Jessica faces a dilemma. As a newly graduated nurse in the state of Victoria she is being pressured by her employer to get an influenza shot. At the moment the flu vaccine is not mandatory but it is only a matter of time until she is forced to submit or lose her job. And after three years of study and laden with considerable university debt she needs her career but the prospect of mandatory vaccines fills her with dread.
Even though there are guidelines and expectations that hospital staff get a flu jab with 83-88 percent of Victorian hospital staff having been vaccinated, the shot has not been mandatory.
However last week the Victorian Government announced it is set to legislate the influenza vaccine for all front line health workers. Health Minister Jenny Mikakos told the media:
It will be mandatory for workers in high-risk areas including intensive care units, neonatal intensive care units and cancer wards to be vaccinated against the flu.
Mikakos added that the Victorian government was ‘looking at legislative change to put this in place.’
Is there evidence that vaccinating hospital workers against the flu protects patients?
According to a study by Z. H Abramson
The evidence base supporting vaccination is unsound and prejudiced. The repeated conclusion that staff vaccination has preventive value for elderly patients in nursing homes appears to be the result of major methodological errors and wishful thinking. Even when there appears to be less morbidity and mortality in the intervention hospitals this probably resulted from other factors.
And then there are the risks of the flu vaccine
These can be considerable and as Peter Doshi says ‘should not be taken lightly.’
In his study Influenza vaccines: time for a rethink, he explains that the risks of the flu are highly exaggerated.
The evidence that influenza represents a threat of public health proportions is questionable, the evidence that influenza vaccines reduce important patient-centred outcomes such as mortality is unreliable…
The author makes the following points:
Influenza vaccines provide no benefit to most recipients since the majority of people do not annually contract the disease.
The “flu” (also known as influenza-like illness) has hundreds of causes. It should not be confused with influenza, which is just one of those causes.
Influenza vaccines can cause serious adverse effects and there is no reliable evidence that they can prevent dangerous complications of the disease.
Does the vaccine prevent flu?
As to the effectiveness of the influenza vaccine: Findings from important Cochrane reviews on the effectiveness of the influenza vaccination aren’t consistent with the advice we have been given.
What the Cochrane reviews found
The first Cochrane review looked at the effects of the influenza vaccine in healthy adults from 25 studies conducted over single influenza seasons in North America, South America, and Europe between 1969 and 2009. It found the vaccine reduced the chance of getting laboratory confirmed influenza from 23 cases out of 1,000 to 9 cases out of 1,000.
While this seems to be a reduction of more than 50%, that seems less optimistic expressed in absolute terms.
The infection rate in adults drops from 2% per year to 1%. You could say that’s halved, but it effectively only drops by 1%. So this means that out of every 100 healthy adults vaccinated, 99 get no benefit against laboratory confirmed influenza.
Adverse effects of the influenza vaccine
Serious reactions to the flu vaccine include, but are not limited to:
Life-threatening allergies to various ingredients
Guillain-Barre Syndrome (a severe paralytic disease that is fatal in about one in 20 cases)
Encephalitis (brain inflammation)
Thrombocytopenia (a serious blood disorder)
Why is the public is so afraid of the flu?
Over recent months we’ve been inundated with media stories about the ‘horror flu season’. This happens every year. Researchers use the term flunami.
The New Daily suggests
The fear of a uniquely severe and dangerous flu season leads more people to go to their GP or emergency department for an assessment if they’re experiencing flu-like symptoms. In turn, it may also lead more doctors to test for influenza, resulting in increased influenza counts.
Young nurse Jessica will not make her decision lightly especially if she becomes aware of the recent death of a 43-year-old hospital worker who died from a strain of the flu despite being vaccinated.
James Day was a healthy Traralgon based hospital worker and a father. He had received his recommended flu shot and yet spent one week in hospital battling influenza before he died.
Pharma and big profits
Flu vaccines are very profitable and aren’t very effective but they make pharmaceutical companies $3 billion a year.
As to getting a flu vaccine every year which is what is to be mandated for Victorian health workers this is a bad idea with a growing body of evidence indicating that more may not always be better.
Some research is now suggesting that getting flu shots repeatedly can gradually reduce the effectiveness of the vaccines under some circumstances.
Ohmit SE, Petrie JG, et el, found that adults who were vaccinated 2 years in a row were just as likely to get the flu as others who were not given the vaccine either year. Such research would therefore suggest that annual and mandatory flu vaccines for hospital workers are of no benefit and potentially harmful.
Dr. Edward Belongia and colleagues at Wisconsin’s Marshfield Clinic Research Foundation found that children who received an annual flu vaccine were more likely to contract the flu than kids who did not receive an annual flu shot. We should listen to this advice as Australia children are now being targeted for annual flu vaccines. We ignore this at our peril.
Final word regarding vaccine mandates
Health departments and hospital managers should concentrate on staff hand washing and drying, along with caring for their workers and patients rather than instigating vaccine mandates.
Let’s hope the targeted hospital workers do some research before they submit to the annual flu jab.