Theres an obvious problem though, the paper noted. Nowhere near that many people die from flu in the US.
The Centers for Disease Control and Prevention estimates there are between 3,000 and 49,000 flu deaths a year in this country, including people of all ages. The death toll varies depending on which strain of flu is causing the most illness and how well-matched the strains in the vaccine are to the viruses making people sick.
If the calculation is applied to the 5.5 million hospital workers, mandatory flu shots should avert 687,500 deaths each year more than the number of Americans who died in the 1918 Spanish flu, estimated to be 675,000. The Spanish flu was the worst influenza pandemic in known history.
Do we have scientific data supporting that? I think the bottom line of our paper is to say there is no valid scientific evidence, even now, underpinning enforced health care worker immunizations, De Serres told STAT.
Not flu deaths. All deaths.
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Rapid Response To Pandemic Flu
The rapid development, production, and distribution of pandemic influenza vaccines could potentially save millions of lives during an influenza pandemic. Due to the short time frame between identification of a pandemic strain and need for vaccination, researchers are looking at novel technologies for vaccine production that could provide better “real-time” access and be produced more affordably, thereby increasing access for people living in low- and moderate-income countries, where an influenza pandemic may likely originate, such as live attenuated technology and recombinant technologies . As of July 2009, more than seventy known clinical trials have been completed or are ongoing for pandemic influenza vaccines. In September 2009, the FDA approved four vaccines against the 2009 H1N1 influenza virus , and expected the initial vaccine lots to be available within the following month.
In January 2020, the US Food and Drug Administration approved Audenz as a vaccine for the H5N1 flu virus. Audenz is a vaccine indicated for active immunization for the prevention of disease caused by the influenza A virus H5N1 subtype contained in the vaccine. Audenz is approved for use in persons six months of age and older at increased risk of exposure to the influenza A virus H5N1 subtype contained in the vaccine.
First Hospital To Mandate Flu Vaccination Reports On Challenges Success
Given perennially low flu vaccine uptake in healthcare providers, more infection control officials are eyeing mandatory vaccination to raise coverage rates. Seasonal flu vaccination rates typically hover around 44% for healthcare workers, and facilities that have made intensive efforts to boost rates beyond that have had only modest success.
Last year New York became the first state in the nation to mandate flu vaccination for healthcare workers, but it rescinded its policy at the start of the flu season because at that time the pandemic H1N1 vaccine was in short supply. The state’s law also faced legal challenges from unions.
Virginia Mason’s vaccination mandate, launched during the 2005-06 flu season, affected 5,000 employees. The new report on the first 5 years of the policy appears in the September issue of Infection Control and Hospital Epidemiology.
In the 2003-04 flu season, which was 2 years before Virginia Mason adopted its policy, about 54% of healthcare workers were immunized. After the first year of the requirement the rate rose to 97.6%, and it reached 98.9% in the 2009-10 season.
The researchers detailed the steps the facility took to adopt its mandatory flu vaccine policy, which started gaining momentum after a workshop on improving flu vaccine coverage in employees. Virginia Mason’s board of trustees approved the step, and hospital administrators set up a multidisciplinary task force to lead and implement the new policy.
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Occupational Safety And Health Administration
OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA’s interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA’s website at .
Aged Care Worker Walks Out After Flu Vaccine Becomes Mandatory
Registered nurse Anki Groening, of Bega, has chosen to leave her profession rather than receive an annual flu vaccination. Photo: Supplied.
Did you know that from 1 May 2020, its mandatory for all aged care workers and visitors to an aged care facility in Australia to have received the flu vaccine?
Along with continuing to respond to the spread of COVID-19, the Federal Governments response to the flu this year has been early and hefty, with $80 million invested in providing a record 16.5 million free flu shots to Australians.
While flu vaccination does not prevent COVID-19, both influenza and COVID-19 cause serious respiratory illness. The combination of both diseases could be life threatening, said a statement from the Department of Health.
But the hardline approach is costing some workers their jobs and leaving them wondering if making the vaccine mandatory is a knee-jerk reaction to the spread of COVID-19.
Anki Groening, of Bega, has worked as a registered nurse for 10 years, first as a midwife and, for the past three years, in aged care at a Bega facility.
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She says that for her, the risks associated with getting the flu shot every year far outweigh the benefits.
I had a round of vaccinations to get up-to-date when I completed my nursing degree and had an immediate reaction, she explains. I was in bed for six weeks and had unexplained arthritis for two years afterwards.
Again, she was seriously ill.
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Agreeing To Be Vaccinated
Its important that as many health and social care workers as possible get the vaccine it protects you, your family, and the people you care for from the flu but if you dont want to have the vaccine for whatever reason, you dont have to have it.
All frontline health and social care workers who are directly involved in the care of clinically vulnerable patients/clients, and who are at increased risk from exposure to influenza, should receive a vaccination this season. This should be provided by their employer, in order to meet their responsibility to protect their staff and patients and ensure the overall safe running of services. Employers should commission a service which makes access easy to the vaccine for all frontline staff, encourage staff to get vaccinated, and monitor the delivery of their programmes.
Where employee-led occupational health services are not in place, the NHS will continue to support vaccination of social care and hospice workers employed by registered residential or domiciliary care providers, as well as those employed through Direct Payment and/or Personal Health Budgets to deliver domiciliary care to patients and service users. Vaccination will be available through community pharmacy or their registered general practice. This scheme is intended to complement, not replace, any established occupational health schemes that employers have in place to offer flu vaccination to their workforce.
H1n1 Vaccination To Be Required For Us Military
In a news release, Army Lt. Col. Wayne Hachey, the department’s director of preventive medicine, said vaccination will be mandatory for uniformed personnel and will be available to all military family members who want it.
