2009 News

Health care workers taking a pass on H1N1 vaccinations | NECN

09.30.2009

(NECN: Ally Donnelly, Boston, Mass.) - In Boston’s Longwood Medical area health care workers hustle between buildings. Caring for the weakest among us -- some say they have *no* time to get sick themselves.

But Alfred Tennyson -- who works at Brigham and Women's hospital -- is in the minority. According to the Centers for Disease Control more than half of all health care workers don't get the seasonal flu shot -- and many we talked to don't plan to be vaccinated against the H1N1 or so called swine flu, like Tennyson's colleague Leon Dunn a phlebotomist at the Brigham.

Leon Dun, BWH, phlebotomist: I don't believe in getting vaccinated. Personally, I feel my immune system is strong enough to handle something like that.

We aren't singling out the Brigham. Healthcare workers from many of Boston’s teaching hospitals -- Beth Israel, Mass General, Dana Farber cancer institute, Boston Medical Center --- gave us similar responses.

Their reasons vary -- from not liking needles to fear of possible side effects from a new vaccine.

Many we talked to are not doctors and nurses, and said because they have limited interaction with patients they're not as concerned. Their job descriptions? Repairing surgical instruments, secretaries on patient floors, blood bank workers.

Dr. Sean Palfrey is a pediatrician at Boston Medical Center and one of several doctors working to spread the word about vaccination. He says everyone working in a hospital --

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from cafeteria workers to housekeeping staff --- can pose a risk to patients often already weakened by infection.

Palfrey: It's communicated by sneezing, by coughs, by touching, by breathing and as you do your work, you could give it to a person or get the germs on surfaces or tools that will be in contact with people at risk.

John Suerbach is the director of the Massachusetts Department of Public Health -- he says it's critical to get health care workers vaccinated not only to keep patients healthy and alive, but to have a strong healthcare force for what is expected to be a less deadly but viciously contagious flu season.

That said he will not follow the lead of New York state which is making it mandatory for health care workers to be vaccinated -- they can either get the shot or stay home.

This month the Massachusetts DPH mandated that all healthcare centers offer the swine flu vaccination to workers, but doesn't make it a condition of employment. At the suggestion of the DPH, the majority of Bay State hospitals are asking employees to sign a form, saying they've either been immunized or decline to be immunized, but understand the benefits...and risks. Auerbach says it's not a shaming tool, but hopes it will encourage personal responsibility.

In order to work in a Massachusetts health care facility, employees already have to prove they've gotten a number of immunizations -- measles, mumps, polio -- why not add flu to the list?

Palfrey: There's a lot of question whether the law should be the defining way that we say you have to be injected, protected, cared for.

So if the majority of the people who should presumably "know better"...aren't getting vaccinated against swine flu. How invested should we be? And experts say ask 10 different people what their doctors are telling them to do and ---you'll likely --- get 10 different answers.

Doctor Steven Flier is a primary care physician in Newton and an associate professor at Harvard Medical School. He says from a public health perspective it's easy to push for broad vaccination -- especially for those groups at greatest risk for this particular flu like children, pregnant women and others with compromised immune systems, but it's a much more complicated decision on an individual basis.

Flier: Many people have to weigh...what are the uncertainties of the vaccine and what are the benefits to me personally?

Flier who got the seasonal flu shot and does plan on getting vaccinated against swine flu says he understands patients concerns about a new vaccine.

Flier: This particular preparation has not been tested in very large numbers of people. The tests have been done on the hundreds of thousands of patients, but not on hundreds of thousands or millions and we expect to immunize millions of people so rare complications, rarer side effects aren't expected to show up until there are very broad immunization experiences.

The FDA recently approved the swine flu vaccine, and Palfrey says the flu typically moves from the west coast, through the south and then east.

Palfrey: By the time the vaccine is given to people in New Eengland we are going to have seen how well it's going to be responded to, reacted to by thousands probably millions of people.

When a strain of swine flu presented in the 1970s, there were reports of Guillain Barre Symdrome -- a paralyzing neuromuscular disorder that affected a small number of people who got that particular swine flu vaccine. A link was never definitively proved or disproved.

Flier: What if there is a bad reaction down the road? Well, I think we need to keep attuned to information and learn as we go along.

Palfrey: Part of our message is that this is a new vaccine just the way every flu vaccine is a new vaccine, however it's made in exactly the same way with the same controls, the same tests and that there's no reason to worry.

But will there be enough vaccine? Health officials, say yes, eventually. Auerbach estimates that there are two and a half to 3 million people in the highest risk categories living in Massachusetts.

Auerback says by late November/early December there will be enough for everyone, but experts warn swine flu could hit New England hard in the next six weeks or so.

Auerbach: We're going to have to be very careful about targeting the distribution of the vaccine until we have sufficient numbers.

Auerbach says they will likely give the first vaccines to obstetricians and pediatricians -- no one knows why, but this swine flu is hitting children hardest -- particularly kids under five.

Palfrey: They have smaller bodies, their immune systems may not be as strong, they may not be able to clear secretions as well.

Public health officials say we will have to work together in an unprecedented way to keep each other healthy. They call it herd immunity -- daycare workers, teachers, parents...getting immunized, and until enough vaccine is available everyone else using good health hygiene, staying home from work or school when sick and not crowding hospital ERs. ERs that could be hit themselves with a healthcare corps home with the flu.

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