Each year, doctors and nurses tell their patients to get flu shots.
They often don’t follow their own advice.
Now, with swine flu already officially declared a pandemic, the Washington State Hospital Association is considering asking the state Department of Health to require every hospital employee to get flu shots to help stem the outbreak — a step some states already have taken.
That idea is already being opposed by the Service Employees International Union, which represents nurses and nonmedical hospital employees.
The union objects to the state forcing employees into a personal health decision. “We don’t support mandatory vaccinations,” said Chris Barton, secretary/treasurer of Local 1199 Northwest. And neither, she notes, do federal health agencies.
The Washington State Nurses Association, a professional organization, does not support individual hospitals making vaccinations mandatory for employees, said Anne Tan Piazza, the group’s spokeswoman.
The debate over just what steps medical workers should be required to take to prevent the spread of swine flu comes at a time when the virus is spreading rapidly in many states across the nation, including Washington, according to the federal Centers for Disease Control and Prevention. Nearly 600 people in the U.S. have died from swine flu, including 49 children.
This has state and local health departments trying to persuade people in the high-risk groups to get the swine flu vaccine. In Snohomish County, public health officials are planning to immunize up to 100,000 people as soon as the shot becomes available.
Yet concern over many types of immunizations is growing, in some cases led by Hollywood celebrities who claim shots are more dangerous than the diseases they prevent.
At the same time, some people even hold play dates in order to expose their children to viruses, such as chicken pox and swine flu, in hopes that the immunity will be gained by boys and girls actually contracting the illnesses.
Some of the concern is about the minute amount of mercury used in vaccines, which at a certain level is toxic.
Not only hospital workers, but any medical employee should be the vanguard in getting vaccinated to limit the spread of the swine flu virus, said Dr. Yuan-Po Tu, who monitors influenza issues for The Everett Clinic.
“I think it’s a moral and professional responsibility to protect your patients,” he said, part of an overall plan that includes using appropriate sterile and germ-fighting techniques. “They’re ill; you certainly don’t want to impart an illness on them.”
He has never understood why medical workers don’t routinely get the influenza shot. They may simply tell themselves — just as anyone else does — “I never get sick; I never get the flu,” he said.
But influenza can be spread before its symptoms — high fever, chills and aches — set in. “With people with heart disease or asthma, you could potentially land those cases in the hospital or in the worst case, they could end up dying,” he said.
Although vaccination rates vary from hospital to hospital, rates at local hospitals range from 50 percent at Valley General Hospital in Monroe to 84 percent at Cascade Valley Hospital in Arlington.
Nationally, the number of hospital workers who get annual flu shots is about 45 percent to 50 percent.
“It’s terrible, abysmal,” said Cassie Sauer of the Washington State Hospital Association, which has more than 100 members, including all four hospitals in Snohomish County.
Washington isn’t the first to consider taking the step. Earlier this year, New York’s health department decided it would require health care workers in that state to get flu shots. California requires hospital workers to be vaccinated or sign a statement declining it.
North Carolina, Rhode Island and Massachusetts are among the states considering similar measures, Sauer said.
In part, that’s because studies have shown immunized health care workers get sick less and don’t pass on the virus, so fewer patients become sick or die from the flu.
The hospital association thinks it would be good policy, and believes the state Department of Health has the authority to require hospital employees to get the shot, Sauer said.
But if the state agency disagrees, the hospital association may push for state legislation that would give the Department of Health that power, she said.
The proposed requirement would apply to any type of flu shot, whether it’s seasonal flu, swine flu this year or bird flu in the future.
The proposal is being reviewed by the state Department of Health.
But at first glance, it appears the state does not give the department that kind of authority, spokesman Donn Moyer said Tuesday.
Every state is different, he said. In Washington, local health officers have a lot of independent authority. “The state has almost no authority over local health agencies,” he said.
“On top of that, we’re not sure that’s the best strategy,” Moyer said. “Mandatory — that’s pretty big.”
Masks are what the SEIU’s Barton would like to see more of, instead of a “mandatory, punitive approach” of requiring vaccines. She would like to see more widespread use in health care settings of special tight-fitting N-95 masks that are far more effective in stopping the spread of the virus than traditional paper masks.
And persuasion can work, too, she said.
Health care organizations that have launched education campaigns on the flu vaccine’s effectiveness and made the shot easily available have seen the number of employees getting the shot rise to as much as 80 percent to 90 percent, Barton said.
The nurses association’s objections involve privacy rights.
Workers must have the right to decline the shots without divulging personal health care information that would explain why they don’t want the shot, Piazza said.
“We believe the protection has to be broader than hospitals. We don’t have bubbles around hospitals, and must include all health care settings and all health care workers,” she said.
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