Health Impact News Editor Comments:
All across the U.S. hospitals are increasingly implementing mandatory policies to force their employees to receive the annual influenza vaccination as a condition of employment. In some cases, refusal results in termination of employment. In many other cases, anyone refusing to receive the mandatory flu vaccine is required to wear a mask over their face during the entire flu season, usually from the beginning of November until the end of March.
As we have recently reported, nurses across the U.S. are refusing the flu vaccine and choosing instead to wear masks (see: Nurses Across the U.S. are Taking a Stand Against Forced Flu Vaccines ). Many have reported that they have faced intimidation and harassment by co-workers and doctors for refusing the flu vaccine. The decision of whether or not to receive the vaccine is obvious to anyone who sees them wearing a mask all day long.
While the reasons given for these mandatory policies are always that they are for the “safety of the patients,” the truth is that with the implementation of the Affordable Care Act (Obamacare), healthcare facilities can now lose some of their federal reimbursements from Medicare and Medicaid if their facility does not comply with a 90% vaccination rate for the annual flu vaccine. In addition to this new mandatory policy, a recent study conducted by the CDC found that vaccination of healthcare workers with the flu vaccine did not reduce lab-confirmed cases of the flu among their patients (see: CDC Study: Mandatory Flu Vaccinations of Health Care Workers Offer NO Protection to Patients ).
A doctor in Los Angeles recently reported that LA County has implemented a county-wide requirement that all healthcare workers in LA County must be vaccinated with the flu vaccine or wear a mask. She correctly points out that this government mandate violates the HIPAA privacy law. Dr. Sibert, it should be noted, is not anti-vaccine, but pro-vaccine.
No HIPAA for us in healthcare
We guard the privacy of patients in my hospital zealously—we take care of a lot of celebrities since we’re right in the shadow of Beverly Hills. And of course we live in terror of HIPAA violations, those federally mandated HHS rules that protect individually identifiable healthcare information and could bring down “civil money penalties” upon us if we don’t keep our patients’ medical records strictly confidential.
But for healthcare workers—physicians, nurses, technicians, even medical supply vendors—in LA County, the usual privacy rules don’t apply any more. Now everybody gets to know at least some of our medical history: whether or not we’ve been vaccinated against influenza.
How will anyone know whether or not I’ve had this year’s flu vaccine? Because policy dictates that I must publicly say so, whether I want to “out” that information or not.
As of October 2013, all healthcare workers in Los Angeles County must be vaccinated against influenza or wear a protective mask any time they might have contact with patients or stray into patient care areas. This is an order that came down by fiat from Dr. Jonathan Fielding, the Director of the LA County Department of Public Health, and now applies in LA County to every hospital and care facility.
You might think that sounds like a reasonable idea. After all, the flu is a dangerous disease that may even lead to death. My personal choice is to take the flu vaccine every year, in the hope that I’ll make it through another winter without the high fever, bone-rattling chills, racking cough, and other miserable symptoms that characterize classic flu.
But I choose to take the flu vaccine realizing that the vaccine won’t necessarily protect me against all the different strains of the flu virus, and knowing too that I could suffer severe side effects. Those side effects can range from mild fever and chills to a potentially devastating condition called Guillain-Barré syndrome, which causes muscle weakness and even paralysis, and may leave its victims with permanent nerve damage.
I’ve always agreed with the general recommendation that people who work in healthcare should be vaccinated against the flu, but that still needs to be a personal decision, not a government mandate. Each person has individual responsibility to make decisions about safety issues of all kinds–whether or not to smoke, to eat that second piece of cake, to get the tires checked on the car before the road trip. While we acknowledge that bad decisions may put others at risk to a greater or lesser degree, in America we still believe that personal decisions are just that: personal.
Not in LA County, however. In other southern California counties, healthcare personnel may still decide whether the risks of the flu vaccine outweigh the potential benefits, and keep that decision to themselves with the same right to medical privacy that everyone else has. But in LA County, you either get the vaccine or wear a mask, even if you’re perfectly healthy and haven’t got the slightest symptom of the flu. Because that’s what Dr. Fielding has ordered.
Let me point out the obvious flaws in this system. If I should become ill with a strain of influenza that hasn’t been covered by this year’s vaccine, since I’ve been vaccinated I don’t have to wear a mask though I could be quite contagious for at least a day before I develop overt symptoms. No hospital (to my knowledge) is requiring patients’ visitors and families to provide evidence of flu vaccination or wear masks, though they go in and out of patient care areas at will. If we are really to be logical and scientific about flu transmission, either we all should wear masks or none of us should bother.
Many of us in clinical healthcare have good reason to resent the obvious HIPAA violation that is taking place when healthcare workers are required to divulge whether or not they’ve been vaccinated against this year’s most likely influenza strains. Apparently, HIPAA only applies to some patients, not to all. Patient privacy, it seems, only matters when the government wants it to, and confidentiality doesn’t extend to those of us who come to work every day to take care of our patients.
Source: aPennedPoint  – The observations of Karen Sullivan Sibert, MD a Los Angeles anesthesiologist, writer, and mother.
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