DoD expects to receive 1 million doses of the vaccine in early October and another 1.7 million doses later in the month, the release said.
First in line for the vaccine will be healthcare workers, deploying troops, those serving on ships and submarines, and new recruits, according to DoD.
“Any place where we take a lot of people, squash them all together and get them nice and close and put them under stressful conditions will get the vaccine,” Hachey said.
To distribute the vaccine, he said, the military will use its usual seasonal flu vaccine distribution chain, a system in use for decades.
He noted that a decision is still awaited on whether each person will need one dose or two. “The assumption right now is that people will need two doses, 21 days apart. That may change,” he said. Federal officials are awaiting early results of clinical trials for guidance on the number of doses.
DoD already has seasonal flu vaccine and will begin giving the immunizations soon, Hachey said. “That has been our message to immunizers: to try and get as many people as they can immunized against the season flu early.”
The civilian immunization program for H1N1 is expected to start in mid October.
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Annual Updates To The Immunization Schedule 1995 To 2010
As more vaccines became available, an annual update to the schedule was important because of changes that providers needed to know, such as detailed information about who should receive each vaccine, age of receipt, number of doses, time between doses, or use of combination vaccines. New vaccines were also added.
Important changes to the schedule between 1995 and 2010 included:
- New vaccines: Varicella , rotavirus hepatitis A pneumococcal vaccine
- Additional recommendations for existing vaccines: influenza hepatitis A
- New versions of existing vaccines: acellular pertussis vaccine intranasal influenza
- Discontinuation of vaccine: Oral polio vaccine
2000 | Recommended Vaccines
* Given in combination as DTaP** Given in combination as MMR
Influenza Vaccination Of Persons With A History Of Egg Allergy
Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. The ACIP Guidelines recommend watching these and non-allergic persons for 15 minutes following vaccination to decrease the risk of injury due to syncope. Persons with severe egg allergy should be vaccinated under the supervision of a medical provider who is able to recognize and manage severe allergic conditions.
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A Brief History Of The Flu Vaccine
Every year, three to five million people catch the seasonal flu, according to the World Health Organization , and between 290,000 and 650,000 people die from it worldwide. Still, thanks to the flu vaccine, this is only a fraction of how many people it used to kill. During the last major flu pandemic of 1918-1919, it killed between 50 and 100 million people around the world.
For a long time, scientists had thought that the flu was caused by a bacteria called Haemophilus influenzae, but after the 1918-19 pandemic, they started to suspect it was caused by a virus instead. However, it wouldnt be until the 1930s that they would confirm that. In 1933, three scientists isolated the Influenza A virus in ferrets one of the three types of flu and in 1936, it was discovered that the virus could be grown inside embryonated chicken eggs, a key step towards making a vaccine.
Just two years later, in 1938, Jonas Salk and Thomas Francis developed the first vaccine using fertilized chicken eggs and an inactivated strain of the Influenza A virus.
This new vaccine was first used to help protect soldiers fighting in World War II it wouldnt be approved for civilians until 1946. According to a 1944 study of the new vaccine, it helped reduce illness that was accompanied by a temperature above 99 degrees Fahrenheit.
Know your flu risk. Check out the Flu Tracker on The Weather Channel App.
Two Of Four Flu Vaccines Held Unacceptable For Military Use
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WASHINGTON, July 14Advisers to the Army. Navy and Air Force have concluded the swine influenza vaccine made by two of the four manufacturers is unacceptable for the 2.1 million active duty military employees.
Experts on the Armed Forces Epidemiological Board refused yesterday to endorse the type of flu vaccine manufactured by Wyeth Laboratories and Parke Davis & Company. They said that military personnel could be guaranteed adequte immunity only if inocluated with vaccine produced by the other two manufacturers.
The advisers prescribed dosage and composition of the vaccine to be used in military personnel regardless of problems besetting the civilian part of the program proposed by President Ford.
The problem for the Health. Education and Welfare and Defense Departments is that no experimental vaccine has proved clearly safe end effective in volunteers under the age of 24 or 25. About half of the 2.1 million active duty military personnel are in that age group.
The advisers endorsed the vaccine made by MerrellNational Laboratories and Merck & Company, though the latter produced a substantial rate of side effects in military tests.
The Pentagon, if it accepts this advice, would buy this vactine only from Merrell and Merck.
The military vaccine is designed to safeguard military personnel dispersed around the world, where troops may be exposed to many strains of flu virus.
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Vaccination Mandates And Their Opponents
Mandatory vaccination requirements have become increasingly prevalent as the threat of an H1N1 pandemic has intensified. A number of hospitals across the country, including Childrens Hospital of Philadelphia, Emory Hospital in Atlanta, and all 273 facilities of Hospital Corporation of America, have instituted such rules for their own personnel. Additional facilities may join them.
New York State was the first in the nation to try to mandate vaccination as a matter of law, but the effort proved to be short-lived. The Department of Health issued a rule last August that would have barred workers who declined either seasonal or H1N1 influenza vaccination from assignments involving patient contact in any hospital, outpatient clinic or home-care program. However, a group of nurses sued and obtained a restraining order suspending enforcement. Subsequently, the Department, citing vaccine shortages, withdrew the proposal. It is not clear whether other states will attempt similar measures.
For the most part, unions representing nurses have been vocal in opposing vaccine mandates. Although they generally support voluntary vaccination and strongly encourage their members to comply, they believe that each health care worker should be entitled to make his or her own decision. They point out that all vaccines can pose risks. Even for people without allergies, hazards may lurk in additives, such as thimerosal, a mercury-based preservative used in some vaccines.