Mandated Flu Shots for Health Workers on Shaky Ground, Journal Article States

TUCSON, Ariz., Dec. 12, 2012 /PRNewswire-USNewswire/ -- Health workers nationwide are facing an ultimatum to either receive an influenza vaccination, or be fired. TriHealth, for example, one of Cincinnati's largest employers, recently threatened to fire 150 workers if they did not get the vaccine, or a religious or medical exemption, by Dec 3.

The presumption is that the vaccine is safe and effective, and that health workers have a duty to protect their patients from a potentially lethal disease. But according to an article in the winter issue of the Journal of American Physicians and Surgeons, evidence of efficacy is weak, and safety data are limited. In particular, there is no evidence showing that vaccinated workers are less likely to transmit virus.

In the past, more than half of health workers have declined to get an annual flu vaccine. "It is demeaning to assume that they are all uninformed or irresponsible," writes Jane M. Orient, M.D. An on-line, in-house survey by the Association of American Physicians and Surgeons (AAPS) showed that of about 700 respondents, nearly 80% think that influenza vaccination should be a matter of personal choice. More than 150 physicians expressed willingness to risk their medical staff privileges to avoid the vaccine. Colorado workers have formed an activist group, Colorado Health Care Workers against Forced Vaccination.

An extensive literature review by the Cochrane Collaboration found a "modest" effect of vaccine on influenza symptoms or workdays lost. If the vaccine happens to match the virus in circulation, 4% of unvaccinated people get influenza symptoms compared to 1% of vaccinated people. If the vaccine is not well-matched, the figures are 2% versus 1%.

Besides Guillain-Barre syndrome, there are other safety risks. Some vaccine products have been withdrawn, as when Bell's palsy or narcolepsy was observed in many recipients, the article points out. Some risks come from the contamination of animal-derived culture material, including chick embryos and bovine serum. Vegans are exempt from the influenza vaccine mandate.

As cited in the Journal article, Cochrane authors state that there is "evidence of widespread manipulation of conclusions" in vaccine studies, and that authors for the Centers for Disease Control and Prevention (CDC) "clearly do not weight interpretation by quality of the evidence, but quote anything that supports their theory."

"With such weak evidence, why the pressure to push this vaccine?" asks Orient. "Hospitals are apparently feeling pressure from the government. In 2014, Medicare will add influenza vaccine coverage to quality reporting measures, and will withhold 2% of payments for failure to report."

Conflicts of interest are rampant, she notes, as representatives on relevant advisory committees receive substantial compensation or grants from vaccine manufacturers. Unlike with other pharmaceuticals, manufacturers are immunized from liability for adverse reactions from mandated vaccines.

The influenza vaccine mandate is "authority-based," the article concludes. It "trumps individual autonomy, the Hippocratic ethic, and also evidence-based medicine."

The Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties founded in 1943, publishes the Journal of American Physicians and Surgeons.