Many health workers refuse flu shots

(OTTAWA CITZEN) – Many incentives have been tried in hopes of persuading Ottawa hospital workers and others on the front lines to get seasonal flu vaccines – chocolate bars, lottery tickets and free lunches – but the numbers who roll up the sleeves of their uniforms stay stubbornly around 50 per cent.

This has public health experts worried and wondering what tack to take this year. Vaccinating Ottawa’s health workers to protect patients and also keep hospitals and clinics running is the cornerstone of plans for coping with the H1N1 virus. After all, if doctors, nurses and other health-care workers fall sick at the peak of the pandemic, it could hobble the local health-care system.

Yet many strategies to encourage vaccination have failed. And making shots mandatory will meet with huge resistance, it’s predicted.

Ontario paramedics in 2002, for example, threatened to walk off the job en masse if forced to get the seasonal flu vaccine.

Health officials have said H1N1 flu shots will not be mandatory, but that has not been the case across the border. New York, which was the first state to be hard-hit by swine flu, is requiring all health workers to get immunized against both seasonal flu and H1N1 flu.

‘If there is an attempt to make it mandatory I think you would see civil disobedience,’ said Michael Hurley, president of the Ontario Council of Hospital Unions, which represents 20,000 hospital workers.

Yet, what if anything will persuade half of health-care workers to get vaccinated? Many interviewed revealed a deep-seated reluctance to be vaccinated that stems from their own concerns about vaccine safety, questions about whether or not the flu really is a serious risk, balanced with their own obligation to protect patients they come in contact with.

Mr. Hurley said the hospital employees he represents – 85 per cent of whom are women – need to understand the safety profile of vaccines, how thoroughly it’s been tested, particularly on pregnant women, and the studies that show illness and mortality rates are reduced among hospital patients.

Linda O’Regan, a respiratory therapist at the Ottawa Hospital and union official with Local 464 of the Ontario Public Service Employees Union, says her union – which represents 2,300 hospital workers – and the Ottawa Hospital have tried to encourage seasonal flu vaccination.

Last year employees could win a free lunch if their department succeeded in having the most employees vaccinated. O’Regan said the hospital hoped to increase vaccination from about 40 per cent to 80 per cent.

‘It only went up to about 50 per cent. It was really disappointing,’ she said. Her local represents radiation therapists, respiratory therapists, radiology technologists, pharmacists, audiologists and social workers, among others.

The various unions at the hospital have also tried to encourage seasonal flu vaccination programs by running publicity campaigns featuring union officials getting the flu shot. That didn’t have much impact, either, she said.

O’Regan said it’s OPSEU’s position to encourage vaccination, but also supports a worker’s right to say ‘No.’

‘If they refuse, their employer also has the right to tell unvaccinated workers not to come to work. Or the hospital can find them work on a ward where there is no outbreak.’ Those workers who are sent home can opt to take Tamiflu and after two days – when its effects kick in – return to work, she said.

‘If everyone starts to get sick and it breaks into a pandemic situation they are going to need as many employees as possible reporting to work,’ she said. ‘If you take away the 50 per cent of the people who aren’t vaccinated, who are they going to have left?’

Concerns about vaccine safety among health-care workers have long stymied public health officials.

‘We can’t get good uptake among health-care professionals for the standard flu vaccine, which has a long safety record behind it,’ says Dr. Kumanan Wilson, Canada Research Chair in public health policy based at The Ottawa Hospital Research Institute. ‘In the hospital they will come around and offer you a lottery ticket and a chocolate bar if you get the flu shot, and they have the cart right there. A lot of people said no.’

Wilson worries that hospital workers will spread the virus before they are vaccinated. ‘If the health-care worker is the carrier they may have already spread it. We want them vaccinated up front prior to all of this …’

He said making vaccines mandatory is controversial and not popular.

In 2002, the issue of vaccination for seasonal flu became a contentious issue between the provincial government and its health-care workers. Ontario’s 5,000 paramedics fought to have a mandatory flu vaccine removed from the Ambulance Act. The Canadian Union of Public Employees (CUPE) launched a legal challenge on behalf of 50 paramedics who were suspended after they refused to comply with the mandatory flu shot. The clause in the Ambulance Act was eventually amended.

In another case, Ontario labour board arbitrators ruled that a forced flu shot infringed on an employees’ privacy rights and that the express consent of the worker is required.

Linda Haslam-Stroud, president of the Ontario Nurses Association, said there is some resistance to the vaccine among the 54,000 nurses she represents because they have seen some of their colleagues get serious side effects.

GlaxoSmithKline announced Monday that its pandemic vaccine induced a strong immune response after the first dose in a trial involving 130 volunteers, aged 18 to 60. When asked whether any adverse events had been reported in their pandemic vaccine trials, a spokesperson for GlaxoSmithKline responded, ‘We have no information at this time regarding adverse events related to this ongoing clinical trial.’